Loneliness and risk of Alzheimer disease
Loneliness and risk of Alzheimer disease
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DOI：
10.1001/archpsyc.64.2.234
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发表时间：
2007-02-01
影响因子：
--
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
--
作者：
Wilson, Robert S.;Krueger, Kristin R.;Bennett, David A.
背景：老年的社会隔离与患痴呆症的风险有关，但是与感知到的孤立或孤独感相关的风险并不理解。 。从芝加哥III及其周围地区及其周围的老年人设施招募了入学时没有痴呆症的痴呆症。在基线（平均+/- SD，2.3 +/- 0.6）和此后每年以5个项目量表进行评估。死亡时，对大脑进行了统一的死后检查，以量化多个大脑区域的AD病理，并存在脑梗塞的存在。结果：在随访期间，有76名受试者发展了临床广告。与不孤独的人（得分1.4、10％）相比，孤独的人的AD风险翻了一番（分数为3.2，90％），并且控制社会隔离指标并不影响这一发现。孤独与基线时认知水平较低有关，随访期间认知能力更快。孤独感没有显着变化，在研究期间的平均孤独程度与AD的认知下降和发展牢固相关。在90名死亡并进行大脑尸检的参与者中，孤独与脑梗塞的AD病理学的摘要无关。结论：孤独与晚期痴呆的风险增加有关，而与其主要原因无关。
Context: Social isolation in old age has been associated with risk of developing dementia, but the risk associated with perceived isolation, or loneliness, is not well understood.Objective: To test the hypothesis that loneliness is associated with increased risk of Alzheimer disease (AD).Design: Longitudinal clinicopathologic cohort study with up to 4 years of annual in-home follow-up.Participants: A total of 823 older persons free of dementia at enrollment were recruited from senior citizen facilities in and around Chicago, III. Loneliness was assessed with a 5-item scale at baseline (mean +/- SD, 2.3 +/- 0.6) and annually thereafter. At death, a uniform postmortem examination of the brain was conducted to quantify AD pathology in multiple brain regions and the presence of cerebral infarctions.Main Outcome Measures: Clinical diagnosis of AD and change in previously established composite measures of global cognition and specific cognitive functions.Results: During follow-up, 76 subjects developed clinical AD. Risk of AD was more than doubled in lonely persons (score 3.2, 90th percentile) compared with persons who were not lonely (score 1.4, 10th percentile), and controlling for indicators of social isolation did not affect the finding. Loneliness was associated with lower level of cognition at baseline and with more rapid cognitive decline during follow-up. There was no significant change in loneliness, and mean degree of loneliness during the study was robustly associated with cognitive decline and development of AD. In 90 participants who died and in whom autopsy of the brain was performed, loneliness was unrelated to summary measures of AD pathology of to cerebral infarction.Conclusion: Loneliness is associated with an increased risk of late-life dementia but not with its leading causes.