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父母年龄与子代患阿尔茨海默病的风险:系统评价与荟萃分析

Parental Age and the Risk for Alzheimer's Disease in Offspring: Systematic Review and Meta-Analysis.

作者信息

Szejko Natalia, Macul Ferreira de Barros Pedro, Avila-Quintero Victor J, Lombroso Adam, Bloch Michael Howard

机构信息

Department of Neurology, Medical University of Warsaw, Warsaw, Poland.

Department of Bioethics, Medical University of Warsaw, Warsaw, Poland.

出版信息

Dement Geriatr Cogn Dis Extra. 2021 Jun 8;11(2):140-150. doi: 10.1159/000515523. eCollection 2021 May-Aug.

Abstract

BACKGROUND

Alzheimer's disease (AD) is the most common cause of dementia worldwide, accounting for 50-75% of all cases. While older maternal and paternal age at childbirth are established risk factors for Down syndrome which is associated with later AD, it is still not entirely clear whether parental age is a risk factor for AD. Previous studies have suggested contradictory findings.

OBJECTIVES

We conducted a systematic review and meta-analysis to examine whether parental (maternal and paternal) age at birth was associated with AD and whether individuals born to younger or older parents were at an increased risk for AD.

METHODS

Two reviewers searched the electronic database of PubMed for relevant studies. Eligibility for the meta-analysis was based on the following criteria: (1) studies involving patients with AD and an adequate control group, (2) case control or cohort studies, (3) studies investigating parental age. All statistical analyses were completed in STATA/IC version 16.

RESULTS

Eleven studies involving 4,371 participants were included in the systematic review and meta-analysis. Meta-analysis demonstrated no significant association between maternal (weighted mean difference [WMD] 0.49, 95% CI -0.52 to 1.49, = 0.34) and paternal age and AD (WMD 1.00, 95% CI -0.55 to 2.56, = 0.21). Similarly, individuals born to younger (<25 years) or older parents (>35 years) did not demonstrate a differential risk for AD.

CONCLUSIONS

Overall, this meta-analysis did not demonstrate an association between parental age and the risk of AD in offspring. These findings should be interpreted with caution given the limited power of the overall meta-analysis and the methodological limitations of the underlying studies as in many cases no adjustment for potential confounders was included.

摘要

背景

阿尔茨海默病(AD)是全球痴呆最常见的病因,占所有病例的50%-75%。虽然产妇和父亲生育时年龄较大是与晚年AD相关的唐氏综合征的确立危险因素,但父母年龄是否为AD的危险因素仍不完全清楚。既往研究结果相互矛盾。

目的

我们进行了一项系统评价和荟萃分析,以研究父母生育时年龄是否与AD相关,以及父母年龄较小或较大的个体患AD的风险是否增加。

方法

两名评价者检索了PubMed电子数据库中的相关研究。荟萃分析的纳入标准如下:(1)涉及AD患者和适当对照组的研究;(2)病例对照或队列研究;(3)调查父母年龄的研究。所有统计分析均在STATA/IC 16版中完成。

结果

系统评价和荟萃分析纳入了11项研究,共涉及4371名参与者。荟萃分析表明,母亲年龄(加权均数差[WMD] 0.49,95%CI -0.52至1.49,P = 0.34)和父亲年龄与AD之间均无显著关联(WMD 1.00,95%CI -0.55至2.56,P = 0.21)。同样,父母年龄较小(<25岁)或较大(>35岁)的个体患AD的风险也无差异。

结论

总体而言,这项荟萃分析未显示父母年龄与后代患AD风险之间存在关联。鉴于总体荟萃分析的效力有限以及基础研究存在方法学局限性(许多情况下未对潜在混杂因素进行校正),这些结果应谨慎解读。

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