Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease
Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease
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DOI：
10.1001/archneur.62.10.1556
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发表时间：
2005-10-01
影响因子：
--
通讯作者：
Nissinen, A
中科院分区：
文献类型：
--
作者：
Kivipelto, M;Ngandu, T;Nissinen, A
背景：血管危险因素在痴呆的发展中起作用，包括阿尔茨海默病（AD）。然而，关于身体质量指数和血管危险因素聚类对痴呆发展的影响知之甚少。目的：探讨中年体重指数与血管危险因素聚类与老年痴呆和AD的关系。设计和环境：心血管危险因素、衰老和痴呆（CAIDE）研究的参与者来自1972年、1977年、1982年或1987年进行的一项调查中随机、基于人群的样本。经过21年的平均随访，1998年有1449例（73%）65 ~ 79岁的患者参加了复查。主要结局指标：痴呆和AD。结果：即使在调整社会人口学变量后，中年肥胖（体重指数> 30 kg/m(2)）与痴呆和AD的风险相关（优势比[OR]， 2.4[95%置信区间（CI）， 1.2-5.1]）。通过进一步调整中年血压、总胆固醇水平和吸烟（OR, 2.1 [95% CI, 1.0-4.6]）以及载脂蛋白E基因型和血管疾病史（OR, 1.9 [95% CI, 0.8-4.6]），这种关联有所改变。中年肥胖、高总胆固醇水平和高收缩压都是痴呆的重要危险因素，每个因素的OR约为2，并且它们会增加风险（组合的OR为6.2）。结论：中年肥胖与老年痴呆和阿尔茨海默病的风险增加有关。血管危险因素的聚集性以累加的方式增加了风险。减肥对预防痴呆的作用还需要进一步研究。
Background: Vascular risk factors play a role in the development of dementia, including Alzheimer disease (AD). However, little is known about the effect of body mass index and clustering of vascular risk factors on the development of dementia.Objective: To investigate the relation between midlife body mass index and clustering of vascular risk factors and subsequent dementia and AD.Design and Setting: Participants of the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study were derived from random, population-based samples previously studied in a survey carried out in 1972, 1977, 1982, or 1987. After an average follow-up of 21 years, 1449 individuals (73%) aged 65 to 79 years participated in the reexamination in 1998.Main Outcome Measures: Dementia and AD.Results: Obesity at midlife (body mass index > 30 kg/m(2)) was associated with the risk of dementia and AD even after adjusting for sociodemographic variables (odds ratio [OR], 2.4 [95% confidence interval (CI), 1.2-5.1]). The association was somewhat modified by further adjusting for midlife blood pressure, total cholesterol level, and smoking (OR, 2.1 [95% CI, 1.0-4.6]) and also for apolipoprotein E genotype and history of vascular disorders (OR, 1.9 [95% CI, 0.8-4.6]). Midlife obesity, high total cholesterol level, and high systolic blood pressure were all significant risk factors for dementia with ORs of around 2 for each factor, and they increased the risk additively (OR, 6.2 for the combination).Conclusions: Obesity at midlife is associated with an increased risk of dementia and AD later in life. Clustering of vascular risk factors increases the risk in an additive manner. The role of weight reduction for the prevention of dementia needs to be further investigated.