Albumin and Hemoglobin Trajectories and Incident Disabling Dementia in Community-Dwelling Older Japanese
Albumin and Hemoglobin Trajectories and Incident Disabling Dementia in Community-Dwelling Older Japanese
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DOI：
10.1159/000499837
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发表时间：
2019-10-01
影响因子：
2.4
通讯作者：
Shinkai, Shoji
中科院分区：
文献类型：
--
作者：
Taniguchi, Yu;Kitamura, Akihiko;Shinkai, Shoji
背景：血清白蛋白和血红蛋白水平与老年人随后的认知功能减退独立相关。这项前瞻性研究使用重复测量分析来确定血清白蛋白和血红蛋白水平的老化轨迹，并调查这些轨迹是否与社区居住的日本老年人中的致残性痴呆事件相关。研究方法：在2002年6月至2017年7月期间，共有2，005名65-90岁的成年人参加了年度老年健康评估;观察总数为9，330。对日本公共长期护理保险系统的市政数据库进行的审查确定了2，005名基线无痴呆症的成年人中的1，999人，其中278人（13.9%）在随访期间（2002年6月至2017年12月）发展为失能性痴呆症。结果如下：我们确定了65岁至90岁年龄段血清白蛋白和血红蛋白水平的三种轨迹模式（高、中、低）。在控制了潜在的混杂因素后，血清白蛋白水平处于中等和低水平轨迹的参与者发生致残性痴呆的风险比分别为1.27（95%置信区间0.94-1.72）和2.07（1.37-3.11），高轨迹组作为参考。血红蛋白水平的相应风险比分别为1.31（0.93-1.85）和1.58（1.04-2.40）。结论：血清白蛋白和血红蛋白水平低的个体痴呆风险较高。这一发现强调了干预措施的重要性，改善营养状况和控制相关疾病的中老年人低血清白蛋白和血红蛋白水平。
Background: Serum albumin and hemoglobin levels are independently associated with subsequent cognitive deterioration in older adults. This prospective study used repeated measures analysis to identify aging trajectories in serum albumin and hemoglobin levels and investigated if these trajectories were associated with incident disabling dementia among community-dwelling older Japanese. Methods: A total of 2,005 adults aged 65-90 years participated in annual geriatric health assessments during the period from June 2002 through July 2017; the total number of observations was 9,330. A review of a municipal database of the Japanese public long-term care insurance system identified 1,999 of 2,005 adults without dementia at baseline, 278 (13.9%) of whom developed disabling dementia during the follow-up period (June 2002 through December 2017). Results: We identified three trajectory patterns (high, moderate, and low) for serum albumin and hemoglobin levels for the age period 65 through 90 years. After controlling for potential confounders, participants with moderate and low trajectories for serum albumin level had hazard ratios of 1.27 (95% confidence interval 0.94-1.72) and 2.07 (1.37-3.11), respectively, for the development of incident disabling dementia, with the high trajectory group as reference. The respective hazard ratios for hemoglobin level were 1.31 (0.93-1.85) and 1.58 (1.04-2.40), respectively. Conclusion: Dementia risk was higher for individuals with low trajectories for serum albumin and hemoglobin levels. This finding highlights the importance of interventions that improve nutritional status and control relevant diseases in middle-aged and older adults with low serum albumin and hemoglobin levels.