Diabetes and other vascular risk factors for dementia: Which factor matters most? A systematic review
Diabetes and other vascular risk factors for dementia: Which factor matters most? A systematic review
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DOI：
10.1016/j.ejphar.2008.02.049
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发表时间：
2008-05-06
影响因子：
5
通讯作者：
Biessels, Geert Jan
中科院分区：
文献类型：
--
作者：
Kloppenborg, Raoul P.;van den Berg, Esther;Biessels, Geert Jan
血管风险因素，如2型糖尿病，高血压，肥胖和血脂异常往往同时发生。这些因素中的每一个都与痴呆症的风险增加有关，但不确定哪一个因素造成的风险最大。此外，暴露时年龄的影响可能因因素而异。本文系统地回顾了这些危险因素与痴呆症的关联的证据。纳入了基于人群的纵向研究，这些研究评估了痴呆与糖尿病（n = 14）、高血压（n = 13）、血脂异常（n = 8）或肥胖（n = 9）的相关性。所有四个风险因素确实与痴呆症风险增加有关，但糖尿病和肥胖的研究结果最为一致。影响的大小在风险因素中是相当的，“任何痴呆”的比值比约为1.5。对于高血压，肥胖和血脂异常，年龄似乎调节了这种关联：在中年（与晚年相比）测量风险因素的研究中，痴呆的风险通常最大，并且随访时间较长。在中年，高血压的人群归因风险最高，高达30%的老年痴呆症病例。在以后的生活中，糖尿病似乎是痴呆症的最高风险。本综述表明，血管危险因素应被视为预防措施的主要目标，但这些措施的时机似乎是至关重要的。(C)2008 Elsevier B.V.保留所有权利。
Vascular risk factors, such as type 2 diabetes, hypertension, obesity and dyslipidaemia often co-occur. Each of these factors has been associated with an increased risk of dementia, but it is uncertain which factor imposes the greatest risk. Moreover, the effect of age at time of exposure may differ across factors. This paper systematically reviews the evidence for the association of each of these risk factors with dementia. Longitudinal population-based studies that assessed the incidence of dementia in relation to diabetes (n = 14), hypertension (n = 13), dyslipidaemia (n = 8) or obesity (n = 9) were included. All four risk factors were indeed associated with an increased risk of dementia, but the results of studies on diabetes and obesity were most consistent. The magnitude of the effects was comparable across the risk factors, with odds ratios for 'any dementia' around 1.5. For hypertension, obesity and dyslipidaemia age appeared to modulate the association: the risk of dementia was generally largest in studies that measured the risk factor in midlife (compared to late life) and had a long follow-up time. At midlife, the population attributable risk of dementia was highest for hypertension, up to 30% of cases of late life dementia. Later in life diabetes appears to convey the highest risk of dementia. This review shows that vascular risk factors should be regarded as a major target for preventive measures, but that timing of such measures appears to be critical. (C) 2008 Elsevier B.V. All rights reserved.