Relation of diabetes to mild cognitive impairment
Relation of diabetes to mild cognitive impairment
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DOI：
10.1001/archneur.64.4.570
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发表时间：
2007-04-01
影响因子：
--
通讯作者：
Mayeux, Richard
中科院分区：
文献类型：
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作者：
Luchsinger, Jose A.;Reitz, Christiane;Mayeux, Richard
背景资料：2型糖尿病是阿尔茨海默病的一个重要危险因素，与非西班牙裔白色人相比，2型糖尿病在老年少数民族人群中更为普遍。目的：在糖尿病患病率较高的多种族队列中，确定糖尿病是否与轻度认知障碍（MCI）（正常认知与阿尔茨海默病之间的过渡阶段）的较高风险相关。设计：纵向队列研究。设置：北方曼哈顿在纽约，NY。参与者：我们研究的人没有流行的MCI或痴呆症在基线和至少1个随访间隔。在1772名接受完整神经心理学评估的参与者中，19.1%因痴呆而被排除，304例因MCI而被排除（17.2%），211例因失访被排除（11.9%），最终样本为918名参与者进行纵向分析。主要结果指标：我们将自我报告定义的糖尿病与事件全因MCI、遗忘型MCI和非遗忘型MCI相关联。我们进行了多变量分析，采用比例风险回归法调整了年龄、性别、教育年限、种族、载脂蛋白E（APOE）epsilon 4等位基因、高血压、低密度脂蛋白水平、当前吸烟、心脏病和中风。结果：共有334人发生了轻度认知障碍，其中160人（47.9%）患有遗忘型轻度认知障碍，174人（52.1%）患有非遗忘型轻度认知障碍。调整所有协变量后，糖尿病与全因MCI和遗忘型MCI的风险显著升高相关。糖尿病也与非遗忘型MCI的高风险相关，但在调整社会经济变量和血管危险因素后，这种相关性明显减弱。整个样本中糖尿病导致MCI的风险为8.8%，非洲裔美国人的风险更高（8.4%）和西班牙裔人（11.0%）与非西班牙裔白色人相比（4.6%），反映了美国少数民族人群中糖尿病的患病率较高。糖尿病与遗忘型MCI高患病率人群中的较高风险相关。
Background: Type 2 diabetes mellitus is an important risk factor for Alzheimer disease and is more prevalent in elderly minority persons compared with non-Hispanic white persons.Objective: To determine whether diabetes is related to a higher risk of mild cognitive impairment (MCI), a transitional stage between normal cognition and Alzheimer disease, in a multiethnic cohort with a high prevalence of diabetes.Design: Longitudinal cohort study.Setting: Northern Manhattan in New York, NY.Participants: We studied persons without prevalent MCI or dementia at baseline and with at least 1 follow-up interval. Of 1772 participants with a complete neuropsychological evaluation, 339 (19.1%) were excluded because of prevalent dementia, 304 were excluded because of prevalent MCI (17.2%), and 211 were excluded because of loss to follow-up (11.9%), resulting in a final sample of 918 participants for longitudinal analyses.Main Outcome Measures: We related diabetes defined by self-report to incident all-cause MCI, amnestic MCI, and nonamnestic MCI. We conducted multivariate analyses with proportional hazards regression adjusting for age, sex, years of education, ethnic group, apolipoprotein E (APOE) epsilon 4 allele, hypertension, low-density lipoprotein level, current smoking, heart disease, and stroke.Results: A total of 334 persons had incident MCI, 160 (47.9%) had amnestic MCI, and 174 (52.1%) had nonamnestic MCI. Diabetes was related to a significantly higher risk of all-cause MCI and amnestic MCI after adjustment for all covariates. Diabetes was also related to a higher risk of nonamnestic MCI, but this association was appreciably attenuated after adjustment for socioeconomic variables and vascular risk factors. The risk of MCI attributable to diabetes was 8.8% for the whole sample and was higher for African American persons (8.4%) and Hispanic persons (11.0%) compared with non-Hispanic white persons (4.6%), reflecting the higher prevalence of diabetes in minority populations in the United States.Conclusion: Diabetes is related to a higher risk of amnestic MCI in a population with a high prevalence of this disorder.