University of Kansas Alzheimer's Disease Center, Fairway, KS, USA.
Center for Clinical and Translational Sciences (CCTS), Biostatistics, Epidemiology, and Research Design (BERD) Core, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Int J Geriatr Psychiatry. 2019 Jul;34(7):1041-1049. doi: 10.1002/gps.5107. Epub 2019 Apr 23.
Growing evidence shows that cardiovascular health (CVH) is associated with brain health. Little is known about this topic among older adults in Latin America, where the number of people living with dementia is rising. This study aimed to assess the longitudinal association between CVH and dementia in six Latin American countries.
We analyzed longitudinal data from the 10/66 study that included nondementia residents at baseline aged 65+ in six Latin American countries (n = 6447) and were followed up for 3 years. An index of modifiable CVH factors (ranging from 0 to 14) was calculated. Incident dementia was modeled using competing risk regression to adjust for risk of death.
The sample included 6.2% participants with poor (0-5), 81.0% with moderate (6-10), and 12.8% with ideal CVH (11-14). At follow-up, 9.4% had developed dementia and 13.1% had died. Compared with those with poor CVH, participants with moderate and ideal levels of CVH had a significantly lower risk of dementia in both the unadjusted (subhazard ratio for moderate, 0.77; ideal, 0.59) and adjusted models (moderate, 0.73; ideal, 0.66).
Moderate and ideal levels of CVH in old age may protect against dementia incidence. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries.
越来越多的证据表明,心血管健康(CVH)与大脑健康有关。在拉丁美洲,痴呆症患者的数量正在上升,而老年人对这一主题的了解甚少。本研究旨在评估 6 个拉丁美洲国家的 CVH 与痴呆症之间的纵向关联。
我们分析了来自 10/66 研究的纵向数据,该研究包括 6 个拉丁美洲国家的基线时年龄在 65 岁及以上且无痴呆症的居民(n=6447),并随访了 3 年。计算了可改变的 CVH 因素指数(范围为 0 到 14)。使用竞争风险回归模型对痴呆症的发病进行建模,以调整死亡风险。
样本中包括 6.2%的 CVH 较差(0-5)、81.0%的 CVH 中等(6-10)和 12.8%的 CVH 理想(11-14)。随访期间,9.4%的人出现痴呆症,13.1%的人死亡。与 CVH 较差的参与者相比,CVH 中等和理想水平的参与者在未调整模型(中等水平的亚危险比为 0.77;理想水平为 0.59)和调整模型(中等水平为 0.73;理想水平为 0.66)中,痴呆症的发病风险显著降低。
老年时中等和理想的 CVH 水平可能有助于预防痴呆症的发生。这些发现可能为最近在一些拉丁美洲国家通过的痴呆症国家计划中的健康促进工作提供信息。