Is Cancer Protective for Subsequent Alzheimer's Disease Risk? Evidence From the Utah Population Database
Is Cancer Protective for Subsequent Alzheimer's Disease Risk? Evidence From the Utah Population Database
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DOI：
10.1093/geronb/gbw040
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发表时间：
2017-11-01
影响因子：
6.2
通讯作者：
Smith, Ken R.
中科院分区：
文献类型：
--
作者：
Hanson, Heidi A.;Horn, Kevin P.;Smith, Ken R.
几项研究表明，癌症与阿尔茨海默病（AD）发展风险降低有关。本研究旨在通过显示死亡率选择如何改变这种关系来提高我们对癌症与AD发展之间关系的理解。一项回顾性队列研究对来自犹他州人口数据库的92，425名个体（47，873名女性和44，552名男性）进行了检查，这些个体有或没有犹他州癌症登记处确定的任何原发性癌症病史。所有的人年龄在65-79岁，在1992年没有痴呆症，并跟踪了18年以上（1992-2009年）的AD确定，这是确定使用诊断信息从医疗保险索赔data.We重复以前的结果表明，癌症与随后的AD的风险降低特定的统计模型规范。然而，这些结果不应被解释为病因学关联的证据。我们的结论是，较高的整体死亡率与癌症的个体相对于那些没有癌症诱导广泛报道的假定的保护性associationwith cancer. Carefully考虑模型的规格和死亡率选择的深远影响，在老年人的人口是必不可少的，当调查与年龄相关的疾病，如癌症和AD之间的关系。我们表明，癌症并不像以前文献中描述的那样提供对AD的保护。因此，社会科学家寻求了解老年人疾病结果的社会差异，可能要强烈考虑死亡率选择的作用，如果不加以纠正，可能会产生偏见的协会。
Several studies have suggested that cancer is associated with a reduced risk of the development of Alzheimer's disease (AD). This study seeks to improve our understanding of the association between cancer and the development of AD by showing how mortality selection alters this relationship.A retrospective cohort study was carried out examining 92,425 individuals (47,873 women and 44,552 men) from the Utah Population Database with and without a history of any primary cancer identified by the Utah Cancer Registry. All individuals were aged 65-79 years and free of dementia in 1992 and followed for upwards of 18 years (1992-2009) for AD ascertainment, which was identified using diagnostic information from Medicare claims data.We replicate previous results suggesting that cancer is associated with reduced risk of subsequent AD under specific statistical model specifications. However, these results should not be interpreted as evidence of an etiological association. We conclude that higher rates of overall mortality among individuals with cancer relative to those without cancer induce the widely reported putative protective association with cancer.Careful consideration of model specification and the profound effects of mortality selection in the older adult population is essential when investigating the relationship between aging-related diseases such as cancer and AD. We show that cancer does not provide protection from AD as previously described in the literature. Social scientists seeking to understand social disparities in disease outcomes among older adults may therefore want to strongly consider the role of mortality selection which, if uncorrected, may generate biased associations.