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探索多因素格局:泰国三级医疗环境中痴呆症的风险因素

Exploring the Multifactorial Landscape: Risk Factors for Dementia in a Tertiary Care Setting in Thailand.

作者信息

Lawongsa Kasidid, Kengpanich Supatcha, Srisuwan Patsri

机构信息

Family Medicine, Phramongkutklao Hospital, Bangkok, THA.

Geriatrics, Phramongkutklao Hospital, Bangkok, THA.

出版信息

Cureus. 2024 May 13;16(5):e60195. doi: 10.7759/cureus.60195. eCollection 2024 May.

Abstract

BACKGROUND

Dementia poses a significant public health challenge worldwide, necessitating a deeper understanding of its risk factors to inform preventive strategies.

METHOD

This retrospective longitudinal study leveraged clinical data from a tertiary care database to investigate the risk factors associated with an incident dementia diagnosis. The study cohort comprised individuals aged 50 years and older. Key variables including age, income, comorbidities such as depressive disorder, osteoporosis, stroke, and metabolic conditions like type 2 diabetes and hypertension were analyzed by using Cox regression analysis.

RESULT

The study cohort included 127,016 adults 50 years and older. The results revealed that advancing age, with individuals aged 70-79 years having a hazard ratio (HR) of 3.9 (95% confidence interval (CI), 2.6-5.8), and those aged 80 years and above having an HR of 11.6 (95% CI, 7.7-17.3), lower income status (patients with no income or occupation had a notably higher risk of dementia diagnosis, with an HR of 2.0 (95% CI, 1.4-2.8)), depressive disorder (HR of 3.3 (95% CI, 3.3-3.7)), osteoporosis (HR of 1.2 (95% CI, 1.1-1.4)), and stroke (HR of 2.5 (95% CI, 2.3-2.7)) were significantly associated with an increased risk of incident dementia. However, no significant associations were observed for type 2 diabetes, hypertension, obesity, or underweight status managed in tertiary care.

CONCLUSION

The findings underscore the importance of considering a wide range of factors in understanding dementia risk and highlight the potential utility of routinely collected clinical data for comprehensive risk assessment. Further investigation into additional variables and multi-center studies may provide deeper insights into the complex interplay of risk factors contributing to dementia onset.

摘要

背景

痴呆症在全球范围内构成了重大的公共卫生挑战,因此有必要更深入地了解其风险因素,为预防策略提供依据。

方法

这项回顾性纵向研究利用三级医疗数据库中的临床数据,调查与新发痴呆症诊断相关的风险因素。研究队列包括50岁及以上的个体。通过Cox回归分析对年龄、收入、合并症(如抑郁症、骨质疏松症、中风)以及代谢状况(如2型糖尿病和高血压)等关键变量进行了分析。

结果

研究队列包括127,016名50岁及以上的成年人。结果显示,年龄增长与痴呆症风险增加显著相关,70 - 79岁个体的风险比(HR)为3.9(95%置信区间(CI),2.6 - 5.8),80岁及以上个体的HR为11.6(95% CI,7.7 - 17.3);低收入状态(无收入或无职业的患者痴呆症诊断风险显著更高,HR为2.0(95% CI,1.4 - 2.8))、抑郁症(HR为3.3(95% CI,3.3 - 3.7))、骨质疏松症(HR为1.2(95% CI,1.1 - 1.4))和中风(HR为2.5(95% CI,2.3 - 2.7))也与新发痴呆症风险增加显著相关。然而,在三级医疗中管理的2型糖尿病、高血压、肥胖或体重过轻状态与痴呆症风险之间未观察到显著关联。

结论

这些发现强调了在理解痴呆症风险时考虑多种因素的重要性,并突出了常规收集的临床数据在全面风险评估中的潜在效用。对其他变量的进一步研究和多中心研究可能会更深入地了解导致痴呆症发病的风险因素之间的复杂相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a03/11170239/92cc9e657256/cureus-0016-00000060195-i01.jpg

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