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社会隔离、孤独感与遗传风险因素与痴呆症发病风险的相关性:英国生物库队列研究。

Association of social isolation, loneliness and genetic risk with incidence of dementia: UK Biobank Cohort Study.

机构信息

Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland

Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

出版信息

BMJ Open. 2022 Feb 23;12(2):e053936. doi: 10.1136/bmjopen-2021-053936.

Abstract

BACKGROUND

Social isolation and loneliness have been associated with increased risk of dementia, but it is not known whether this risk is modified or confounded by genetic risk of dementia.

METHODS

We used the prospective UK Biobank study with 155 070 participants (mean age 64.1 years), including self-reported social isolation and loneliness. Genetic risk was indicated using the polygenic risk score for Alzheimer's disease and the incident dementia ascertained using electronic health records.

RESULTS

Overall, 8.6% of participants reported that they were socially isolated and 5.5% were lonely. During a mean follow-up of 8.8 years (1.36 million person years), 1444 (0.9% of the total sample) were diagnosed with dementia. Social isolation, but not loneliness, was associated with increased risk of dementia (HR 1.62, 95% CI 1.38 to 1.90). There were no interaction effects between genetic risk and social isolation or between genetic risk and loneliness predicting incident dementia. Of the participants who were socially isolated and had high genetic risk, 4.4% (95% CI 3.4% to 5.5%) were estimated to developed dementia compared with 2.9% (95% CI 2.6% to 3.2%) of those who were not socially isolated but had high genetic risk. Comparable differences were also in those with intermediate and low genetic risk levels.

CONCLUSIONS

Socially isolated individuals are at increased risk of dementia at all levels of genetic risk.

摘要

背景

社会隔离和孤独与痴呆风险增加有关,但尚不清楚这种风险是否受到痴呆遗传风险的修饰或混杂。

方法

我们使用前瞻性英国生物银行研究,该研究纳入了 155070 名参与者(平均年龄 64.1 岁),包括自我报告的社会隔离和孤独感。使用阿尔茨海默病的多基因风险评分来指示遗传风险,使用电子健康记录来确定新发痴呆。

结果

总体而言,8.6%的参与者报告说他们社会隔离,5.5%的参与者感到孤独。在平均 8.8 年(136 万个人年)的随访期间,1444 人(总样本的 0.9%)被诊断为痴呆。社会隔离,但不是孤独,与痴呆风险增加相关(HR 1.62,95%CI 1.38 至 1.90)。遗传风险与社会隔离或遗传风险与孤独感预测新发痴呆之间没有交互作用。在社会隔离且遗传风险高的参与者中,估计有 4.4%(95%CI 3.4%至 5.5%)会发展为痴呆,而在没有社会隔离但遗传风险高的参与者中,这一比例为 2.9%(95%CI 2.6%至 3.2%)。在遗传风险处于中低水平的人群中也存在类似的差异。

结论

在所有遗传风险水平上,社会隔离的个体痴呆风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0458/8867309/9b397d2c5a6e/bmjopen-2021-053936f01.jpg

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