老年人中风后 10 年随访期间的痴呆和死亡：竞争风险模型的结果。
Dementia and Death After Stroke in Older Adults During a 10-year Follow-up: Results from a Competing Risk Model.
机构信息
Yunhwan Lee, MD, DrPH, Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 World cup-ro, Youngtong-gu, Suwon 16499, Korea, Tel: +82-31-219-5085; Fax: +82-31-219-5084; E-mail:
出版信息
J Nutr Health Aging. 2018;22(2):297-301. doi: 10.1007/s12603-017-0914-3.
OBJECTIVES
To investigate the association between stroke and incident dementia in the presence of a competing risk of death.
METHODS
This study used the National Health Insurance Service-Senior (NHIS-Senior) claim database from 2002 to 2013 (n = 22,792). Stroke (I69.0-I69.9) and dementia (F01-F03, G30, G31.1) patients were defined by the International Classification of Disease 10th revision. The association of stroke with dementia or death was assessed with Cox proportional hazards model and competing-risk model.
RESULTS
During the 10-year follow-up period, there were 1,307 dementia events (5.7%) and 9,272 deaths (40.7%). In the Cox model, the adjusted hazard ratio (HR) for dementia was 2.37 times higher in those who experienced strokes, compared with the non-stroke group (95% CI: 2.23, 2.51). In the presence of death as competing event, stroke was associated with an elevated dementia incidence (HR = 2.06, 95% CI: 1.92, 2.20).
CONCLUSION
Stroke was significantly associated with an increased risk of incident dementia, with the magnitude of the association being attenuated in the competing risk model.
目的
探讨在存在死亡竞争风险的情况下，卒中与新发痴呆之间的关联。
方法
本研究使用了 2002 年至 2013 年的国家健康保险服务-老年人（NHIS-老年人）理赔数据库（n=22792）。卒中（I69.0-I69.9）和痴呆（F01-F03、G30、G31.1）患者的定义采用国际疾病分类第 10 版。采用 Cox 比例风险模型和竞争风险模型评估卒中与痴呆或死亡的关联。
结果
在 10 年的随访期间，共发生了 1307 例痴呆事件（5.7%）和 9272 例死亡事件（40.7%）。在 Cox 模型中，与非卒中组相比，经历过卒中的患者发生痴呆的调整后危险比（HR）为 2.37 倍（95%CI：2.23，2.51）。在考虑死亡作为竞争事件的情况下，卒中与痴呆发病率的升高相关（HR=2.06，95%CI：1.92，2.20）。
结论
卒中与新发痴呆的风险增加显著相关，而在竞争风险模型中，这种关联的程度减弱。
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