Marital status and risk of Alzheimer's disease - A French population-based cohort study
Marital status and risk of Alzheimer's disease - A French population-based cohort study
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DOI：
10.1212/wnl.53.9.1953
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发表时间：
1999-12-10
期刊：
影响因子：
9.9
通讯作者：
Dartigues, JF
中科院分区：
文献类型：
--
作者：
Helmer, C;Damon, D;Dartigues, JF
目的：分析婚姻状况与阿尔茨海默病、痴呆症发病风险的关系。方法：本研究从老年人队列(PAQUID)队列中进行，这是一项关于65岁后正常和病理性老龄化的流行病学研究。PAQUID队列始于1988年。在1年、3年和5年对个体进行了跟踪，并积极检测到痴呆症。婚姻状况分为四类：丧偶、从未结婚、离婚或分居，以及参照类别，已婚或同居。采用延迟进入的Cox模型分析婚姻状况与AD或痴呆发病风险的纵向关系。结果：在3675名最初没有痴呆的人中，2106人已婚或同居，1287人丧偶，179人从未结婚，103人离婚或分居。在5年的随访中，2881名至少重新评估过一次痴呆症风险的人中，发现了190例痴呆症病例，其中包括140例阿尔茨海默病。未婚者患痴呆症(RR=1.91，p=0.018)和AD的相对危险度(RR=2.68，p<；0.001)均高于已婚或同居者。这种过度的风险特别与AD有关。调整痴呆症的其他危险因素(教育、饮酒)，或反映社会环境、休闲活动和抑郁的因素，没有改变从未结婚的人患AD的风险(RR=2.31，p=0.02)。结论：我们证实了婚姻状况和AD之间的联系，在从未结婚的人中观察到了额外的风险。这种联系可能为AD的发病机制提供线索。
Objective: To analyze the relationship between marital status and risk of AD or dementia. Methods: This study was carried out from the Personnes Agees QUID (PAQUID) cohort, an epidemiologic study on normal and pathologic aging after age 65 years. The PAQUID cohort began in 1988. Individuals were followed up at 1, 3, and 5 years, with an active detection of dementia. Marital status was divided into four categories: widowed, never married, divorced or separated, and the reference category, married or cohabitant. The longitudinal relationship between marital status and risk of incident AD or dementia was analyzed by a Cox model with delayed entry. Results: Among the 3,675 individuals initially not demented, 2,106 were married or cohabitants, 1,287 were widowers, 179 were never married, and 103 were divorced or separated. Among the 2,881 individuals reevaluated at least once for the risk of dementia during the 5-year follow-up, 190 incident cases of dementia were identified, including 140 with AD. The relative risks (RRs) of dementia (RR = 1.91, p = 0.018) and of AD (RR = 2.68, p < 0.001) were increased for the never-married individuals compared with those who were married or cohabitants. This excess of risk was specifically associated with AD. Adjustment for other risk factors of dementia (education, wine consumption), or for factors reflecting social environment, leisure activities, and depression, did not modify the risk of AD for never-married individuals (RR = 2.31,p = 0.02). Conclusions: We confirmed an association between marital status and AD, with an excess risk observed among never-married individuals. This association may provide clues about the pathogenesis of AD.