Population studies of sporadic cerebral amyloid angiopathy and dementia: a systematic review.
Population studies of sporadic cerebral amyloid angiopathy and dementia: a systematic review.
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DOI：
10.1186/1471-2377-9-3
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发表时间：
2009-01-13
期刊：
影响因子：
2.6
通讯作者：
Brayne C
中科院分区：
文献类型：
--
作者：
Keage HA;Carare RO;Friedland RP;Ince PG;Love S;Nicoll JA;Wharton SB;Weller RO;Brayne C
淀粉样蛋白-β (Aβ) 在大脑血管壁中沉积为脑淀粉样血管病 (CAA)，可能是痴呆发病机制的主要因素。在这里，我们调查老年人群中痴呆症与 CAA 患病率之间的关系。我们在文献中检索了基于人群的前瞻性流行病学临床病理学研究，排除了其他抽样技术的偏差，并将其用作比较。为了确定评估 CAA 和痴呆症的基于人群的研究，采用了之前对基于人群的衰老和痴呆症临床病理学研究的系统回顾。为了确定选定的样本研究，使用术语“淀粉样血管病”检索了 PsychInfo（1806 年 - 2008 年 4 月第 3 周）、OVID MEDLINE（1950 年 - 2008 年 4 月第 2 周）和 Pubmed（检索于 2008 年 4 月 21 日）数据库。这些数据库还用于搜索先前系统评价中未包含的任何基于人群的研究。如果研究报告了与痴呆分类（临床或神经病理学）相关的 CAA 患病率，则研究被纳入。确定了四项基于人群的研究。他们发现，平均 55-59% 的痴呆症患者患有 CAA（任何严重程度），而非痴呆症患者的这一比例为 28-38%。 37-43% 的痴呆症患者表现出严重的 CAA，而非痴呆症患者的这一比例为 7-24%。这些平均值的范围没有重叠，而且变化较小，低于 38 个选定样本研究中报告的水平（痴呆症与非痴呆症：无论严重程度如何，32-100 比 0-77%；仅对于严重程度，0-50 比 0-11%）。与非痴呆人群相比，痴呆人群的 CAA 患病率始终较高。这支持了 CAA 在痴呆发病机制中的重要作用。
Deposition of amyloid-β (Aβ) in vessel walls of the brain as cerebral amyloid angiopathy (CAA) could be a major factor in the pathogenesis of dementia. Here we investigate the relationship between dementia and the prevalence of CAA in older populations. We searched the literature for prospective population-based epidemiological clinicopathological studies, free of the biases of other sampling techniques, which were used as a comparison. To identify population-based studies assessing CAA and dementia, a previous systematic review of population-based clinicopathological studies of ageing and dementia was employed. To identify selected-sample studies, PsychInfo (1806–April Week 3 2008), OVID MEDLINE (1950–April Week 2 2008) and Pubmed (searched 21 April 2008) databases were searched using the term "amyloid angiopathy". These databases were also employed to search for any population-based studies not included in the previous systematic review. Studies were included if they reported the prevalence of CAA relative to a dementia classification (clinical or neuropathological). Four population-based studies were identified. They showed that on average 55–59% of those with dementia displayed CAA (of any severity) compared to 28–38% of the non-demented. 37–43% of the demented displayed severe CAA in contrast to 7–24% of the non-demented. There was no overlap in the range of these averages and they were less variable and lower than those reported in 38 selected sample studies (demented v non-demented: 32–100 v 0–77% regardless of severity; 0–50 v 0–11% for severe only). CAA prevalence in populations is consistently higher in the demented as compared to the non-demented. This supports a significant role for CAA in the pathogenesis of dementia.
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