Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, China.
Int J Geriatr Psychiatry. 2020 Jul;35(7):712-718. doi: 10.1002/gps.5288. Epub 2020 Mar 4.
This study aimed to demonstrate the association between adverse life events (ALEs) and the risk of late-life cognitive decline in older community-dwelling individuals in China.
We prospectively followed up 1657 dementia-free participants with ALE data at baseline in the Shanghai Aging Study. The cohort was categorized into four subgroups (depression with ALEs, depression without ALEs, no depression with ALEs, and no depression without ALEs). Cox regressions were conducted to estimate the hazard ratio (HR) for incident dementia stratified by all participants and depressed and nondepressed participants.
We identified 168 incident dementia cases over a mean period of 5.2 years. The cumulative dementia incidence in nondepressed participants with ALEs was the lowest among the four subgroups. Nondepressed participants with ALEs had a lower risk of incident dementia (HR [95% CI]: 0.50 [0.27-0.92], P = .0267) than those without ALEs, adjusted for age, sex, education, apolipoprotein E ε4 (APOE ε4), body mass index, cigarette smoking, heart disease, hypertension, diabetes, stroke, Mini-Mental State Examination (MMSE) at baseline, and anxiety.
This study explored a significant inverse association between ALEs and the risk of incident cognitive decline among older adults without depression in China. Interventions for depression prevention immediately after ALEs may reduce the risk of cognitive decline later in life.
本研究旨在证明在中国，生活中的不良事件（ALEs）与老年人认知能力下降的风险之间存在关联。
我们前瞻性地随访了上海老龄化研究中基线时有 ALE 数据的 1657 名无痴呆参与者。该队列分为四个亚组（有 ALE 的抑郁、无 ALE 的抑郁、有 ALE 的无抑郁和无 ALE 的无抑郁）。使用 Cox 回归估计所有参与者和抑郁及非抑郁参与者中发生痴呆的风险比（HR）。
我们在平均 5.2 年的时间内发现了 168 例新发痴呆病例。在四个亚组中，无抑郁且有 ALE 的参与者的累积痴呆发生率最低。与无 ALE 的参与者相比，有 ALE 且无抑郁的参与者发生痴呆的风险较低（HR[95%CI]：0.50[0.27-0.92]，P=0.0267），调整了年龄、性别、教育程度、载脂蛋白 E ε4（APOE ε4）、体重指数、吸烟、心脏病、高血压、糖尿病、中风、基线时的简易精神状态检查（MMSE）和焦虑情况。
本研究在中国无抑郁的老年人中探讨了 ALEs 与认知能力下降风险之间的显著负相关关系。在 ALEs 后立即进行抑郁预防干预可能会降低以后发生认知能力下降的风险。
