Relationship of subjective cognitive impairment and cognitive impairment no dementia to chronic disease and multimorbidity in a nation-wide twin study.
Relationship of subjective cognitive impairment and cognitive impairment no dementia to chronic disease and multimorbidity in a nation-wide twin study.
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DOI：
10.3233/jad-122050
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Fratiglioni L
中科院分区：
文献类型：
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作者：
Caracciolo B;Gatz M;Xu W;Marengoni A;Pedersen NL;Fratiglioni L
探讨常见慢性病和多发性硬化与主观认知功能障碍（SCI）和非痴呆性认知功能障碍（CIND）的关系，并探讨遗传背景和共同的家庭环境对这些关系的影响。基于人口的双胞胎研究。瑞典双胞胎来自瑞典双胞胎登记处的11，379名年龄≥ 65岁的无痴呆个体。SCI定义为无客观认知损害的认知改变的主观主诉，CIND按标准定义确定。根据国际标准对慢性病进行分类，多发病被评估为同一个体中至少两种慢性病的同时发生。在不匹配的、完全校正的回归模型中，肌肉骨骼、呼吸和泌尿系统疾病与SCI和CIND的比值比（OR）增加显著相关。循环系统和胃肠道疾病与SCI有关，而内分泌疾病与CIND有关。SCI和CIND的多药耐药校正OR分别为2.1 [95%置信区间（95% CI）：1.8-2.3]和1.5（95% CI：1.3-1.8）。慢性疾病的数量与SCI的OR之间存在显著的剂量依赖关系，但与CIND无关。在双胞胎对照分析中，慢性疾病与SCI的相关性仍然显著，但与CIND的相关性不再具有统计学显著性。慢性疾病与SCI和CIND都有关联，并且当存在多发病时，这种关联更强。遗传和共同的环境因素可能部分解释CIND的相关性，但不能解释SCI与慢性疾病的相关性。
To examine the association of common chronic disease and multimorbidity with subjective cognitive impairment (SCI) and cognitive impairment no-dementia (CIND), and to explore the contribution of genetic background and shared familial environment to these associations. Population-based twin study. Nationwide Swedish twins. 11,379 dementia-free individuals aged ≥ 65 from the Swedish Twin Registry. SCI was defined as subjective complaint of cognitive change without objective cognitive impairment, and CIND was ascertained according to the standard definition. Chronic diseases were classified based on international criteria, and multimorbidity was assessed as the co-occurrence of at least two chronic diseases in the same individual. In unmatched, fully-adjusted regression models, musculoskeletal, respiratory, and urological diseases were significantly associated with increased odds ratios (ORs) of both SCI and CIND. Circulatory and gastrointestinal disorders were related to SCI, while endocrine diseases were associated with CIND. The adjusted ORs of multimorbidity were 2.1 [95% Confidence Intervals (95% CI): 1.8–2.3] for SCI and 1.5 for CIND (95% CI: 1.3–1.8). There was a significant dose-dependent relationship between number of chronic diseases and ORs for SCI but not for CIND. In co-twin control analyses, the chronic diseases-SCI association remained significant but the association with CIND was no longer statistically significant. Chronic diseases are associated with both SCI and CIND and the association is stronger when there is multimorbidity. Genetic and shared environmental factors may partially explain the association of CIND but not that of SCI with chronic diseases.