Xia Xin, Clark Alice, Brogaard Niels Juul, Mourer Alex, Areovimata Anna, Eriksdotter Maria, Zetterberg Henrik, Kern Silke, Skillbäck Tobias, Jönsson Linus
Department of Neurobiology, Care Sciences and Society, Section for Neurogeriatrics, Karolinska Institutet, Solna, Sweden.
Karolinska Institutet, Solnavägen 30, floor 10, BioClinicum, Solna, 171 64, Sweden.
Alzheimers Res Ther. 2025 Jul 12;17(1):155. doi: 10.1186/s13195-025-01807-6.
We explored the associations of comorbidities with cognitive deterioration, institutionalization, and mortality in biomarker-confirmed Alzheimer’s disease (AD) dementia.
We conducted a Swedish Register-based cohort study consisting of 10,857 people (mean age 74 years) with diagnosed dementia and positive AD biomarkers (CSF Aβ/P-tau ratio). Cognitive function was measured by mini-mental state examination (MMSE). Comorbidities by human body organ systems (e.g., diseases of the circulatory system) and six selected comorbidities: type-2 diabetes (T2DM), ischemic heart disease (IHD), stroke, chronic kidney disease (CKD), inflammatory bowel disease, and depression, were analyzed. Multistate Cox regressions assessed the associations of comorbidities with cognitive deterioration, institutionalization, and death.
Only T2DM and IHD were associated with cognitive deterioration. Mental disorders, T2DM, and stroke were linked to higher hazards of institutionalization. Endocrine-metabolic disorders, circulatory system diseases, and CKD were associated with higher mortality rates.
Comorbidities may help inform the prognosis of biomarker-confirmed AD dementia.
The online version contains supplementary material available at 10.1186/s13195-025-01807-6.
我们探讨了共病与生物标志物确诊的阿尔茨海默病（AD）痴呆患者认知功能衰退、入住养老院及死亡率之间的关联。
我们开展了一项基于瑞典登记册的队列研究，纳入了10857名（平均年龄74岁）已确诊痴呆且AD生物标志物（脑脊液Aβ/P-tau比值）呈阳性的患者。通过简易精神状态检查表（MMSE）评估认知功能。分析了按人体器官系统分类的共病情况（如循环系统疾病）以及六种选定的共病：2型糖尿病（T2DM）、缺血性心脏病（IHD）、中风、慢性肾脏病（CKD）、炎症性肠病和抑郁症。多状态Cox回归分析评估了共病与认知功能衰退、入住养老院及死亡之间的关联。
仅T2DM和IHD与认知功能衰退相关。精神障碍、T2DM和中风与入住养老院的较高风险相关。内分泌代谢紊乱、循环系统疾病和CKD与较高死亡率相关。
共病情况可能有助于了解生物标志物确诊的AD痴呆的预后。
在线版本包含可在10.1186/s13195-025-01807-6获取的补充材料。
