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贫血与痴呆症的关联:台湾一项全国性基于人群的队列研究。

Association Between Anemia and Dementia: A Nationwide, Populationbased Cohort Study in Taiwan.

机构信息

Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.

Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

Curr Alzheimer Res. 2020;17(2):196-204. doi: 10.2174/1567205017666200317101516.

Abstract

BACKGROUND

In addition to the traditional risk predictors, whether anemia is an early biomarker of dementia, needs to be confirmed.

OBJECTIVE

This population-based cohort study aimed to investigate the dementia risk in patients with newly diagnosed anemia using data from the Taiwan National Health Insurance Research Database.

METHODS

All newly diagnosed anemia patients (n = 26,343) with no history of stroke hospitalization, central nervous disease other than dementia, psychiatric disorders, traumatic brain injury, major operations, or blood loss diseases, were enrolled. A group of non-anemic controls, 1:4 matched with anemic patients on the basis of demographics and comorbidities, was also included. A competing risk analysis was used to evaluate the dementia risk in anemic patients compared to that of their matched controls.

RESULTS

The adjusted subdistribution hazard ratio (SHR) of dementia risk in anemic patients was 1.14 (95% confidence interval [CI]: 1.081.21, p<0.001). Patients with iron supplements tended to exhibit a lower dementia risk (adjusted SHR: 0.84; 95% CI: 0.750.94, p=0.002) compared to patients without iron supplement. A subgroup analysis showed that a positive association between dementia and anemia existed in females, those aged 70 years and older, and patients without hypertension, diabetes, or hyperlipidemia.

CONCLUSION

The present population-based cohort study identified that newly diagnosed anemia is a risk factor for dementia and also that iron supplementation was able to reduce the risk of dementia in people with iron deficiency anemia.

摘要

背景

除了传统的风险预测因素外,贫血是否是痴呆的早期生物标志物仍需证实。

目的

本基于人群的队列研究旨在利用台湾全民健康保险研究数据库的数据,探讨新诊断贫血患者发生痴呆的风险。

方法

纳入所有无卒中住院史、非痴呆中枢神经系统疾病、精神疾病、创伤性脑损伤、大手术或血液流失性疾病史的新诊断贫血患者(n=26343)。同时,按照年龄、性别、合并症等匹配了一组无贫血对照者,每组人数为贫血患者的 1:4。采用竞争风险分析评估贫血患者与匹配对照者相比发生痴呆的风险。

结果

校正后的亚分布风险比(SHR)显示,贫血患者发生痴呆的风险为 1.14(95%置信区间[CI]:1.081.21,p<0.001)。与未补充铁剂的患者相比,补充铁剂的患者痴呆风险较低(校正 SHR:0.84;95%CI:0.750.94,p=0.002)。亚组分析显示,贫血与痴呆之间存在正相关,在女性、年龄≥70 岁以及无高血压、糖尿病或高血脂的患者中更为明显。

结论

本基于人群的队列研究表明,新诊断的贫血是痴呆的一个危险因素,铁补充剂能够降低缺铁性贫血患者发生痴呆的风险。

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