Mid-life proteinuria and late-life cognitive function and dementia in elderly men: the Honolulu-Asia Aging Study.
Mid-life proteinuria and late-life cognitive function and dementia in elderly men: the Honolulu-Asia Aging Study.
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DOI：
10.1097/wad.0000000000000082
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发表时间：
2015-07
影响因子：
2.1
通讯作者：
Masaki K
中科院分区：
文献类型：
--
作者：
Higuchi M;Chen R;Abbott RD;Bell C;Launer L;Ross GW;Petrovitch H;Masaki K
肾功能受损与认知障碍有关。我们评估了亚洲老年男性的中年蛋白尿和晚年认知功能。檀香山心脏计划是一项前瞻性研究，始于1965年，对象是8，006名年龄在45-68岁之间的日裔美国男性。1971-74年通过尿试纸检测中年蛋白尿。檀香山-亚洲老龄化研究开始于20年后，通过认知能力筛查仪器（CASI）对3,734名男性进行了认知评估。标准标准被用来分类8年发病痴呆症和亚型。在无、微量和阳性中年蛋白尿的人群中，年龄调整后的痴呆发病率从13.8/1000人年显著增加到22.8/1000人年，再增加到39.7/1000人年，p=0.004。使用线性回归校正年龄，教育，APOEε4，中风，高血压，收缩压，糖尿病，空腹血糖，体力活动和基线CASI，蛋白尿阳性者在8年随访期间CASI的年变化显著较高（-1.24，p=0.02），参考=无蛋白尿。多因素考克斯回归分析发现，蛋白尿阳性与全因性痴呆的发生有显著相关性（RR=2.66，95%CI=1.09-6.53，p=0.03），但与阿尔茨海默病或血管性痴呆的发生无显著相关性。中年蛋白尿是8年以上老年事件全因痴呆和认知能力下降的独立预测因子。
Impaired renal function has been linked to cognitive impairment. We assessed mid-life proteinuria and late-life cognitive function in elderly Asian males. The Honolulu Heart Program is a prospective study that began in 1965 with 8,006 Japanese-American men ages 45–68 years. Mid-life proteinuria was detected by urine dipstick in 1971–74. The Honolulu-Asia Aging Study began 20 years later, with cognitive assessment by the Cognitive Abilities Screening Instrument (CASI) in 3,734 men. Standard criteria were used to classify 8-year incident dementia and subtypes. The age-adjusted incidence of dementia increased significantly from 13.8, to 22.8, to 39.7 per 1,000 person years follow-up, among those with no, trace and positive mid-life proteinuria, p=0.004. Using linear regression adjusting for age, education, APOEε4, stroke, hypertension, systolic blood pressure, diabetes, fasting blood glucose, physical activity and baseline CASI, those with positive proteinuria had significantly higher annual change in CASI over 8 years follow-up (−1.24, p=0.02), reference=no proteinuria. Multivariate Cox regression found positive proteinuria had a significant association with incident all-cause dementia (RR=2.66, 95%CI=1.09–6.53, p=0.03), but no significant associations with incident Alzheimer’s disease or vascular dementia. Mid-life proteinuria was an independent predictor for late-life incident all-cause dementia and cognitive decline over 8 years.