Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA.
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
Alzheimers Dement. 2023 Jul;19(7):2975-2983. doi: 10.1002/alz.12940. Epub 2023 Jan 19.
We examined for associations between potentially modifiable risk factors across the adult life course and incident dementia.
Participants from the Framingham Heart Study were included (n = 4015). Potential modifiable risk factors included education, alcohol intake, smoking, body mass index (BMI), physical activity, social network, diabetes, and hypertension. Cox models were used to examine associations between each factor and incident dementia, stratified by early adult life (33-44 years), midlife (45-65 years), and late life (66-80 years).
Increased dementia risk was associated with diabetes (hazard ratio [HR] = 1.62; 95% confidence interval [CI] = 1.07-2.46) and physical inactivity (HR = 1.57; 95% CI = 1.12-2.20) in midlife, and with obesity (HR = 1.76; 95% CI = 1.08-2.87) in late life. Having multiple potential modifiable risk factors in midlife and late life was associated with greater risk.
Potentially modifiable risk factors individually have limited impact on dementia risk in this population across the adult life course, although in combination they may have a synergistic effect.
Diabetes and physical inactivity in midlife is associated with increased dementia risk. Obesity in late life is associated with increased dementia risk. Having more potentially modifiable risk factors in midlife and late life is associated with greater dementia risk.
我们研究了整个成年期潜在可改变的风险因素与痴呆症发病之间的关联。
纳入弗雷明汉心脏研究(Framingham Heart Study)的参与者(n=4015)。潜在可改变的风险因素包括教育程度、饮酒量、吸烟、体重指数(BMI)、身体活动、社交网络、糖尿病和高血压。使用 Cox 模型来检验每个因素与痴呆症发病之间的关联,根据成年早期(33-44 岁)、中年(45-65 岁)和晚年(66-80 岁)进行分层。
与糖尿病(风险比 [HR] = 1.62;95%置信区间 [CI] = 1.07-2.46)和中年缺乏体力活动(HR = 1.57;95%CI = 1.12-2.20)相关的痴呆症风险增加,与晚年肥胖(HR = 1.76;95%CI = 1.08-2.87)相关。中年和晚年存在多个潜在可改变的风险因素与更高的风险相关。
在该人群的整个成年期,潜在可改变的风险因素单独对痴呆症风险的影响有限,尽管它们结合起来可能具有协同作用。
中年的糖尿病和缺乏体力活动与痴呆症风险增加相关。晚年肥胖与痴呆症风险增加相关。中年和晚年存在更多潜在可改变的风险因素与更大的痴呆症风险相关。