Chen Nemin, Caruso Christina, Alonso Alvaro, Derebail Vimal K, Kshirsagar Abhijit V, Sharrett A Richey, Key Nigel S, Gottesman Rebecca F, Grove Megan L, Bressler Jan, Boerwinkle Eric, Windham B Gwen, Mosley Thomas H, Hyacinth Hyacinth I
Department of Epidemiology, University of Pittsburg, Pittsburg, PA, United States of America.
Aflac Cancer and Blood Disorder Center of Children's Healthcare of Atlanta, Emory Department of Pediatrics, Atlanta, GA, United States of America.
eNeurologicalSci. 2019 Jul 22;16:100201. doi: 10.1016/j.ensci.2019.100201. eCollection 2019 Sep.
The incidence and prevalence of cognitive decline and dementia are significantly higher among African Americans compared with non-Hispanic Whites. The aim of this study was to determine whether inheritance of the sickle cell trait (SCT) i.e. heterozygosity for the sickle cell mutation increases the risk of cognitive decline or dementia Among African Americans.
We studied African American participants enrolled in the Atherosclerosis Risk in Communities study. SCT genotype at baseline and outcome data from cognitive assessments at visits 2, 4 and 5, and an MRI performed at visit 5 were analyzed for the association between SCT and risk of cognitive impairment and/or dementia.
There was no significant difference in risk factors profile between participants with SCT ( = 176) and those without SCT ( = 2532). SCT was not independently associated with a higher prevalence of global or domain-specific cognitive impairment at baseline or with more rapid cognitive decline. Participants with SCT had slightly lower incidence of dementia (HR = 0.63 [0.38, 1.05]). On the other hand, SCT seems to interact with the apolipoprotein E ε4 risk allele resulting in poor performance on digit symbol substitution test at baseline (z-score = -0.08, P = 0.05) and over time (z-score = -0.12, P = 0.04); and with diabetes mellitus leading to a moderately increased risk of dementia (HR = 2.06 [0.89, 4.78], P = 0.01).
SCT was not an independent risk factor for prevalence or incidence of cognitive decline or dementia, although it may interact with and modify other putative risk factors for cognitive decline and dementia.
与非西班牙裔白人相比，非裔美国人认知能力下降和痴呆症的发病率和患病率显著更高。本研究的目的是确定镰状细胞性状（SCT）的遗传，即镰状细胞突变的杂合性，是否会增加非裔美国人认知能力下降或患痴呆症的风险。
我们研究了参与社区动脉粥样硬化风险研究的非裔美国参与者。分析了基线时的SCT基因型以及第2、4和5次访视时认知评估的结果数据，以及第5次访视时进行的MRI，以确定SCT与认知障碍和/或痴呆症风险之间的关联。
患有SCT的参与者（n = 176）和未患有SCT的参与者（n = 2532）在风险因素方面没有显著差异。SCT与基线时整体或特定领域认知障碍的较高患病率或更快的认知能力下降没有独立关联。患有SCT的参与者痴呆症发病率略低（HR = 0.63 [0.38, 1.05]）。另一方面，SCT似乎与载脂蛋白Eε4风险等位基因相互作用，导致基线时数字符号替换测试表现不佳（z分数 = -0.08，P = 0.05），且随着时间推移表现更差（z分数 = -0.12，P = 0.04）；并且与糖尿病相互作用，导致痴呆症风险适度增加（HR = 2.06 [0.89, 4.78]，P = 0.01）。
SCT不是认知能力下降或痴呆症患病率或发病率的独立风险因素，尽管它可能与认知能力下降和痴呆症的其他假定风险因素相互作用并对其产生影响。
