头部或脑部损伤与阿尔茨海默病：巢式病例对照登记研究。
Head or brain injuries and Alzheimer's disease: A nested case-control register study.
机构信息
School of Pharmacy, University of Eastern Finland, Kuopio, Finland; School of Pharmacy, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland.
School of Pharmacy, University of Eastern Finland, Kuopio, Finland; School of Pharmacy, Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland; Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
出版信息
Alzheimers Dement. 2017 Dec;13(12):1371-1379. doi: 10.1016/j.jalz.2017.04.010. Epub 2017 Jun 7.
INTRODUCTION
Many previous studies have been limited by self- or proxy-reported injury or short follow-up. We investigated whether head or brain injuries are associated with Alzheimer's disease (AD), possible modifying factors and dose-response relationship.
METHODS
Nested register-based case-control study of all community dwellers who received clinically verified AD diagnosis in Finland in 2005 to 2011 (n = 70,719) and one to four matched controls for each case (n of controls = 282,862).
RESULTS
The magnitude of association between hospital-treated head and/or brain injuries was strongly dependent on the lag time between exposure and outcome. With a 5-year lag time, head injury (adjusted odds ratio; 95% confidence interval 1.19; 1.15-1.23) or brain injury (1.23; 1.18-1.29) was associated with higher risk of AD. Dose-response relationship with number and severity of injuries was observed. Associations were stronger in those with earlier onset of AD.
CONCLUSIONS
Stronger associations with shorter lag times indicate that head and/or brain injuries may also reflect the ongoing AD disease process.
简介
许多先前的研究受到自我或代理报告的伤害或短期随访的限制。我们研究了头部或脑部受伤是否与阿尔茨海默病（AD）有关，以及可能的修饰因素和剂量反应关系。
方法
基于注册的病例对照研究，纳入了 2005 年至 2011 年间在芬兰居住的所有社区居民，他们均接受了临床证实的 AD 诊断（n=70719），并为每个病例匹配了 1 至 4 名对照者（n 对照者=282862）。
结果
暴露与结局之间的时间间隔对医院治疗的头部和/或脑部损伤之间的关联程度有很大影响。在 5 年的时间间隔内，头部损伤（调整后的优势比；95%置信区间 1.19；1.15-1.23）或脑部损伤（1.23；1.18-1.29）与 AD 的风险增加有关。观察到与受伤次数和严重程度的剂量反应关系。在 AD 发病较早的患者中，相关性更强。
结论
与较短的时间间隔的更强关联表明，头部和/或脑部损伤也可能反映 AD 疾病的持续过程。
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