Faculty of Medicine and Health Science, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
J Gerontol A Biol Sci Med Sci. 2024 Aug 1;79(8). doi: 10.1093/gerona/glae161.
High blood pressure and poor cardiorespiratory fitness are independent risk factors for dementia. However, few studies have examined if combined longitudinal patterns of these modifiable risk factors are associated with dementia risk.
In this prospective cohort study, we used data from the population-based Trøndelag Health (HUNT) Study, Norway. We applied group-based multidimensional trajectory modeling to identify age-specific multidimensional trajectories of SBP, DBP, and estimated cardiorespiratory fitness across 3 surveys (HUNT1, 1984-1986 to HUNT3, 2006-2008). Dementia was diagnosed in the HUNT4 70+ substudy in 2017-2019. We used multivariate logistic regression to estimate odds ratios (ORs) and risk differences (RDs) of dementia.
In total, 7 594 participants (54.9% women) were included, with a mean age of 44.7 (SD 6.3) years at HUNT1. Dementia was diagnosed in 1 062 (14.0%) participants. We identified 2 multidimensional trajectories throughout adulthood within 3 age groups: one with higher systolic blood pressure (SBP) and diastolic blood pressure (DBP), and lower estimated cardiorespiratory fitness (the poorer group), and one with lower SBP and DBP, and higher cardiorespiratory fitness (the better group). After adjustment for sex, apolipoprotein E ε4 status, education, marital status, and diabetes, the better group had consistently lower risk of dementia in all age groups with the lowest OR in the middle-aged group of 0.63 (95% confidence intervals [95% CI]: 0.51, 0.78) with corresponding RD of -0.07 (95% CI: -0.10, -0.04).
Having a beneficial multidimensional trajectory of SBP, DBP, and cardiorespiratory fitness in adulthood was associated with reduced dementia risk. Aiming for optimal SBP, DBP, and estimated cardiorespiratory fitness throughout adulthood may reduce dementia risk.
高血压和心肺功能差是痴呆的独立危险因素。然而，很少有研究探讨这些可改变的危险因素的综合纵向模式是否与痴呆风险相关。
在这项基于人群的挪威特隆赫姆健康（HUNT）研究的前瞻性队列研究中，我们使用了数据。我们应用基于群组的多维轨迹建模来识别 SBP、DBP 和在 3 次调查（HUNT1，1984-1986 至 HUNT3，2006-2008）中跨年龄的多维轨迹。在 2017-2019 年的 HUNT4 70+子研究中诊断为痴呆。我们使用多变量逻辑回归来估计痴呆的优势比（OR）和风险差异（RD）。
共纳入 7594 名参与者（54.9%为女性），HUNT1 时的平均年龄为 44.7（SD 6.3）岁。在 1062 名参与者（14.0%）中诊断为痴呆。我们在 3 个年龄组中识别出成年期的 2 个多维轨迹：一个具有较高的收缩压（SBP）和舒张压（DBP）以及较低的估计心肺功能（较差组），另一个具有较低的 SBP 和 DBP 以及较高的心肺功能（较好组）。在校正性别、载脂蛋白 E ε4 状态、教育程度、婚姻状况和糖尿病后，在所有年龄组中，较好组的痴呆风险始终较低，在中年组中的 OR 最低为 0.63（95%CI：0.51，0.78），相应的 RD 为-0.07（95%CI：-0.10，-0.04）。
在成年期具有有益的 SBP、DBP 和心肺功能多维轨迹与降低痴呆风险相关。在整个成年期追求最佳的 SBP、DBP 和估计心肺功能可能会降低痴呆风险。
