Rogers Bayard
University College London, London, UK.
Alzheimers Dement. 2025 Mar;21(3):e14564. doi: 10.1002/alz.14564.
Comorbid conditions associated with Alzheimer's disease (AD) are poorly understood regarding timing and potential impact on disease onset and progression.
Medical Information Mart for Intensive Care-IV electronic health records from 2008 to 2019 were examined. The study identified 2527 AD patients (34.9% male, mean age 80.27 years) among 299,712 patients. We examined the timing of 12 cardiovascular and metabolic diseases relative to AD diagnosis. Data from the National Alzheimer's Coordinating Center validated the findings.
Hypertension was the most common comorbidity, diagnosed 1.09 years before AD. Depression was the only comorbidity diagnosed after AD start, 0.16 years on average. AD patients had greater rates of hypertension, hypercholesterolemia, and depression compared to the general population.
The findings emphasize early detection and therapy of AD-related comorbidities, notably cardiovascular and metabolic diseases. The temporal link between these diseases and AD suggests opportunities for preventive strategies and improved care pathways.
Temporal analysis of comorbidities: The study reveals hypertension and hyperlipidemia as leading precursors to AD, typically diagnosed 1 to 1.3 years prior to AD onset, while depression emerges predominantly after diagnosis. Unique data integration: Large-scale datasets from MIMIC-IV (n = 299,712) and NACC (n = 51,836) were leveraged to identify chronological patterns in 12 key comorbid conditions relative to AD diagnosis. Sex- and age-specific insights: AD prevalence peaks at 80 to 86 years, with females exhibiting higher rates of LOAD compared to males. Depression as a post-diagnostic marker: Unlike other comorbidities, depression's post-diagnostic mean onset (0.16 years after AD diagnosis) highlights the need for targeted mental health interventions in AD patients. Implications for early detection: Findings suggest that managing hypertension, hyperlipidemia, and other modifiable conditions in midlife may delay or reduce the risk of AD development. Comorbidity variability across cohorts: Hypertension and hypercholesterolemia showed significantly higher prevalence in the NACC cohort compared to MIMIC-IV, reflecting potential dataset-specific biases or regional healthcare differences. Future research directions: Advocates for longitudinal, multiethnic, and global studies to refine early diagnostic criteria and explore preventive strategies tailored to comorbid conditions.
关于与阿尔茨海默病（AD）相关的共病状况，人们对其发生时间以及对疾病发病和进展的潜在影响了解甚少。
对2008年至2019年重症监护医学信息集市-IV电子健康记录进行了检查。该研究在299,712名患者中识别出2527名AD患者（男性占34.9%，平均年龄80.27岁）。我们研究了12种心血管和代谢疾病相对于AD诊断的发生时间。来自国家阿尔茨海默病协调中心的数据验证了研究结果。
高血压是最常见的共病，在AD诊断前1.09年被诊断出来。抑郁症是唯一在AD发病后被诊断出的共病，平均为发病后0.16年。与普通人群相比，AD患者患高血压、高胆固醇血症和抑郁症的比例更高。
研究结果强调了对AD相关共病，尤其是心血管和代谢疾病的早期检测和治疗。这些疾病与AD之间的时间联系为预防策略和改善护理途径提供了机会。
共病的时间分析：该研究表明高血压和高脂血症是AD的主要先兆，通常在AD发病前1至1.3年被诊断出来，而抑郁症主要在诊断后出现。独特的数据整合：利用来自重症监护医学信息集市-IV（n = 299,712）和国家阿尔茨海默病协调中心（n = 51,836）的大规模数据集，确定了12种关键共病相对于AD诊断的时间模式。性别和年龄特异性见解：AD患病率在80至86岁达到峰值，女性患晚发性阿尔茨海默病的比例高于男性。抑郁症作为诊断后的标志物：与其他共病不同，抑郁症诊断后的平均发病时间（AD诊断后0.16年）凸显了对AD患者进行有针对性心理健康干预的必要性。对早期检测的意义：研究结果表明，在中年管理高血压、高脂血症和其他可改变的状况可能会延迟或降低AD发病风险。不同队列中共病的变异性：与重症监护医学信息集市-IV相比，国家阿尔茨海默病协调中心队列中高血压和高胆固醇血症的患病率显著更高，这反映了潜在的数据集特定偏差或地区医疗差异。未来研究方向：提倡进行纵向、多民族和全球性研究，以完善早期诊断标准，并探索针对共病状况的预防策略。
