The potential for prevention of dementia across two decades: the prospective, population-based Rotterdam Study.
The potential for prevention of dementia across two decades: the prospective, population-based Rotterdam Study.
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DOI：
10.1186/s12916-015-0377-5
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发表时间：
2015-07-21
期刊：
影响因子：
9.3
通讯作者：
Ikram MA
中科院分区：
文献类型：
--
作者：
de Bruijn RF;Bos MJ;Portegies ML;Hofman A;Franco OH;Koudstaal PJ;Ikram MA
心血管因素和文化程度低是痴呆的重要危险因素。我们提供了对如果消除可改变的风险因素（即，人群归因风险（PAR）。此外，我们还研究了PAR在过去二十年中是否发生了变化。我们纳入了鹿特丹研究原始队列（从1990年开始）的7,003名参与者和扩展队列（从2000年开始）的2,953名参与者。两个队列的痴呆症随访至基线后10年。我们计算了超重、高血压、糖尿病、胆固醇、吸烟和教育的PAR。此外，我们还评估了中风、冠心病、心力衰竭和房颤的PAR。我们分别计算了每个风险因素的PAR，并考虑到风险因素的相互作用，计算了合并的PAR。在57，996人年期间，原始队列的624名参与者患上了痴呆症，在26，177人年期间，扩展队列的145名参与者患上了痴呆症。原始队列的合并PAR为0.23（95% CI，0.05-0.62）。扩展队列的PAR略高，为0.30（95% CI，0.06-0.76）。原始队列中包括心血管疾病的合并PAR为0.25（95%CI，0.07-0.62），扩展队列中为0.33（95%CI，0.07-0.77）。如果消除可改变的风险因素，很大一部分痴呆症病例是可以预防的。虽然心血管危险因素和疾病的预防和治疗方案有所改善，但在过去二十年中，痴呆症的预防潜力并没有下降。
Cardiovascular factors and low education are important risk factors of dementia. We provide contemporary estimates of the proportion of dementia cases that could be prevented if modifiable risk factors were eliminated, i.e., population attributable risk (PAR). Furthermore, we studied whether the PAR has changed across the last two decades. We included 7,003 participants of the original cohort (starting in 1990) and 2,953 participants of the extended cohort (starting in 2000) of the Rotterdam Study. Both cohorts were followed for dementia until ten years after baseline. We calculated the PAR of overweight, hypertension, diabetes mellitus, cholesterol, smoking, and education. Additionally, we assessed the PAR of stroke, coronary heart disease, heart failure, and atrial fibrillation. We calculated the PAR for each risk factor separately and the combined PAR taking into account the interaction of risk factors. During 57,996 person-years, 624 participants of the original cohort developed dementia, and during 26,177 person-years, 145 participants of the extended cohort developed dementia. The combined PAR in the original cohort was 0.23 (95 % CI, 0.05–0.62). The PAR in the extended cohort was slightly higher at 0.30 (95 % CI, 0.06–0.76). The combined PAR including cardiovascular diseases was 0.25 (95 % CI, 0.07–0.62) in the original cohort and 0.33 (95 % CI, 0.07–0.77) in the extended cohort. A substantial part of dementia cases could be prevented if modifiable risk factors would be eliminated. Although prevention and treatment options of cardiovascular risk factors and diseases have improved, the preventive potential for dementia has not declined over the last two decades.