Risk of dementia hospitalisation associated with cardiovascular risk factors in midlife and older age: the Atherosclerosis Risk in Communities (ARIC) study.
Risk of dementia hospitalisation associated with cardiovascular risk factors in midlife and older age: the Atherosclerosis Risk in Communities (ARIC) study.
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与中年和老年人的心血管危险因素有关的痴呆症住院风险：社区中的动脉粥样硬化风险（ARIC）研究。
DOI：
10.1136/jnnp.2009.176818
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发表时间：
2009-11
影响因子：
11
通讯作者：
Coresh, J.
中科院分区：
文献类型：
--
作者：
Alonso, A.;Mosley, T. H., Jr.;Gottesman, R. F.;Catellier, D.;Sharrett, A. R.;Coresh, J.
心血管危险因素与患痴呆症的风险较高有关。然而，对老年人的研究往往未能显示出这种关系。我们评估了中年时测量的心血管危险因素与痴呆住院风险之间的关联，并确定这种关联是否因年龄和种族而改变。我们在1990-1992年研究了11，151名参与者，年龄在46-70岁之间（23%为非洲裔美国人），当时参与者接受了体格检查和认知测试。到2004年12月，痴呆症住院情况得到了确认。在随访期间，确定了203例痴呆住院病例。在白人和非裔美国人中，吸烟（风险比（HR），95%置信区间（CI）：1.7，1.2-2.5）、高血压（HR，95% CI：1.6，1.2-2.2）和糖尿病（HR，95% CI：2.2，1.6-3.0）与痴呆症密切相关。当在年轻时测量风险因素时，这些关联比在老年时更强。在包括随访期间风险因素更新信息的分析中，高血压与非高血压参与者中痴呆的HR在年龄<55岁时为1.8，而在年龄70岁以上时为1.0。在糖尿病（<55岁的HR 3.4，≥70岁的HR 2.0）、吸烟（<55岁的HR 4.8，≥70岁的HR 0.5）和高胆固醇血症（<55岁的HR 1.7，≥70岁的HR 0.9）中观察到平行结果。在这项前瞻性研究中，吸烟、高血压和糖尿病与随后因痴呆住院的风险密切相关，尤其是在中年人中。我们的研究结果强调了早期生活方式改变和危险因素治疗对预防痴呆症的重要性。
Cardiovascular risk factors are associated with a higher risk of developing dementia. Studies in older populations, however, have often failed to show this relationship. We assessed the association between cardiovascular risk factors measured in midlife and risk of being hospitalized with dementia and determined whether this association was modified by age and ethnicity. We studied 11,151 participants in the population-based Atherosclerosis Risk in Communities cohort, aged 46-70 (23% African Americans) in 1990-1992, when participants underwent a physical exam and cognitive testing. Hospitalizations with dementia were ascertained through December 2004. During follow-up, 203 cases of hospitalization with dementia were identified. Smoking (hazard ratio (HR), 95% confidence interval (CI): 1.7, 1.2-2.5), hypertension (HR, 95% CI: 1.6, 1.2-2.2) and diabetes (HR, 95% CI: 2.2, 1.6-3.0) were strongly associated with dementia, both in whites and African-Americans. These associations were stronger when risk factors were measured at younger age than at older age. In analyses including updated information on risk factors during follow-up, the HR of dementia in hypertensive versus non-hypertensive participants was 1.8 at age <55 years compared to 1.0 at age 70+ years. Parallel results were observed for diabetes (HR 3.4 in <55, 2.0 in ≥70), smoking (4.8 in <55, 0.5 in ≥70), and hypercholesterolemia (HR 1.7 in <55, 0.9 in ≥70) In this prospective study, smoking, hypertension, and diabetes were strongly associated with subsequent risk of hospitalization with dementia, particularly in middle aged individuals. Our results emphasize the importance of early lifestyle modification and risk factor treatment to prevent dementia.
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影响因子：
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作者：
Kivipelto, M;Ngandu, T;Nissinen, A
通讯作者：
Nissinen, A
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作者：
Forette, F;Seux, ML;Birkenhäger, WH
通讯作者：
Birkenhäger, WH
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9.9
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Jin, P;Gatz, M;Pedersen, NL
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Pedersen, NL
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5
作者：
Luchsinger, JA;Tang, MX;Mayeux, R
通讯作者：
Mayeux, R
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4.9
作者：
Lithell, H;Hansson, L;Zanchetti, A
通讯作者：
Zanchetti, A