Institute for Molecular Medicine Finland, FIMM, Helsinki Institute of Life Sciences, HiLIFE, University of Helsinki, Helsinki, Finland
HUS Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
J Neurol Neurosurg Psychiatry. 2021 Mar;92(3):323-330. doi: 10.1136/jnnp-2020-324009. Epub 2020 Nov 5.
Middle-age risk scores predict cognitive impairment, but it is not known if these associations are evident when controlling for shared genetic and environmental factors. Using two risk scores, self-report educational-occupational score and Cardiovascular Risk Factors, Aging and Dementia (CAIDE), we investigated if twins with higher middle-age dementia risk have poorer old-age cognition compared with their co-twins with lower risk.
We used a population-based older Finnish Twin Cohort study with middle-age questionnaire data (n=15 169, mean age=52.0 years, SD=11.8) and old-age cognition measured via telephone interview (mean age=74.1, SD=4.1, n=4302). Between-family and within-family linear regression analyses were performed.
In between-family analyses (N=2359), higher educational-occupational score was related to better cognition (B=0.76, 95% CI 0.69 to 0.83) and higher CAIDE score was associated with poorer cognition (B=-0.73, 95% CI -0.82 to -0.65). Within twin-pair differences in educational-occupational score were significantly related to within twin-pair differences in cognition in dizygotic (DZ) pairs (B=0.78, 95% CI 0.25 to 1.31; N=338) but not in monozygotic (MZ) pairs (B=0.12, 95% CI -0.44 to 0.68; N=221). Within twin-pair differences in CAIDE score were not related to within twin-pair differences in cognition: DZ B=-0.38 (95% CI -0.90 to 0.14, N=343) and MZ B=-0.05 (95% CI -0.59 to 0.49; N=226).
Middle-age dementia risk scores predicted old-age cognition, but within twin-pair analyses gave little support for associations independent of shared environmental and genetic factors. Understanding genetic underpinnings of risk score-cognition associations is important for early detection of dementia and designing intervention trials.
中年风险评分可预测认知障碍，但尚不清楚在控制共同遗传和环境因素后，这些关联是否明显。我们使用两种风险评分，即自我报告的教育职业评分和心血管风险因素、衰老和痴呆症（CAIDE），研究了中年痴呆风险较高的双胞胎与风险较低的同卵双胞胎相比，其老年认知能力是否较差。
我们使用了一项基于人群的芬兰老年双胞胎队列研究，其中包括中年问卷调查数据（n=15169，平均年龄=52.0 岁，标准差=11.8）和通过电话访谈测量的老年认知能力（n=4302，平均年龄=74.1 岁，标准差=4.1）。进行了家系间和家系内线性回归分析。
在家系间分析（n=2359）中，较高的教育职业评分与更好的认知能力相关（B=0.76，95%置信区间 0.69 至 0.83），而较高的 CAIDE 评分与较差的认知能力相关（B=-0.73，95%置信区间-0.82 至-0.65）。在双生子对中，教育职业评分的双胞胎间差异与双生子对中认知能力的双胞胎间差异显著相关（B=0.78，95%置信区间 0.25 至 1.31；n=338），但在同卵双胞胎中无显著相关性（B=0.12，95%置信区间-0.44 至 0.68；n=221）。CAIDE 评分的双胞胎间差异与双胞胎间认知能力的差异无关：DZ 双胞胎 B=-0.38（95%置信区间-0.90 至 0.14，n=343），MZ 双胞胎 B=-0.05（95%置信区间-0.59 至 0.49；n=226）。
中年痴呆风险评分可预测老年认知能力，但双胞胎内分析几乎没有提供独立于共同环境和遗传因素的关联证据。了解风险评分与认知能力关联的遗传基础对于早期发现痴呆症和设计干预试验非常重要。
