Association of a wide range of chronic diseases and apolipoprotein E4 genotype with subsequent risk of dementia in community-dwelling adults: A retrospective cohort study.
Association of a wide range of chronic diseases and apolipoprotein E4 genotype with subsequent risk of dementia in community-dwelling adults: A retrospective cohort study.
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各种慢性疾病和载脂蛋白E4基因型与随后在社区居民成年人中的痴呆症风险的关联：回顾性队列研究。
DOI：
10.1016/j.eclinm.2022.101335
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发表时间：
2022-03
影响因子：
15.1
通讯作者：
He M
中科院分区：
文献类型：
--
作者：
Shang X;Zhu Z;Zhang X;Huang Y;Zhang X;Liu J;Wang W;Tang S;Yu H;Ge Z;Yang X;He M
确定多种疾病和多发病以及载脂蛋白E4 （APOE4）与痴呆之间独立和相互作用的关联可能有助于促进认知健康。本研究的主要目的是调查这些疾病及其多发病与痴呆的关系。在这项回顾性队列研究中，我们纳入了471485名来自英国生物银行的欧洲血统个体，基线年龄为38-73岁（2006 - 2010）。通过住院记录和死亡登记簿确定痴呆。随访期为2006年3月16日至2021年1月31日。在中位11.9年的随访期间，记录了6189例突发全因痴呆（503例年轻发病，5686例晚发）。在多变量调整分析中，63种主要疾病中有33种与痴呆风险增加有关。肥胖的危险比（HR [95% CI]）为1.12(1.06 - 1.19)，帕金森病的危险比为14.22（12.33 - 16.18）。除传统疾病外，呼吸系统疾病、肌肉骨骼疾病、消化系统疾病、疼痛状况和慢性肾脏疾病也与痴呆风险增加有关。痴呆的HR在更多的疾病中更大（≥6种疾病的HR为3.97[3.51 - 4.48]，而无疾病的HR为3.51 - 4.48]）。这些个体疾病和多发病比晚发性痴呆更能预测早发性痴呆。纳入多病、年龄和APOE4状态的痴呆风险评分具有较强的预测效果（曲线下面积[95% CI]: 82.2%[86.7% - 82.7%]）。APOE4对晚发型痴呆的预测力（HR [95% CI]: 2.90[2.75 ~ 3.06]）高于对年轻发型痴呆的预测力（HR [95% CI]: 1.26[1.03 ~ 1.54]）。在非apoe4携带者中，疼痛、抑郁、肥胖、糖尿病、中风、帕金森病、高胆固醇及其与痴呆的多重发病率之间的关联更强。除了传统疾病外，许多疾病都与痴呆症的风险增加有关。这些个体疾病和多病更能预测年轻发病的痴呆，而APOE4更能预测晚发性痴呆。个体疾病和多病性是非apoe4携带者痴呆的较强预测因子。虽然在分析中对多个危险因素进行了调整，但未知因素的潜在混淆可能会使相关性产生偏差。眼科国家重点实验室基本科研业务费项目，广州市金融业从业人员健康状况调查项目（Z012014075），广州市科技计划项目（202,002,020,049）。
Identifying independent and interactive associations of a wide range of diseases and multimorbidity and apolipoprotein E4 (APOE4) with dementia may help promote cognitive health. The main aim of the present study was to investigate associations of such diseases and their multimorbidity with incident dementia. In this retrospective cohort study, we included 471,485 individuals of European ancestry from the UK Biobank, aged 38–73 years at baseline (2006–10). Dementia was identified using inpatient records and death registers. The follow-up period was between March 16, 2006, and Jan 31, 2021. During a median follow-up of 11·9 years, 6189 cases of incident all-cause dementia (503 young-onset cases, 5686 late-onset cases) were documented. In multivariable-adjusted analysis, 33 out of 63 major diseases were associated with an increased risk of dementia. The hazard ratio (HR [95% CI]) ranged from 1·12 (1·06–1·19) for obesity to 14·22 (12·33–16·18) for Parkinson's disease. In addition to conventional diseases, respiratory disorders, musculoskeletal disorders, digestive disorders, painful conditions, and chronic kidney disease were associated with increased dementia risk. A larger HR for dementia was observed for a larger number of diseases (3·97 [3·51–4·48] for ≥6 diseases versus no disease). These individual diseases and multimorbidity were more predictive of young-onset dementia than of late-onset dementia. Dementia risk score incorporating multimorbidity, age, and APOE4 status had strong prediction performance (area under the curve [95% CI]: 82·2% [81·7–82·7%]). APOE4 was more predictive of late-onset dementia (HR [95% CI]: 2·90 [2·75–3·06]) than of young-onset dementia (1·26 [1·03–1·54]). Associations of painful conditions, depression, obesity, diabetes, stroke, Parkinson's disease, high cholesterol, and their multimorbidity with incident dementia were stronger among non-APOE4 carriers. Besides conventional diseases, numerous diseases are associated with an increased risk of dementia. These individual diseases and multimorbidity are more predictive of young-onset dementia, whereas APOE4 is more predictive of late-onset dementia. Individual diseases and multimorbidity are stronger predictors of dementia in non-APOE4 carriers. Although multiple risk factors have been adjusted for in the analysis, potential confounding from unknown factors may have biased the associations. The Fundamental Research Funds of the State Key Laboratory of Ophthalmology, Project of Investigation on Health Status of Employees in Financial Industry in Guangzhou, China (Z012014075), Science and Technology Program of Guangzhou, China (202,002,020,049).
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影响因子：
64.8
作者：
Bycroft C;Freeman C;Petkova D;Band G;Elliott LT;Sharp K;Motyer A;Vukcevic D;Delaneau O;O'Connell J;Cortes A;Welsh S;Young A;Effingham M;McVean G;Leslie S;Allen N;Donnelly P;Marchini J
通讯作者：
Marchini J
全球痴呆症死亡率：2019 年全球疾病负担研究新方法的应用和结果。
DOI：
10.1002/trc2.12200
发表时间：
2021
期刊：
Alzheimer's & dementia (New York, N. Y.)
影响因子：
--
作者：
GBD 2019 Collaborators
通讯作者：
GBD 2019 Collaborators
影响因子：
2.1
作者：
Rajan, Kumar B.;Aggarwal, Neelum T.;Evans, Denis A.
通讯作者：
Evans, Denis A.
影响因子：
14
作者：
通讯作者：
--
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y