Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, UT, United States of America.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America.
Exp Gerontol. 2020 Sep;138:110986. doi: 10.1016/j.exger.2020.110986. Epub 2020 Jun 1.
BACKGROUND/OBJECTIVE: Inflammation is implicated in cognitive decline; however, there is a paucity of data for African American populations and for sex-specific associations.
Prospective cohort study.
Genetic Epidemiology Network of Arteriopathy/Genetics of Microangiopathic Brain Injury studies.
African-American sibships (N = 1010).
Neurocognitive tests assessed global cognition and four cognitive domains: processing speed, memory, language, and executive function at two time points over seven years. Circulating levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor receptor (TNFR)-1 and TNFR2 were measured at study baseline. Linear mixed models were used to investigate the association between inflammation markers and cognitive decline.
Among men, a one SD increase in CRP was associated with an increased rate of decline over 7 years in global cognitive Z-score (adjusted difference in slopes = -0.31, p = 0.006) and in processing speed Z-score (adjusted difference in slopes = -0.10, p = 0.02), but not declines in memory, language, or executive function Z-scores. Also among men, a one SD increase in IL-6 was associated with an increased decline rate in global cognitive Z-score (adjusted difference in slopes = -0.33, p = 0.002) and in processing speed Z-score (adjusted difference in slopes = -0.12, p = 0.007). There was no difference in decline rates by CRP or IL-6 level in adjusted analyses among women for any cognitive scores. Among men and women combined, a one SD increase in baseline sTNFR1 was associated with a faster rate of decline in memory Z-score (adjusted difference in slopes = -0.09, p = 0.02). Baseline sTNFR2 levels did not significantly predict rate of cognitive decline in any cognitive domains.
Circulating markers of CRP and IL-6 may be differential risk factors for men and women in relation to cognitive decline. A novel inflammation marker, sTNFR1, may be a useful predictor of memory decline in older adults.
背景/目的：炎症与认知能力下降有关；然而，针对非裔美国人人群和特定性别相关性的数据仍然很少。
前瞻性队列研究。
动脉粥样硬化遗传流行病学网络/微血管脑损伤的遗传学研究。
非裔美国人同胞（N=1010）。
神经认知测试在七年的两个时间点评估了整体认知和四个认知领域：加工速度、记忆、语言和执行功能。在研究基线时测量了 C 反应蛋白（CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子受体（TNFR）-1 和 TNFR2 的循环水平。线性混合模型用于研究炎症标志物与认知能力下降之间的关系。
在男性中，CRP 增加一个标准差与全球认知 Z 分数在 7 年内的下降速度加快有关（调整后的斜率差异= -0.31，p=0.006），与加工速度 Z 分数的下降速度加快有关（调整后的斜率差异= -0.10，p=0.02），但与记忆、语言或执行功能 Z 分数的下降无关。同样在男性中，IL-6 增加一个标准差与全球认知 Z 分数的下降速度加快有关（调整后的斜率差异= -0.33，p=0.002），与加工速度 Z 分数的下降速度加快有关（调整后的斜率差异= -0.12，p=0.007）。在调整后的分析中，CRP 或 IL-6 水平对女性任何认知评分的下降率都没有差异。在男性和女性的综合分析中，基线 sTNFR1 增加一个标准差与记忆 Z 分数的下降速度加快有关（调整后的斜率差异= -0.09，p=0.02）。基线 sTNFR2 水平与任何认知领域的认知下降速度无显著相关性。
循环 CRP 和 IL-6 标志物可能是男性和女性认知能力下降的不同危险因素。一种新的炎症标志物 sTNFR1 可能是老年人大脑记忆衰退的有用预测指标。
