Brayne C, Gill C, Huppert F A, Barkley C, Gehlhaar E, Girling D M, O'Connor D W, Paykel E S
Department of Community Medicine, University of Cambridge, Institute of Public Health, UK.
Dement Geriatr Cogn Disord. 1998 May-Jun;9(3):175-80. doi: 10.1159/000017043.
The contribution of vascular pathology to the manifestation of dementia and the importance of vascular risk to measures of cognitive function is being increasingly recognized. In particular, confirmation of this risk points towards approaches for prevention in large sections of the population. Information on determinants of incident dementia is increasing, but still relatively few studies of risk have been based on incident cases of dementia in very elderly populations. In this study based on incident cases of dementia in a population aged 75 and over, vascular risks were obtained from informants of the respondents with incident dementia. When compared with controls the factors associated with incident dementia were history of heart attack (odds ratio 2.9), transient ischaemic attacks (4.8), cerebrovascular accidents (3.4), family history of first-degree relatives with dementia (4.0), and occupational exposure to vibrating instruments (1.4). If only Alzheimer's disease, clinically diagnosed, was included, diabetes (1.4) and a history of dementia in first-degree relatives (6.6) emerged. Thus, vascular risk continues to be of importance in the oldest age groups.
血管病理学对痴呆症表现的影响以及血管风险对认知功能测量的重要性正日益得到认可。特别是，这种风险的确认指向了在很大一部分人群中进行预防的方法。关于新发痴呆症决定因素的信息越来越多，但基于非常老年人群中痴呆症新发病例的风险研究仍然相对较少。在这项基于75岁及以上人群中痴呆症新发病例的研究中，血管风险是从患有新发痴呆症的受访者的 informant 那里获得的。与对照组相比，与新发痴呆症相关的因素有心脏病发作史（比值比2.9）、短暂性脑缺血发作（4.8）、脑血管意外（3.4）、痴呆症患者一级亲属的家族史（4.0）以及职业接触振动仪器（1.4）。如果仅纳入临床诊断的阿尔茨海默病，则出现了糖尿病（1.4）和一级亲属的痴呆症病史（6.6）。因此，血管风险在最年长的年龄组中仍然很重要。
