Risk of Developing Alzheimer's Disease and Related Dementias in Association with Cardiovascular Disease, Stroke, Hypertension, and Diabetes in a Large Cohort of Women with Breast Cancer and with up to 26 Years of Follow-Up.
Risk of Developing Alzheimer's Disease and Related Dementias in Association with Cardiovascular Disease, Stroke, Hypertension, and Diabetes in a Large Cohort of Women with Breast Cancer and with up to 26 Years of Follow-Up.
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DOI：
10.3233/jad-215657
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Chan W
中科院分区：
文献类型：
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作者：
Du XL;Song L;Schulz PE;Xu H;Chan W
关于血管疾病引起的乳腺癌妇女中阿尔茨海默病（AD）和相关痴呆（ADRD）的长期发病率的研究尚未报道。确定乳腺癌女性患者中ADRD与心血管疾病（CVD）、卒中、高血压和糖尿病相关的风险。研究确定了1991年至2015年期间246，686名年龄≥65岁的女性诊断患有乳腺癌，来自监测，流行病学和最终结果（SEER）-Medicare链接数据库。女性在癌症诊断时没有ADRD，并从1991年到2016年进行了随访。26年随访期间，根据CVD、卒中、高血压和糖尿病，AD的累积发病率从10.7%至13.6%不等。有CVD（40.75%）与无CVD（31.32%）、卒中（40.24%）与无卒中（31.34%）、高血压（33.06%）与无高血压（30.47%）、糖尿病（33.38%）与无糖尿病（31.77%）的患者中ADRD的累积发生率较高。校正混杂因素后，CVD（危害比：1.30，95%CI：1.27-1.33）、卒中（1.50，1.47 -1.54）、高血压（1.08，1.06 -1.09）和糖尿病（1.26，1.24 -1.29）患者发生ADRD的风险显著增高。80-84岁和≥85岁的女性患AD的风险分别是65-69岁女性的5倍和7倍。与白色女性相比，黑人女性患AD的风险显著更高（1.21，1.16-1.27），而亚洲人/太平洋岛民患AD的风险显著更低（0.77，0.71-0.83）。在乳腺癌患者中，CVD、中风、高血压和糖尿病与任何ADRD合并的显著更高风险相关。与白色女性相比，黑人女性ADRD的风险更高，而亚洲/太平洋岛民的风险更低。
No study on the long-term incidence of Alzheimer’s disease (AD) and related dementias (ADRD) has been reported in women with breast cancer by vascular diseases. To determine the risk of ADRD in association with cardiovascular diseases (CVD), stroke, hypertension, and diabetes in women with breast cancer. Study identified 246,686 women diagnosed with breast cancer at age≥65 years in 1991–2015 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Women were free of ADRD at the time of cancer diagnosis and followed from 1991 to 2016. Cumulative incidence of AD over 26 years of follow-up varied from 10.7% to 13.6% by CVD, stroke, hypertension, and diabetes. Cumulative incidence of ADRD was higher in those with CVD (40.75%) versus no-CVD (31.32%), stroke (40.24%) versus no-stroke (31.34%), hypertension (33.06%) versus no-hypertension (30.47%), and diabetes (33.38%) versus no-diabetes (31.77%). After adjusting for confounders, those with CVD (hazard ratio:1.30, 95% CI: 1.27–1.33), stroke (1.50,1.47–1.54), hypertension (1.08,1.06–1.09), and diabetes (1.26,1.24–1.29) had significantly higher risks of developing ADRD. Women aged 80–84, and≥85 had 5- and 7-fold higher risks of AD than those aged 65–69. As compared to white women, black women had a significantly higher risk of AD (1.21, 1.16–1.27), whereas Asians/Pacific-Islanders had a significantly lower risk of AD (0.77, 0.71–0.83). In women with breast cancer, CVD, stroke, hypertension, and diabetes were associated with a significantly higher risk of developing any ADRD combined. The risk of ADRD was higher in black women and lower in Asian/Pacific-Islanders than white women.