Coffee intake in midlife and risk of dementia and its neuropathologic correlates.
Coffee intake in midlife and risk of dementia and its neuropathologic correlates.
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DOI：
10.3233/jad-2010-101428
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
White LR
中科院分区：
文献类型：
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作者：
Gelber RP;Petrovitch H;Masaki KH;Ross GW;White LR
虽然动物数据表明咖啡因对认知有保护作用，但对人类的研究仍然不一致。我们研究了1991-1993年间在檀香山-亚洲老龄化研究中3494名男性(队列进入时的平均年龄为52岁)的中年咖啡和咖啡因摄入与痴呆症风险、其神经病理相关性和认知损害之间的关系，其中包括418名接受脑部尸检的死者。咖啡因摄入量是根据基线时自己报告的咖啡、茶和可乐的摄入量来确定的。根据咖啡和咖啡因的摄入量，用Logistic回归计算全面性痴呆、阿尔茨海默病(AD)、血管性痴呆(VAD)、认知损害(认知能力筛查工具评分74)和死亡时的神经病理损害(阿尔茨海默病、微血管缺血损害、皮质路易体、海马体硬化、广泛性萎缩)的优势比(OR)和95%可信区间(CI)。226名男性(包括118名AD，80名VAD)被诊断为痴呆症，347名男性被诊断为认知障碍。咖啡或咖啡因摄入量与认知损害、全面性痴呆、AD、VAD或个别神经病理损害类型的中/高度水平之间没有显著关联。然而，咖啡因摄入量最高的四分之一(≥411.0毫克/天)的男性比咖啡因摄入量最低的四分位数(≤137.0毫克)的男性患上任何一种病变类型的可能性更小(调整后的OR，0.45；95%CI，0.23-0.89；p，趋势=0.04)。中年摄入咖啡和咖啡因与认知障碍、痴呆症或个别神经病理损害无关，尽管咖啡因摄入量较高与尸检时出现任何类型病变的几率较低相关。
While animal data suggest a protective effect of caffeine on cognition, studies in humans remain inconsistent. We examined associations of coffee and caffeine intake in midlife with risk of dementia, its neuropathologic correlates, and cognitive impairment among 3494 men in the Honolulu-Asia Aging Study (mean age 52 at cohort entry, 1965–1968) examined for dementia in 1991–1993, including 418 decedents (1992–2004) who underwent brain autopsy. Caffeine intake was determined according to self-reported coffee, tea, and cola consumption at baseline. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for overall dementia, Alzheimer's disease (AD), vascular dementia (VaD), cognitive impairment (Cognitive Abilities Screening Instrument score <74), and neuropathologic lesions at death (Alzheimer lesions, microvascular ischemic lesions, cortical Lewy bodies, hippocampal sclerosis, generalized atrophy), according to coffee and caffeine intake. Dementia was diagnosed in 226 men (including 118 AD, 80 VaD), and cognitive impairment in 347. There were no significant associations between coffee or caffeine intake and risk of cognitive impairment, overall dementia, AD, VaD, or moderate/high levels of the individual neuropathologic lesion types. However, men in the highest quartile of caffeine intake (≥411.0 mg/d) were less likely than men in the lowest quartile (≤137.0 mg) to have any of the lesion types (adjusted-OR, 0.45; 95% CI, 0.23–0.89; p, trend = 0.04). Coffee and caffeine intake in midlife were not associated with cognitive impairment, dementia, or individual neuropathologic lesions, although higher caffeine intake was associated with a lower odds of having any of the lesion types at autopsy.