Department of Cardiology, Faculty of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC, Canada.
Sci Rep. 2023 Sep 9;13(1):14881. doi: 10.1038/s41598-023-42071-8.
The link between cardiovascular (CV) risk factors or diseases and dementia is documented. There is conflicting evidence whether age moderates the association. We need to study this gap so that research and clinical initiatives target appropriate age groups. A cohort of 320,630 adult patients without dementia was built using Quebec healthcare databases (1998-2010). The CV risk factors were hypertension, diabetes and dyslipidemia, while diseases included stroke, myocardial infarction (MI), chronic heart failure (HF), and atrial fibrillation (AF). Dementia risk and CV risk factors or diseases were assessed using incidence rate ratios and Cox regression across age groups. The cohort presented by mainly female sex (67.7%) and mean age of 74.1 years. Incident rate of dementia increased with age, ranging from 4.1 to 93.5 per 1000 person-years. Diabetes, stroke, HF and AF were significantly associated with dementia risk, hazard ratios ranged from 1.08 to 3.54. The strength of association decreased in advanced age for diabetes, stroke and HF. The results suggest that prevention of diabetes, stroke, HF and AF are crucial to mitigate dementia risk. The pathophysiology of dementia in younger and older populations seems to differ, with less impact of CV risk factors in advanced age.
心血管 (CV) 危险因素或疾病与痴呆之间存在关联。年龄是否调节这种关联存在争议。我们需要研究这一差距，以便研究和临床计划针对适当的年龄组。使用魁北克省医疗保健数据库（1998-2010 年）构建了一个无痴呆症的 320630 名成年患者队列。CV 危险因素包括高血压、糖尿病和血脂异常，而疾病包括中风、心肌梗死 (MI)、慢性心力衰竭 (HF) 和心房颤动 (AF)。使用发病率比率和 Cox 回归在不同年龄组评估痴呆风险和 CV 危险因素或疾病。队列主要由女性（67.7%）和平均年龄为 74.1 岁组成。痴呆的发病率随年龄增长而增加，范围为每 1000 人年 4.1 至 93.5 例。糖尿病、中风、HF 和 AF 与痴呆风险显著相关，风险比范围为 1.08 至 3.54。随着年龄的增长，糖尿病、中风和 HF 的关联强度减弱。结果表明，预防糖尿病、中风、HF 和 AF 对于降低痴呆风险至关重要。在年轻和老年人群中，痴呆的病理生理学似乎不同，CV 危险因素的影响在老年时较小。
