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生物心理社会脆弱与痴呆症发病风险:意大利老龄化纵向研究。

Biopsychosocial frailty and the risk of incident dementia: The Italian longitudinal study on aging.

机构信息

"C. Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy.

National Centre on Addiction and Doping, Istituto Superiore di Sanità (ISS), Roma, Italy.

出版信息

Alzheimers Dement. 2019 Aug;15(8):1019-1028. doi: 10.1016/j.jalz.2019.04.013. Epub 2019 Jul 2.

Abstract

INTRODUCTION

Frailty is a critical intermediate status of the aging process including physical, cognitive, and psychosocial domains/phenotypes. We operationalized a new biopsychosocial frailty (BF) construct, estimating its impact on the risk of incident dementia and its subtypes.

METHODS

In 2171 older individuals from the population-based Italian Longitudinal Study on Aging (ILSA), we identified by latent class procedures the BF construct as the physical frail status plus at least one of the two items of the 30-item Geriatric Depression Scale impaired (items 3/10).

RESULTS

Over a 3.5-year follow-up, participants with BF showed an increased risk of overall dementia (hazard ratio [HR]: 2.16, 95% confidence interval [CI]:1.07-4.37), particularly vascular dementia (VaD) (HR: 3.21, 95% CI: 1.05-9.75). Similarly, over a 7-year follow-up, an increased risk of overall dementia (HR: 1.84, 95% CI: 1.06-3.20), particularly VaD (HR: 2.53, 95% CI: 1.08-5.91), was also observed.

DISCUSSION

In a large cohort of Italian older individuals without cognitive impairment at baseline, a BF model was a short- and long-term predictor of overall dementia, particularly VaD.

摘要

简介

衰弱是衰老过程中的一个关键中间状态,包括身体、认知和心理社会领域/表型。我们将一种新的生物心理社会衰弱(BF)结构进行了操作化,评估其对新发痴呆及其亚型风险的影响。

方法

在来自基于人群的意大利老龄化纵向研究(ILSA)的 2171 名老年人中,我们通过潜在类别程序确定 BF 结构为身体脆弱状态,加上 30 项老年抑郁量表中至少一项受损的两个项目之一(项目 3/10)。

结果

在 3.5 年的随访中,具有 BF 的参与者发生总体痴呆(风险比 [HR]:2.16,95%置信区间 [CI]:1.07-4.37),尤其是血管性痴呆(VaD)(HR:3.21,95% CI:1.05-9.75)的风险增加。同样,在 7 年的随访中,也观察到总体痴呆(HR:1.84,95% CI:1.06-3.20),尤其是 VaD(HR:2.53,95% CI:1.08-5.91)的风险增加。

讨论

在一个没有认知障碍的意大利老年人的大型队列中,BF 模型是短期和长期总体痴呆,尤其是 VaD 的预测因子。

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