Midlife psychological stress and risk of dementia: a 35-year longitudinal population study
Midlife psychological stress and risk of dementia: a 35-year longitudinal population study
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DOI：
10.1093/brain/awq116
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发表时间：
2010-08-01
期刊：
影响因子：
14.5
通讯作者：
Skoog, Ingmar
中科院分区：
文献类型：
--
作者：
Johansson, Lena;Guo, Xinxin;Skoog, Ingmar
随着全球老龄化，痴呆症患者人数急剧增加。然而，这些疾病的发病机制还没有得到充分的了解。本研究旨在分析中年心理压力与老年痴呆发展的关系。在1968-69年对38-60岁的女性样本（n = 1462）进行了检查，并在1974-75年、1980-81年、1992-93年和2000-03年重新进行了检查。心理压力是根据1968年、1974年和1980年的标准化问题进行评分的。根据《精神疾病诊断和统计手册》的标准，根据来自神经精神检查、信息提供者访谈、医院记录和登记数据的信息，诊断出痴呆症。在35年的随访中，161名女性患上了痴呆症（105名患有阿尔茨海默病，40名患有血管性痴呆，16名患有其他痴呆症）。我们发现，1968年（1.60,1.10-2.34）、1974年（1.65,1.12-2.41）和1980年（1.60,1.01-2.52）报告频繁/持续压力的女性患痴呆的风险（风险比，95%置信区间）增加。1968年和1974年报道的频繁/持续的压力与阿尔茨海默病有关。在一次、两次或三次检查中报告压力与痴呆风险依次升高有关。与报告无压力的女性相比，在一次检查中报告频繁/持续压力的女性发生痴呆的风险比（95%置信区间）为1.10(0.71-1.71)，在两次检查中报告压力的女性为1.73(1.01-2.95)，在三次检查中报告压力的女性为2.51（1.33-4.77）。总之，我们发现中年妇女的心理压力与痴呆症的发展，特别是阿尔茨海默病之间存在关联。需要更多的研究来证实我们的发现，并研究这些关联的潜在神经生物学机制。
The number of people with dementia has increased dramatically with global ageing. Nevertheless, the pathogeneses of these diseases are not sufficiently understood. The present study aims to analyse the relationship between psychological stress in midlife and the development of dementia in late-life. A representative sample of females (n = 1462) aged 38-60 years were examined in 1968-69 and re-examined in 1974-75, 1980-81, 1992-93 and 2000-03. Psychological stress was rated according to a standardized question in 1968, 1974 and 1980. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders criteria based on information from neuropsychiatric examinations, informant interviews, hospital records and registry data. During the 35-year follow-up, 161 females developed dementia (105 Alzheimer's disease, 40 vascular dementia and 16 other dementias). We found that the risk of dementia (hazard ratios, 95% confidence intervals) was increased in females reporting frequent/constant stress in 1968 (1.60, 1.10-2.34), in 1974 (1.65, 1.12-2.41) and in 1980 (1.60, 1.01-2.52). Frequent/constant stress reported in 1968 and 1974 was associated with Alzheimer's disease. Reporting stress at one, two or three examinations was related to a sequentially higher dementia risk. Compared to females reporting no stress, hazard ratios (95% confidence intervals) for incident dementia were 1.10 (0.71-1.71) for females reporting frequent/constant stress at one examination, 1.73 (1.01-2.95) for those reporting stress at two examinations and 2.51 (1.33-4.77) at three examinations. To conclude, we found an association between psychological stress in middle-aged women and development of dementia, especially Alzheimer's disease. More studies are needed to confirm our findings and to study potential neurobiological mechanisms of these associations.