Cognitive and Behavior Unit, Department of Neurology (AG, MJGB, MM, WB, MR, MCF), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Master of Neuropsychology (AG, MJGB, MM, WB, MCF), University Institute of the Italian Hospital, Buenos Aires, Argentina.
Cognitive and Behavior Unit, Department of Neurology (AG, MJGB, MM, WB, MR, MCF), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Master of Neuropsychology (AG, MJGB, MM, WB, MCF), University Institute of the Italian Hospital, Buenos Aires, Argentina.
Am J Geriatr Psychiatry. 2024 Sep;32(9):1063-1077. doi: 10.1016/j.jagp.2024.04.005. Epub 2024 Apr 10.
Past reports have suggested that attention-deficit/hyperactivity disorder (ADHD) may be a risk factor for Lewy body disease (LBD). To confirm this relationship, we conducted the present study.
A prospective observational cohort study with a follow-up to 15 years.
The subjects were recruited from cognitive neurology clinics, where they attended for a cognitive complaint or health check-up.
Two groups of subjects: ADHD adults and healthy subjects.
The risk of dementia and LBD was estimated with Kaplan-Meier analysis comparing for the presence or absence of ADHD with the log-rank test. Predictors of conversion were assessed through separate univariate and multivariate Cox regression analyses, adjusting for several variables.
The baseline sample consisted of 161 subjects with ADHD and 109 without ADHD. At the end of the follow-up, 31 subjects developed dementia, 27 cases in the ADHD group and 4 in comparison group. Dementia with Lewy bodies (DLB) was the most frequent type (N:20) of which 19 corresponded to the ADHD group. The incidence of non-amnestic-MCI in the ADHD group was higher representing 67.1 % of these subjects (N:108), and 17.4% (N:19) of healthy cases. The hazard ratios for dementia and LBD in the multivariate adjusted model were 3.33 (95% CI 1.0915 to 10.1699) and 54.54 (95% CI 7.4849 to 397.5028), respectively in the ADHD group.
This study showed that adult ADHD is independently associated with an increased risk of LBD, dementia, and na-MCI. Future studies should clarify this relationship to develop preventive measures for these patients.
既往研究提示，注意力缺陷多动障碍（ADHD）可能是路易体病（LBD）的一个危险因素。为了证实这种关系，我们开展了本次研究。
前瞻性观察队列研究，随访时间为 15 年。
研究对象来自认知神经科诊所，他们因认知主诉或健康体检而就诊。
两组研究对象：ADHD 成人组和健康对照组。
采用 Kaplan-Meier 分析比较有无 ADHD 患者的痴呆和 LBD 风险，用对数秩检验比较。通过单变量和多变量 Cox 回归分析分别评估转化的预测因素，调整了几个变量。
基线样本包括 161 例 ADHD 患者和 109 例无 ADHD 患者。随访结束时，31 例患者发展为痴呆，ADHD 组 27 例，对照组 4 例。以路易体痴呆（DLB）最常见（20 例），其中 19 例为 ADHD 组。ADHD 组非遗忘性轻度认知障碍（MCI）的发病率较高，占这些患者的 67.1%（108 例），健康对照组为 17.4%（19 例）。多变量调整模型中，ADHD 组痴呆和 LBD 的风险比分别为 3.33（95%CI 1.0915 至 10.1699）和 54.54（95%CI 7.4849 至 397.5028）。
本研究表明，成人 ADHD 与 LBD、痴呆和非遗忘性 MCI 的风险增加独立相关。未来的研究应该进一步明确这种关系，以便为这些患者制定预防措施。
