种族差异导致阿尔茨海默病痴呆风险的复杂相互作用。
Complex interactions underlie racial disparity in the risk of developing Alzheimer's disease dementia.
机构信息
Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA.
Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA.
出版信息
Alzheimers Dement. 2020 Apr;16(4):589-597. doi: 10.1002/alz.12060. Epub 2020 Feb 17.
Abstract
INTRODUCTION
We aim to determine racial disparities and their modifying factors in risk for Alzheimer's disease (AD) dementia among cognitively normal individuals 65 years or older.
METHODS
Longitudinal data from the National Alzheimer's Coordinating Center Uniform Data Set on 1229 African Americans (AAs) and 6679 whites were analyzed for the risk of AD using competing risk models with death as a competing event.
RESULTS
Major AD risk factors modified racial differences which, when statistically significant, occurred only with older age among APOE ε4 negative individuals, but also with younger age among APOE ε4 positive individuals. The racial differences favored AAs among individuals with body mass index (BMI) < 30, but whites among individuals with a high BMI (≥ 30), and were additionally modified by sex, education, hypertension, and smoking status.
CONCLUSIONS
The presence, direction, and relative magnitude of racial disparity for AD represent an interactive function of major AD and cerebrovascular risk factors.
摘要
简介
我们旨在确定认知正常的 65 岁及以上个体中阿尔茨海默病（AD）痴呆的风险的种族差异及其调节因素。
方法
对来自国家阿尔茨海默病协调中心统一数据集中的 1229 名非裔美国人（AA）和 6679 名白人的纵向数据进行分析，使用竞争风险模型，以死亡为竞争事件来预测 AD 的风险。
结果
主要的 AD 风险因素修饰了种族差异，这些差异仅在 APOE ε4 阴性个体中随着年龄的增长而具有统计学意义，但在 APOE ε4 阳性个体中也与年龄的降低有关。在 BMI<30 的个体中，种族差异有利于 AA 人群，而在 BMI≥30 的个体中则有利于白人人群，种族差异还受到性别、教育、高血压和吸烟状况的修饰。
结论
AD 种族差异的存在、方向和相对程度代表了主要 AD 和脑血管风险因素的相互作用函数。
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