Estimating the risk for conversion from mild cognitive impairment to Alzheimer's disease in an elderly Arab community.
Estimating the risk for conversion from mild cognitive impairment to Alzheimer's disease in an elderly Arab community.
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DOI：
10.3233/jad-142871
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Friedland RP
中科院分区：
文献类型：
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作者：
Inzelberg R;Massarwa M;Schechtman E;Strugatsky R;Farrer LA;Friedland RP
血管危险因素和缺乏正规教育可能会增加患阿尔茨海默病的风险。确定血管危险因素和教育对轻度认知障碍（MCI）和阿尔茨海默病（AD）风险的影响，并估计从MCI转换为AD的风险。这项挨家挨户的调查是由一个讲阿拉伯语的小组在以色列的Wadi Ara村庄进行的。对所有年龄≥ 65岁的知情居民进行病史访谈，并进行神经和认知检查。个体认知分类为正常（CN）、MCI、AD、血管性痴呆（VD）或不可分类。MCI患者至少在一年后重新检查以确定是否转化为AD。使用逻辑回归模型估计年龄、性别、受教育年限和血管危险因素对转换概率的贡献。在906名参与者中，297名（33%）患有MCI，95名（10%）患有AD。与CN相比，年龄较大（p=0.0008）、女性（p=0.023）、受教育程度低（p<0.0001）和高血压（p=0.0002）是MCI的显著风险因素，糖尿病处于临界状态（p=0.051）。AD与CN的风险与年龄（p<0.0001）、女性（p<0.0001）、低学历（p=0.004）和高血压（p=0.049）显著相关。在重新检查的231名MCI受试者中，有65名转化为AD。在该人群中，年龄、女性、缺乏正规教育和高血压是AD和MCI的危险因素。从MCI到AD的转换风险可以估计为年龄、检查间隔时间和高血压的函数。
Vascular risk factors and lack of formal education may increase the risk of Alzheimer’s disease. To determine the contribution of vascular risk factors and education to the risk of Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) and to estimate the risk for conversion from MCI to AD. This door-to-door survey was performed by an Arab-speaking team in Wadi Ara villages in Israel. All consenting residents aged≥ 65 years were interviewed for medical history and underwent neurological and cognitive examinations. Individuals were cognitively classified as normal (CN), MCI, AD, vascular dementia (VD) or unclassifiable. MCI patients were re-examined at least one year later to determine conversion to AD. The contributions of age, gender, school years and vascular risk factors to the probability of conversion were estimated using logistic regression models. Of the 906 participants, 297 (33%) had MCI and 95 (10%) had AD. Older age (p=0.0008), female gender (p=0.023), low schooling (p<0.0001), and hypertension (p=0.0002) significantly accounted for risk of MCI vs. CN, and diabetes was borderline (p=0.051). The risk of AD vs. CN was significantly associated with age (p<0.0001), female gender (p<0.0001), low schooling (p=0.004) and hypertension (p=0.049). Of the 231 subjects with MCI that were re-examined, 65 converted to AD. In this population, age, female gender, lack of formal education and hypertension are risk factors for both AD and MCI. Conversion risk from MCI to AD could be estimated as a function of age, time interval between examinations and hypertension.