Association between age at onset of multimorbidity and incidence of dementia: 30 year follow-up in Whitehall II prospective cohort study.
Association between age at onset of multimorbidity and incidence of dementia: 30 year follow-up in Whitehall II prospective cohort study.
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DOI：
10.1136/bmj-2021-068005
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发表时间：
2022-02-02
影响因子：
105.7
通讯作者：
Singh-Manoux, Archana
中科院分区：
文献类型：
--
作者：
Ben Hassen, Celine;Fayosse, Aurore;Landre, Benjamin;Raggi, Martina;Bloomberg, Mikaela;Sabia, Severine;Singh-Manoux, Archana
研究中年和晚年多发性痴呆症的相关性，包括多发性痴呆症的严重程度与痴呆症的发生。前瞻性队列研究。伦敦的公务员部门（白厅II研究，1985-88年开始研究）。10 095名参与者，基线年龄为35至55岁。1985年至2019年随访时的痴呆事件。原因特异性考克斯比例风险回归被用来检查总体和55岁、60岁、65岁和70岁时多Mortality与随后的痴呆症的相关性，同时考虑到死亡的竞争风险。55岁和70岁时多发病（≥2种慢性疾病）的患病率分别为6.6%（655/9937）和31.7%（2464/7783）;在中位随访31.7年期间发生了639例偶发性痴呆。在调整社会人口因素和健康行为后，55岁时的多发病与随后的痴呆风险相关（每1000人年的发病率差异为1.56，95%置信区间为0.62至2.77;风险比为2.44，95%置信区间为1.82至3.26）。这种关联随着多发性硬化症发病年龄的增大而逐渐减弱。在65岁时，55岁之前发生多Morphosis与3.86（1.80 - 6.52）每1000人年痴呆症发病率高（风险比2.46，1.80至2.26），60至65岁之间发病与1.85（0.64 ~ 3.39）每1000人年发病率高（1.51，1.16 ~ 1.97）。多发性硬化的严重程度（≥3种慢性疾病）与5.22（1.14至11.95）每1000人年痴呆症发病率较高（风险比4.96，2.54至9.67）; 70岁时的相同分析显示每1000人年4.49（2.33至7.19）的发病率较高（1.65，1.25至2.18）。多发性痴呆，特别是在中年而不是晚年发病时，与随后的痴呆有很强的关联。多发性硬化症发病年龄越来越小，这使得预防首次慢性病患者的多发性硬化症非常重要。
To examine the association of midlife and late life multimorbidity, including severity of multimorbidity, with incident dementia. Prospective cohort study. Civil service departments in London (Whitehall II study, study inception in 1985-88). 10 095 participants, aged 35 to 55 at baseline. Incident dementia at follow-up between 1985 and 2019. Cause specific Cox proportional hazards regression was used to examine the association of multimorbidity overall and at age 55, 60, 65, and 70 with subsequent dementia, taking into account the competing risk of death. The prevalence of multimorbidity (≥2 chronic diseases) was 6.6% (655/9937) at age 55 and 31.7% (2464/7783) at age 70; 639 cases of incident dementia occurred over a median follow-up of 31.7 years. After adjustment for sociodemographic factors and health behaviours, multimorbidity at age 55 was associated with subsequent risk of dementia (difference in incidence rate per 1000 person years 1.56, 95% confidence interval 0.62 to 2.77; hazard ratio 2.44, 95% confidence interval 1.82 to 3.26). The association weakened progressively with older age at onset of multimorbidity. At age 65, onset of multimorbidity before age 55 was associated with 3.86 (1.80 to 6.52) per 1000 person years higher incidence of dementia (hazard ratio 2.46, 1.80 to 2.26) and onset between 60 and 65 was associated with 1.85 (0.64 to 3.39) per 1000 person years higher incidence (1.51, 1.16 to 1.97). Severity of multimorbidity (≥3 chronic diseases) at age 55 was associated with a 5.22 (1.14 to 11.95) per 1000 person years higher incidence of dementia (hazard ratio 4.96, 2.54 to 9.67); the same analyses at age 70 showed 4.49 (2.33 to 7.19) per 1000 person years higher incidence (1.65, 1.25 to 2.18). Multimorbidity, particularly when onset is in midlife rather than late life, has a robust association with subsequent dementia. The increasingly younger age at onset of multimorbidity makes prevention of multimorbidity in people with a first chronic disease important.
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影响因子：
168.9
作者：
McKee, Martin;Dunnell, Karen;Anderson, Michael;Brayne, Carol;Charlesworth, Anita;Johnston-Webber, Charlotte;Knapp, Martin;McGuire, Alistair;Newton, John N.;Taylor, David;Watt, Richard G.
通讯作者：
Watt, Richard G.
DOI：
10.1038/npjparkd.2016.18
发表时间：
2016
期刊：
NPJ Parkinson's disease
影响因子：
--
作者：
Biundo R;Weis L;Antonini A
通讯作者：
Antonini A
影响因子：
120.7
作者：
Amidei, Claudio Barbiellini;Fayosse, Aurore;Singh-Manoux, Archana
通讯作者：
Singh-Manoux, Archana
影响因子：
4
作者：
Lee, Yura;Cho, Chi C.
通讯作者：
Cho, Chi C.
影响因子：
81.5
作者：
Aarsland, Dag;Batzu, Lucia;Weintraub, Daniel
通讯作者：
Weintraub, Daniel