Department of Nursing, College of Medicine, Chosun University, Gwangju 61452, Korea.
Department of Psychiatry, Seoul National University Hospital and Seoul Metropolitan Center for Dementia (SMCD), Seoul 03080, Korea.
Int J Environ Res Public Health. 2019 Jul 23;16(14):2616. doi: 10.3390/ijerph16142616.
Due to an aging population, dementia incidence has rapidly increased in South Korea, heaping psychological and economic burdens upon families and the society. This study was aimed at investigating the associations of health insurance type and cardiovascular risk factors with the risk of dementia. The study was performed using data from 15,043 participants aged 60 years and above, enrolled in the Seoul Dementia Management Project in 2008 and followed up until 2012. Factors such as demographic data, health insurance type, lifestyle factors, and cardiovascular risk factors were subjected to Cox proportional hazard regression analysis to identify their associations with dementia incidence. During the follow-up, 495 participants (3.3%) developed dementia. Medical Aid beneficiaries were associated with an increase in the risk of dementia (hazard ratio [HR] 1.77, 95% confidence interval [CI] 1.421-2.215). Upon analyzing a composite cardiovascular risk score derived from all five cardiovascular risk factors, the risk for dementia incidence in participants increased from 1.56 for the presence of three risk factors to 2.55 for that of four risk factors (HR 2.55, 95% CI 1.174-5.546), compared with those who had no risk factors. The Medical Aid beneficiaries of health insurance type and the presence of multiple cardiovascular risk factors were found to be associated with a higher risk of dementia incidence.
由于人口老龄化，痴呆症在韩国的发病率迅速上升，给家庭和社会带来了心理和经济负担。本研究旨在调查医疗保险类型和心血管危险因素与痴呆风险的关系。该研究使用了 2008 年参加首尔痴呆症管理项目并随访至 2012 年的 15043 名 60 岁及以上参与者的数据。对人口统计学数据、医疗保险类型、生活方式因素和心血管危险因素等因素进行 Cox 比例风险回归分析，以确定它们与痴呆发病率的关系。在随访期间，有 495 名参与者（3.3%）发生了痴呆。医疗补助受益人与痴呆风险增加相关（风险比 [HR] 1.77，95%置信区间 [CI] 1.421-2.215）。在分析由所有五个心血管危险因素得出的复合心血管风险评分时，与没有危险因素的参与者相比，存在三个危险因素的参与者的痴呆发病率风险从 1.56 增加到存在四个危险因素的风险为 2.55（HR 2.55，95% CI 1.174-5.546）。医疗保险类型为医疗补助受益人和存在多种心血管危险因素与痴呆发病率风险增加相关。
