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在健康检查中,白蛋白尿的发生与老年人早期痴呆风险之间的关联:一项基于社区的队列研究在台湾。

Association between the occurrence of albuminuria and the risk of early dementia among older people upon health examination: a community-based cohort study in Taiwan.

机构信息

Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan.

Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

BMJ Open. 2020 Dec 8;10(12):e041664. doi: 10.1136/bmjopen-2020-041664.

Abstract

OBJECTIVES

This study aimed to investigate the associations between biochemical markers, renal function, health behaviours and dementia among older people.

DESIGN

A retrospective cohort study.

SETTING

Community-based health examination database from Taipei city.

PARTICIPANTS

In total, 35 434 older people were included from February 2005 to December 2012. To assess changes in renal function, we selected participants who attended health examinations at least twice and responded to the AD8 questionnaire in 2012. We excluded those with dementia at baseline.

PRIMARY OUTCOME MEASURES

Early dementia was assessed using the AD8 questionnaire in 2012. Explanatory variables included demographic factors, health behaviours, biochemical markers and renal function. We used a Cox proportional hazard model to estimate the HR for early dementia onset.

RESULTS

Individuals with mild albuminuria (HR 1.228; 95% CI 1.066 to 1.414), lower eGFR (HR 1.549; 95% CI 1.319 to 1.820) and higher age (HR 1.022; 95% CI 1.015 to 1.028) were associated with a high risk of early dementia. Older people with no alcohol intake (HR 0.872; 95% CI 0.794 to 0.958), and higher education levels (HR 0.647; 95% CI 0.589 to 0.710) were at a low risk of early dementia.

CONCLUSIONS

Elevated mild albuminuria and low eGFR were associated with a high risk of early dementia in this community-based cohort. Routine health examinations for older people can help screen out the high-risk population, and clinical management might reduce or delay the risk of early dementia.

摘要

目的

本研究旨在探讨老年人中生化标志物、肾功能、健康行为与痴呆之间的关联。

设计

回顾性队列研究。

设置

台北市社区健康检查数据库。

参与者

共纳入 35434 名老年人,纳入时间为 2005 年 2 月至 2012 年 12 月。为评估肾功能变化,我们选择了至少两次参加健康检查并在 2012 年回答 AD8 问卷的参与者。我们排除了基线时患有痴呆症的患者。

主要结局测量

2012 年使用 AD8 问卷评估早期痴呆。解释变量包括人口统计学因素、健康行为、生化标志物和肾功能。我们使用 Cox 比例风险模型估计早期痴呆发病的 HR。

结果

轻度白蛋白尿(HR 1.228;95%CI 1.066 至 1.414)、较低的 eGFR(HR 1.549;95%CI 1.319 至 1.820)和较高的年龄(HR 1.022;95%CI 1.015 至 1.028)与早期痴呆的高风险相关。不饮酒(HR 0.872;95%CI 0.794 至 0.958)和较高教育水平(HR 0.647;95%CI 0.589 至 0.710)的老年人患早期痴呆的风险较低。

结论

在本社区队列中,轻度白蛋白尿升高和 eGFR 降低与早期痴呆的高风险相关。对老年人进行常规健康检查有助于筛选出高危人群,临床管理可能会降低或延迟早期痴呆的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/011d/7725074/62d893af3d96/bmjopen-2020-041664f01.jpg

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