Head trauma and risk of dementia and Alzheimer's disease - The Rotterdam Study
Head trauma and risk of dementia and Alzheimer's disease - The Rotterdam Study
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DOI：
10.1212/wnl.53.9.1959
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发表时间：
1999-12-10
期刊：
影响因子：
9.9
通讯作者：
Breteler, MMB
中科院分区：
文献类型：
--
作者：
Mehta, KM;Ott, A;Breteler, MMB
目的：通过前瞻性人群研究，探讨脑外伤与痴呆发病率的关系。背景：头部创伤是否会增加痴呆和AD的风险仍然存在争议。有研究表明，携带APOE-β 4等位基因的患者的风险可能会特别增加。研究方法：研究人群包括6645名基于前瞻性人群的鹿特丹研究的参与者，年龄≥ 55岁，基线时无痴呆。在基线时通过向医生自我报告来测量头部创伤伴意识丧失，并详细描述头部创伤的数量、自头部创伤以来的时间和意识丧失的持续时间。根据国际标准诊断的痴呆事件对该队列进行了随访。在调整年龄、性别和教育后，使用Logistic回归计算痴呆的风险。结果如下：对于有头部创伤伴意识丧失史的患者，未发现痴呆或AD的风险增加（痴呆的相对风险[RR]= 1.0，95%CI，0.5-2.0; AD的RR = 0.8，95%CT，0.4-1.9）。多发性头部创伤、头部创伤后的时间和无意识的持续时间对痴呆的风险没有显著影响。此外，APOE-β 4等位基因没有改变这种关系。结论：这项研究表明，轻度头部外伤不是老年痴呆或AD的主要危险因素。此外，本研究不同意以前的横断面研究表明与载脂蛋白E基因型的相互作用。
Objective: To investigate the relation between head trauma and incidence of dementia in a prospective population-based study. Background: Whether head trauma increases the risk of dementia and AD remains controversial. It has been suggested that the risk might be particularly increased for carriers of the APOE-epsilon 4 allele. Methods: The study population included 6645 participants of the prospective population-based Rotterdam Study, aged 55 years or older, who were free of dementia at baseline. Head trauma with loss of consciousness was measured at baseline by a self-report to a physician and detailed the number of head traumas, time since head trauma, and duration of loss of consciousness. The cohort was followed for incident dementia that was diagnosed according to international criteria. Logistic regression was used to calculate the risk of dementia after adjusting for age, gender, and education. Results: No increased risk of dementia or AD was found for persons with a history of head trauma with loss of consciousness (relative risk [RR] for dementia = 1.0, 95% CI, 0.5-2.0; RR for AD = 0.8, 95% CT, 0.4-1.9). Multiple head traumas, time since head trauma, and duration of unconsciousness did not significantly influence the risk of dementia. In addition, the APOE-epsilon 4 allele did not modify the relationship. Conclusions: This study suggests that mild head trauma is not a major risk factor for dementia or AD in the elderly. In addition, this study does not concur with previous cross-sectional studies suggesting an interaction with the APOE genotype.