Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
J Alzheimers Dis. 2022;90(1):211-231. doi: 10.3233/JAD-220548.
Long term risk of Alzheimer's disease (AD) and related dementias (ADRD) associated with vascular diseases in people with colorectal cancer is unknown.
To determine the risk of ADRD in association with cardiovascular diseases (CVD), stroke, hypertension, and diabetes in a cohort of patients with colorectal cancer.
This retrospective cohort study consisted of 210,809 patients diagnosed with colorectal cancer at age≥65 years in 1991-2015 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database with follow-up from 1991-2016, who were free of any ADRD at the baseline (<12 months prior to or < 30 days after the date of cancer diagnosis).
The crude 26-year cumulative incidence of total ADRD in men and women with colorectal cancer was higher in those with versus without CVD (31.92% versus 28.12%), with versus without stroke (39.82% versus 26.39%), with versus without hypertension (31.88% versus 24.88%), and with versus without diabetes (32.01% versus 27.66%). After adjusting for socio-demographic and tumor factors, the risk of developing ADRD was significantly higher in patients with CVD (adjusted hazard ratio: 1.17, 95% confidence intervals: 1.14-1.20), stroke (1.65, 1.62-1.68), hypertension (1.07, 1.05-1.09), and diabetes (1.26, 1.24-1.29) versus persons without. For those with 1, 2, 3 and 4 vascular diseases present versus absent, the risk of AD increased from 1.12 (1.07-1.16) to 1.31 (1.25-1.36), 1.66 (1.57-1.75), and 2.03 (1.82-2.27).
In older patients with colorectal cancer, a significant dose-response relationship was observed between an increasing number of these vascular diseases and the risk of all types of dementia.
患有结直肠癌的人群中，与血管疾病相关的阿尔茨海默病（AD）和相关痴呆症（ADRD）的长期风险尚不清楚。
确定在结直肠癌患者队列中，心血管疾病（CVD）、中风、高血压和糖尿病与 ADRD 风险之间的关系。
这是一项回顾性队列研究，纳入了 1991 年至 2015 年期间年龄≥65 岁、在 SEER-Medicare 数据库中诊断为结直肠癌且基线时（癌症诊断前<12 个月或<30 天）无任何 ADRD 的 210809 例患者，随访至 1991 年至 2016 年。
男性和女性结直肠癌患者的 ADRD 累积 26 年发生率，在有 CVD 者高于无 CVD 者（31.92% vs. 28.12%）、有中风者高于无中风者（39.82% vs. 26.39%）、有高血压者高于无高血压者（31.88% vs. 24.88%）、有糖尿病者高于无糖尿病者（32.01% vs. 27.66%）。在校正了社会人口统计学和肿瘤因素后，CVD（调整后的危险比：1.17，95%置信区间：1.14-1.20）、中风（1.65，1.62-1.68）、高血压（1.07，1.05-1.09）和糖尿病（1.26，1.24-1.29）患者发生 ADRD 的风险明显高于无上述疾病者。与无血管疾病者相比，有 1、2、3 和 4 种血管疾病者的 AD 风险从 1.12（1.07-1.16）增加到 1.31（1.25-1.36）、1.66（1.57-1.75）和 2.03（1.82-2.27）。
在患有结直肠癌的老年患者中，这些血管疾病数量的增加与所有类型痴呆的风险之间存在显著的剂量-反应关系。
