Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Alzheimers Dement. 2020 Mar;16(3):524-530. doi: 10.1002/alz.12049. Epub 2020 Feb 11.
Clinical Alzheimer's disease (AD) and dementia with Lewy bodies often have mixed AD and Lewy pathology, making it difficult to delineate risk factors.
Six risk factors for earlier dementia onset due to autopsy-confirmed AD (n = 647), mixed AD and Lewy body disease (AD + LBD; n = 221), and LBD (n = 63) were entered into multiple linear regressions using data from the National Alzheimer's Coordinating Center.
In AD and AD + LBD, male sex and apolipoprotein E (APOE) ɛ4 alleles each predicted a 2- to 3-year-earlier onset and depression predicted a 3-year-earlier onset. In LBD, higher education predicted earlier onset and depression predicted a 5.5-year-earlier onset.
Male sex and APOE ɛ4 alleles increase risk for earlier dementia onset in AD but not LBD. Depression increases risk for earlier dementia onset in AD, LBD, and AD + LBD, but evaluating the course, treatment, and severity is needed in future studies.
临床阿尔茨海默病(AD)和路易体痴呆症常伴有 AD 和路易体混合病理学,这使得确定风险因素变得困难。
使用国家阿尔茨海默病协调中心的数据,将 6 个与尸检证实的 AD(n=647)、AD 和路易体病混合(AD+LBD;n=221)和 LBD(n=63)发病时间提前相关的风险因素输入到多线性回归中。
在 AD 和 AD+LBD 中,男性和载脂蛋白 E(APOE)ɛ4 等位基因各预测发病时间提前 2-3 年,而抑郁则预测发病时间提前 3 年。在 LBD 中,较高的教育程度预测发病时间更早,而抑郁则预测发病时间提前 5.5 年。
男性和 APOEɛ4 等位基因增加了 AD 患者痴呆发病时间提前的风险,但对 LBD 无影响。抑郁增加了 AD、LBD 和 AD+LBD 患者痴呆发病时间提前的风险,但未来的研究需要评估其病程、治疗和严重程度。