百岁认知健康研究:原理、设计和队列描述。
The 100-plus Study of cognitively healthy centenarians: rationale, design and cohort description.
机构信息
Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, de Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.
Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, de Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.
出版信息
Eur J Epidemiol. 2018 Dec;33(12):1229-1249. doi: 10.1007/s10654-018-0451-3. Epub 2018 Oct 25.
Although the incidence of dementia increases exponentially with age, some individuals reach more than 100 years with fully retained cognitive abilities. To identify the characteristics associated with the escape or delay of cognitive decline, we initiated the 100-plus Study ( www.100plus.nl ). The 100-plus Study is an on-going prospective cohort study of Dutch centenarians who self-reported to be cognitively healthy, their first-degree family members and their respective partners. We collect demographics, life history, medical history, genealogy, neuropsychological data and blood samples. Centenarians are followed annually until death. PET-MRI scans and feces donation are optional. Almost 30% of the centenarians agreed to post-mortem brain donation. To date (September 2018), 332 centenarians were included in the study. We analyzed demographic statistics of the first 300 centenarians (25% males) included in the cohort. Centenarians came from higher socio-economic classes and had higher levels of education compared to their birth cohort; alcohol consumption of centenarians was similar, and most males smoked during their lifetime. At baseline, the centenarians had a median MMSE score of 25 points (IQR 22.0-27.5); most centenarians lived independently, retained hearing and vision abilities and were independently mobile. Mortality was associated with cognitive functioning: centenarians with a baseline MMSE score ≥ 26 points had a mortality percentage of 17% per annual year in the second year after baseline, while centenarians with a baseline MMSE score < 26 points had a mortality of 42% per annual year (p = 0.003). The cohort was 2.1-fold enriched with the neuroprotective APOE-ε2 allele relative to 60-80 year-old population controls (p = 4.8 × 10), APOE-ε3 was unchanged and the APOE-ε4 allele was 2.3-fold depleted (p = 6.3 × 10). Comprehensive characterization of the 100-plus cohort of cognitively healthy centenarians might reveal protective factors that explain the physiology of long-term preserved cognitive health.
尽管痴呆症的发病率随年龄呈指数级增长,但有些个体的认知能力完全保持在 100 岁以上。为了确定与认知能力下降的逃避或延迟相关的特征,我们启动了 100 岁以上研究(www.100plus.nl)。100 岁以上研究是一项正在进行的荷兰百岁老人前瞻性队列研究,这些百岁老人自我报告认知健康,他们的一级亲属及其各自的伴侣。我们收集人口统计学、生活史、病史、家谱、神经心理学数据和血液样本。百岁老人每年随访至死亡。PET-MRI 扫描和粪便捐赠是可选的。近 30%的百岁老人同意死后捐献大脑。截至 2018 年 9 月,已有 332 名百岁老人参与了这项研究。我们分析了队列中前 300 名百岁老人(25%为男性)的人口统计学数据。百岁老人来自较高的社会经济阶层,教育程度高于他们的出生队列;百岁老人的饮酒量相似,大多数男性在一生中都吸烟。在基线时,百岁老人的 MMSE 中位数为 25 分(IQR 22.0-27.5);大多数百岁老人独立生活,保持听力和视力能力,独立移动。死亡率与认知功能相关:在基线后第二年,MMSE 基线评分≥26 分的百岁老人每年的死亡率为 17%,而 MMSE 基线评分<26 分的百岁老人每年的死亡率为 42%(p=0.003)。与 60-80 岁人群对照组相比,队列中神经保护性 APOE-ε2 等位基因富集了 2.1 倍(p=4.8×10),APOE-ε3 不变,APOE-ε4 等位基因减少了 2.3 倍(p=6.3×10)。对认知健康百岁老人的 100 岁以上队列进行全面特征描述可能会揭示解释长期保持认知健康的保护因素。