School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan.
Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan.
Int J Environ Res Public Health. 2023 Feb 9;20(4):3065. doi: 10.3390/ijerph20043065.
The aim of this study was to identify dementia trajectories and their associated predictors among elderly Taiwanese people over a 14-year period using a nationwide representative longitudinal study. This retrospective cohort study was performed using the National Health Insurance Research Database. Group-based trajectory modeling (GBTM) was used to distinguish the specific trajectory groups of incident dementia during 2000-2013. All 42,407 patients were classified by GBTM to identify the trajectory of incident dementia, which included high- ( = 11,637, 29.0%), moderate- ( = 19,036, 44.9%), and low-incidence ( = 11,734, 26.1%) groups. Those diagnosed with hypertension (adjusted odds ratio [aOR] = 1.43; 95% confidence interval [CI] = 1.35-1.52), stroke (aOR = 1.45, 95% CI = 1.31-1.60), coronary heart disease (aOR = 1.29, 95% CI = 1.19-1.39), heart failure (aOR = 1.62, 95% CI = 1.36-1.93), and chronic obstructive pulmonary disease (aOR = 1.10, 95% CI = 1.02-1.18) at baseline revealed tendencies to be classified into high-incidence groups in dementia risk. The results from a 14-year longitudinal study identified three distinct trajectories of incident dementia among elderly Taiwanese people: patients with cardiovascular disease risk factors and cardiovascular disease events tended to be classified into high-incidence dementia groups. Early detection and management of these associated risk factors in the elderly may prevent or delay the deterioration of cognitive decline.
本研究旨在通过一项全国性的代表性纵向研究，确定台湾老年人在 14 年内的痴呆轨迹及其相关预测因素。这项回顾性队列研究使用了国家健康保险研究数据库。使用基于群组的轨迹建模（GBTM）来区分 2000-2013 年期间发生痴呆的特定轨迹组。所有 42407 名患者都通过 GBTM 进行分类，以确定发生痴呆的轨迹，包括高发组（=11637，29.0%）、中发组（=19036，44.9%）和低发组（=11734，26.1%）。患有高血压（调整后的优势比[aOR]=1.43；95%置信区间[CI]=1.35-1.52）、中风（aOR=1.45，95%CI=1.31-1.60）、冠心病（aOR=1.29，95%CI=1.19-1.39）、心力衰竭（aOR=1.62，95%CI=1.36-1.93）和慢性阻塞性肺疾病（aOR=1.10，95%CI=1.02-1.18）的患者在基线时更倾向于被归类为痴呆风险的高发组。这项为期 14 年的纵向研究结果确定了台湾老年人发生痴呆的三种不同轨迹：患有心血管疾病危险因素和心血管疾病事件的患者更倾向于被归类为高发痴呆组。早期发现和管理这些与老年人相关的危险因素可能会预防或延缓认知能力下降的恶化。
