Division of Aging, Brigham and Women's Hospital, Boston, MA, USA.
Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Alzheimers Dement. 2017 Dec;13(12):1364-1370. doi: 10.1016/j.jalz.2017.04.012. Epub 2017 Jul 12.
To examine the risk of Alzheimer's disease (AD) among cancer survivors in a national database.
Retrospective cohort of 3,499,378 mostly male US veterans aged ≥65 years were followed between 1996 and 2011. We used Cox models to estimate risk of AD and alternative outcomes (non-AD dementia, osteoarthritis, stroke, and macular degeneration) in veterans with and without a history of cancer.
Survivors of a wide variety of cancers had modestly lower AD risk, but increased risk of the alternative outcomes. Survivors of screened cancers, including prostate cancer, had a slightly increased AD risk. Cancer treatment was independently associated with decreased AD risk; those who received chemotherapy had a lower risk than those who did not.
Survivors of some cancers have a lower risk of AD but not other age-related conditions, arguing that lower AD diagnosis is not simply due to bias. Cancer treatment may be associated with decreased risk of AD.
在国家数据库中研究癌症幸存者患阿尔茨海默病(AD)的风险。
对 1996 年至 2011 年间年龄在 65 岁及以上的 3499378 名主要为男性的美国退伍军人进行回顾性队列研究。我们使用 Cox 模型来估计有和没有癌症病史的退伍军人患 AD 和其他疾病(非 AD 痴呆、骨关节炎、中风和黄斑变性)的风险。
患有多种癌症的幸存者 AD 风险略低,但其他疾病的风险增加。包括前列腺癌在内的筛查癌症的幸存者 AD 风险略有增加。癌症治疗与 AD 风险降低独立相关;接受化疗的人比未接受化疗的人风险更低。
某些癌症的幸存者 AD 风险较低,但其他与年龄相关的疾病风险较高,这表明 AD 诊断较低并非仅仅是由于偏差所致。癌症治疗可能与 AD 风险降低有关。