Xiuhua Ding, M.D., Ph.D., Department of Public Health, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY 42101, USA, Email:
J Prev Alzheimers Dis. 2021;8(2):169-174. doi: 10.14283/jpad.2020.50.
The Medical Outcomes Study Questionnaire Short Form 36 health survey (SF-36) measures health-related quality of life (HRQoL) from the individual's point of view and is an indicator of overall health status.
To examine whether HRQoL shows differential changes over time prior to dementia onset and investigate whether HRQoL predicts incidence of dementia.
Prevention of Alzheimer's Disease (AD) by Vitamin E and Selenium (PREADViSE) trial, which recruited 7,547 non-demented men between 2002 and 2009. A subset of 2,746 PREADViSE participants who completed up to five SF-36 assessments at annual visits was included in the current analysis.
Secondary data analysis of PREADViSE data.
A subset of 2,746 PREADViSE participants who completed up to five SF-36 assessments at annual visits was included in the current analysis.
Two summary T scores were generated for analysis: physical component score (PCS) and mental component score (MCS), each with a mean of 50 (standard deviation of 10); higher scores are better. Linear mixed models (LMM) were applied to determine if mean component scores varied over time or by eventual dementia status. Cox proportional hazards regression was used to determine if the baseline component scores were associated with dementia incidence, adjusting for baseline age, race, APOE-4 carrier status, sleep apnea, and self-reported memory complaint at baseline.
The mean baseline MCS score for participants who later developed dementia (mean± SD: 53.9±9.5) was significantly lower than for those participants who did not develop dementia during the study (mean±SD: 56.4±6.5; p = 0.005). Mean PCS scores at baseline (dementia: 49.3±7.9 vs. non-dementia: 49.8±7.8) were not significantly different (p = 0.5) but LMM analysis showed a significant time effect. For MCS, the indicator for eventual dementia diagnosis was significantly associated with poorer scores after adjusting for baseline age, race, and memory complaint. Adjusted for other baseline risk factors, the Cox model showed that a 10-unit increase in MCS was associated with a 44% decrease in the hazard of a future dementia diagnosis (95% CI: 32%-55%).
The SF-36 MCS summary score may serve as a predictor for future dementia and could be prognostic in longitudinal dementia research.
医疗结局研究问卷简表 36 健康调查（SF-36）从个人角度衡量与健康相关的生活质量（HRQoL），是整体健康状况的指标。
探讨 HRQoL 在痴呆症发病前是否存在随时间的差异变化，并研究 HRQoL 是否预测痴呆症的发生。
预防阿尔茨海默病（AD）的维生素 E 和硒研究（PREADViSE）试验，该试验于 2002 年至 2009 年间招募了 7547 名非痴呆男性。本分析纳入了在年度就诊时完成了最多五次 SF-36 评估的 2746 名 PREADViSE 参与者的一个子集。
PREADViSE 数据的二次数据分析。
本分析纳入了在年度就诊时完成了最多五次 SF-36 评估的 2746 名 PREADViSE 参与者的一个子集。
为分析生成了两个综合 T 分数：生理成分评分（PCS）和心理成分评分（MCS），每个分数的平均值为 50（标准差为 10）；分数越高越好。线性混合模型（LMM）用于确定平均成分分数是否随时间或最终痴呆状态而变化。Cox 比例风险回归用于确定基线成分分数是否与痴呆症的发生相关，调整了基线年龄、种族、APOE-4 携带者状态、睡眠呼吸暂停和基线时的自我报告记忆问题。
后来发展为痴呆症的参与者的基线 MCS 平均得分（平均±SD：53.9±9.5）明显低于研究期间未发展为痴呆症的参与者（平均±SD：56.4±6.5；p=0.005）。基线时的平均 PCS 得分（痴呆症：49.3±7.9 vs. 非痴呆症：49.8±7.8）无显著差异（p=0.5），但 LMM 分析显示出显著的时间效应。对于 MCS，对于最终痴呆症诊断的指标在调整了基线年龄、种族和记忆问题后，与较差的评分显著相关。调整其他基线风险因素后，Cox 模型显示 MCS 增加 10 个单位与未来痴呆症诊断的风险降低 44%相关（95%CI：32%-55%）。
SF-36 MCS 综合评分可作为未来痴呆症的预测指标，并可在纵向痴呆症研究中进行预后。
