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脉波速度与痴呆之间无独立关联性:一项基于人群的前瞻性研究。

No independent association between pulse wave velocity and dementia: a population-based, prospective study.

机构信息

aClinical Memory Research Unit, Department of Clinical Sciences Malmö bDivision of Geriatric Medicine, Department of Health Sciences, Lund University cSkåne University Hospital dDepartment of Clinical Sciences, Lund University eMemory Clinic, Skåne University Hospital, Malmö, Sweden.

出版信息

J Hypertens. 2017 Dec;35(12):2462-2467. doi: 10.1097/HJH.0000000000001480.

Abstract

OBJECTIVE

Carotid-femoral pulse wave velocity (CFPWV), a marker of aortic stiffness, has been associated with cognitive test results and markers of cerebral small vessel disease, but its association with dementia has not been studied in detail. Our aim was to assess the association of CFPWV with prevalent and incident dementia in a large population-based study.

METHODS

In total, CFPWV was measured in 3056 participants of the Malmö Diet and Cancer study 2007-2012 (age range 61-85 years). Individuals scoring below preset cut-offs on cognitive screening tests were thoroughly evaluated for prevalent dementia. Also, dementia diagnoses were retrieved from the Swedish National Patient Register up until 31 December 2014, and then validated through medical records and neuroimaging findings.

RESULTS

We identified 159 cases of dementia, of which 57 were classified as prevalent, and 102 as incident during a median follow-up of 4.6 years. In fully adjusted logistic regressions, CFPWV was not associated with prevalent all-cause dementia (odds ratio 0.95 per 1 m/s increase in CFPWV, 95% confidence interval 0.83-1.08), and it did not predict incident all-cause dementia (odds ratio 1.00, 95% confidence interval 0.91-1.09). Neither was CFPWV associated with subtypes of dementia (Alzheimer's disease, vascular dementia, mixed dementia), although the number of cases in subgroups were low.

CONCLUSION

No independent association was found between CFPWV and dementia. It remains a matter of debate why CFPWV repeatedly has been associated with cognitive test results and markers of cerebral small vessel disease, but not with dementia.

摘要

目的

颈动脉-股动脉脉搏波速度(CFPWV)是主动脉僵硬度的标志物,与认知测试结果和脑小血管疾病标志物相关,但与痴呆的关系尚未详细研究。我们的目的是在一项大型基于人群的研究中评估 CFPWV 与现患和新发痴呆的相关性。

方法

在 2007-2012 年的马尔默饮食与癌症研究中,共对 3056 名参与者测量了 CFPWV(年龄范围 61-85 岁)。在认知筛查测试中得分低于预设截止值的个体将接受全面评估以确定现患痴呆。此外,截至 2014 年 12 月 31 日,从瑞典国家患者登记处检索到痴呆诊断,然后通过医疗记录和神经影像学检查进行验证。

结果

我们确定了 159 例痴呆病例,其中 57 例为现患,102 例为发病,中位随访时间为 4.6 年。在完全调整的逻辑回归中,CFPW 与现患全因痴呆无关(每增加 1 m/s,CFPW 的比值比为 0.95,95%置信区间为 0.83-1.08),也不能预测全因新发痴呆(比值比为 1.00,95%置信区间为 0.91-1.09)。CFPW 也与痴呆的亚型(阿尔茨海默病、血管性痴呆、混合性痴呆)无关,尽管亚组的病例数较少。

结论

CFPW 与痴呆之间没有独立的相关性。CFPW 为何与认知测试结果和脑小血管疾病标志物相关,但与痴呆无关,这仍然是一个争论的问题。

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