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澳大利亚托雷斯海峡地区人群的初级保健生物标志物与痴呆症:扩展数据分析

Primary care biomarkers and dementia in people of the Torres Strait, Australia: extended data analysis.

作者信息

Thompson Fintan, Russell Sarah, Quigley Rachel, McDonald Malcolm, Sagigi Betty, Taylor Sean, Campbell Sandy, Schmidt Barbara, Esterman Adrian, Harriss Linton R, Miller Gavin, Mills Phillip, Strivens Edward, McDermott Robyn

机构信息

Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia.

School of Health Sciences, University of South Australia, Adelaide, SA, Australia.

出版信息

Front Dement. 2023 Jul 31;2:1218709. doi: 10.3389/frdem.2023.1218709. eCollection 2023.

Abstract

OBJECTIVE

Dementia disproportionately affects First Nations populations. Biomarkers collected in primary care may assist with determining dementia risk. Our previous underpowered study showed some suggestive associations between baseline biomarkers with follow-up dementia or cognitive impairment. The current study extended this work with a larger linked dataset.

STUDY DESIGN AND SETTING

Probabilistic data linkage was used to combine four baseline datasets with one follow-up assessment of dementia status 0-20 years later in a First Nations population in Australia. Mixed Effects Generalized Linear Regression models were used to test associations between baseline measures and follow-up status, accounting for repeated measures within individuals.

RESULTS

Linked data were available for 88 individuals, with 101-279 baseline observations, depending on the type of measure. Higher urinary albumin to creatine ratio was associated with greater risk of cognitive impairment/dementia, whereas body weight and key lipid markers were negatively associated. There was no clear trend when these associations were examined by timing of measurement (i.e., ≤10 years or >10 years before a dementia assessment).

CONCLUSIONS

The results of this study support findings from our previous work and indicate that microalbuminuria can be an early indicator of dementia risk in this population. The weight and lipid profile findings reflect the mixed results in the published literature and require further investigation and interpretation.

摘要

目的

痴呆症对原住民的影响尤为严重。在初级保健中收集的生物标志物可能有助于确定痴呆症风险。我们之前的研究样本量不足,显示基线生物标志物与随访时的痴呆症或认知障碍之间存在一些提示性关联。本研究利用更大的关联数据集扩展了这项工作。

研究设计与设置

采用概率数据链接方法,将四个基线数据集与澳大利亚原住民0至20年后痴呆症状态的一次随访评估相结合。使用混合效应广义线性回归模型来检验基线测量值与随访状态之间的关联,并考虑个体内的重复测量。

结果

共有88名个体的关联数据可用,根据测量类型,基线观察值为101至279个。较高的尿白蛋白与肌酐比值与认知障碍/痴呆症风险增加相关,而体重和关键脂质标志物则呈负相关。按测量时间(即痴呆症评估前≤10年或>10年)检查这些关联时,没有明显趋势。

结论

本研究结果支持我们之前工作的发现,并表明微量白蛋白尿可能是该人群痴呆症风险的早期指标。体重和血脂情况的研究结果反映了已发表文献中的混合结果,需要进一步调查和解读。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6631/11285673/de74fdc095be/frdem-02-1218709-g0001.jpg

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