Risk factors for age at onset of dementia due to Alzheimer's disease in a sample of patients with low mean schooling from Sao Paulo, Brazil
Risk factors for age at onset of dementia due to Alzheimer's disease in a sample of patients with low mean schooling from Sao Paulo, Brazil
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DOI：
10.1002/gps.4094
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发表时间：
2014-10-01
影响因子：
4
通讯作者：
Smith, Marilia Cardoso
中科院分区：
文献类型：
--
作者：
de Oliveira, Fabricio Ferreira;Ferreira Bertolucci, Paulo Henrique;Smith, Marilia Cardoso
目的：鉴于阿尔茨海默病（AD）所致痴呆的药物治疗效果轻微，寻找可改变的危险因素是一个重要的挑战。虽然阿尔茨海默病的危险因素已被广泛认识，但影响痴呆综合征发病时间的因素尚未全面报道。我们的目的是调查哪些风险因素可能与来自巴西圣保罗的低平均学校教育患者的发病年龄相关。方法：连续纳入210例迟发性AD患者，调查教育程度、性别、国籍、城市生活和卫生、职业、认知和缺乏运动、头部创伤、抑郁、全身性感染、手术干预、脑血管危险因素、神经退行性疾病或心血管疾病家族史、载脂蛋白E基因（APOE）单倍型是否与AD发病年龄相关。结果：每个APOE-epsilon 4拷贝导致AD的发病时间几乎提前2年，而抑郁、吸烟、较高的体重指数和心血管疾病家族史也具有高度显著性。保护因素包括非巴西国籍、使用起搏器和腰围。脑血管危险因素对阿尔茨海默病的早期发病有轻微的综合影响。结论：APOE单倍型、抑郁、国籍和脑血管危险因素是影响本组患者AD发病年龄的最重要因素，而性别、受教育程度、职业和体育活动对AD发病年龄没有孤立影响。版权所有：John Wiley & Sons， Ltd
Objective: In view of the mild effects of pharmacological treatment for dementia due to Alzheimer's disease (AD), the search for modifiable risk factors is an important challenge. Although risk factors for AD are widely recognized, elements that influence the time of onset of the dementia syndrome have not been comprehensively reported. We aimed to investigate which risk factors might be associated with the age at onset of AD in a sample of patients with low mean schooling from Sao Paulo, Brazil.Methods: We included 210 consecutive patients with late-onset AD to investigate whether education, gender, nationality, urban living and sanitation, occupation, cognitive and physical inactivity, head trauma, depression, systemic infections, surgical interventions, cerebrovascular risk factors, family history of neurodegenerative diseases or cardiovascular diseases and apolipoprotein E gene (APOE) haplotypes might be related to the age at AD onset.Results: Each copy of APOE-epsilon 4 led to onset of AD almost 2 years earlier, while depression, smoking, higher body mass index and family history of cardiovascular diseases were also highly significant. Protective factors included non-Brazilian nationality, use of a pacemaker and waist circumference. Cerebrovascular risk factors had a mild combined effect for earlier onset of AD.Conclusion: APOE haplotypes, depression, nationality and cerebrovascular risk factors were the most important elements to influence the age at AD onset in this sample, whereas gender, education, occupation and physical activities had no isolated effects over the age at onset of this dementia syndrome. Copyright (C) 2014 John Wiley & Sons, Ltd.