Lindsay J, Hébert R, Rockwood K
Laboratory Centre for Disease Control, Health Canada, Ottawa, Ont.
Stroke. 1997 Mar;28(3):526-30. doi: 10.1161/01.str.28.3.526.
The Canadian Study of Health and Aging (CSHA) was conducted in communities and institutions in 10 Canadian provinces. One objective of the study was to study risk factors for vascular dementia (VaD).
This was a population-based case-control study. It included 129 patients clinically diagnosed with VaD with duration of symptoms no more than 3 years and 535 control subjects, frequency matched by age group, study center, and residence in community or institution, who were clinically confirmed to be cognitively normal. Odds ratios (ORs) were calculated using unconditional logistic regression for potential risk factors for VaD.
Risk of VaD was associated with history of arterial hypertension (OR, 2.08; 95% confidence interval, 1.29 to 3.35). Other significantly elevated ORs were seen for history of alcohol abuse (2.45), history of heart condition (1.71), use of aspirin (3.10), and occupational exposure to pesticides and herbicides (2.60), as well as liquid plastic or rubber (2.59). The OR for less than 6 years of education compared with 10 or more years was 4.02.
The study confirmed some previously reported risk factors for VaD, such as history of heart disease. Higher levels of education seemed to lower the risk or delay onset of symptoms of VaD. Use of aspirin may be a predictor of survival rather than a risk factor. The occupational associations, particularly with pesticides and fertilizers, need further study.
加拿大健康与老龄化研究（CSHA）在加拿大10个省的社区和机构中开展。该研究的一个目标是研究血管性痴呆（VaD）的危险因素。
这是一项基于人群的病例对照研究。研究纳入了129例临床诊断为VaD且症状持续时间不超过3年的患者，以及535例对照者，后者按年龄组、研究中心以及社区或机构居住情况进行频数匹配，且经临床确认认知功能正常。采用无条件逻辑回归计算VaD潜在危险因素的比值比（OR）。
VaD风险与动脉高血压病史相关（OR，2.08；95%置信区间，1.29至3.35）。其他显著升高的OR还见于酒精滥用史（2.45）、心脏病史（1.71）、阿司匹林使用（3.10）、职业性接触杀虫剂和除草剂（2.60）以及液体塑料或橡胶（2.59）。受教育年限不足6年与10年及以上相比，OR为4.02。
该研究证实了一些先前报道的VaD危险因素，如心脏病史。较高的教育水平似乎可降低VaD风险或延迟症状发作。使用阿司匹林可能是生存的一个预测因素而非危险因素。职业关联，尤其是与杀虫剂和肥料的关联，需要进一步研究。
