Program in Public Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, NY, USA.
Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, NY, USA.
Am J Alzheimers Dis Other Demen. 2021 Jan-Dec;36:15333175211012235. doi: 10.1177/15333175211012235.
Few studies have jointly estimated incidence of MCI, conversion to probable dementia, and mortality in a nationally representatie sample.
We used data from six waves of the National Health and Aging Trends Study (2011-2016). Multivariable-adjusted multi-state survival models (MSMs) were used to model incidence upon accounting for misclassification.
A total of 6,078 eligible NHATS participants were included (average age: 77.49 ± 7.79 years; 58.42% females; 68.99% non-Hispanic white). The incidence of MCI was estimated to be 41.0 [35.5, 47.3]/1,000 person-years (PY). Participants converted to probable dementia at a high rate of 241.3 [189.6, 307.0]/1,000 PY, though a small number also reverted from MCI to cognitively normal. Education was associated with lower incidence of MCI and conversion to probable dementia, but increased mortality in those with MCI. There were also substantial racial and ethnic disparities in the incidence of MCI and dementia.
Our results underscore the relatively common incidence of and conversions between MCI and dementia in community-dwelling older Americans and uncover the beneficial impact of education to withstand cognitive impairment before death.
很少有研究同时估计认知障碍(MCI)的发病率、向可能的痴呆症的转化率和死亡率,且这些研究都是基于全国代表性样本。
我们使用了来自六轮国家健康老龄化趋势研究(2011-2016 年)的数据。多变量调整多状态生存模型(MSMs)用于在考虑分类错误的情况下对发病率进行建模。
共纳入 6078 名符合条件的 NHATS 参与者(平均年龄:77.49 ± 7.79 岁;58.42%女性;68.99%非西班牙裔白人)。MCI 的发病率估计为 41.0[35.5,47.3]/1000 人年(PY)。参与者以高转化率 241.3[189.6,307.0]/1000 PY 转换为可能的痴呆症,但也有一小部分从 MCI 恢复到认知正常。教育与 MCI 和向可能的痴呆症的转化率降低有关,但对患有 MCI 的人死亡率增加。在 MCI 和痴呆症的发病率方面也存在显著的种族和民族差异。
我们的研究结果强调了社区居住的美国老年人中 MCI 和痴呆症之间相对常见的发病率和转换,揭示了教育对在死亡前抵御认知障碍的有益影响。