Association between dementia and midlife risk factors: the Radiation Effects Research Foundation Adult Health Study
Association between dementia and midlife risk factors: the Radiation Effects Research Foundation Adult Health Study
复制标题
DOI：
10.1046/j.1532-5415.2003.51117.x
复制
发表时间：
2003-03-01
影响因子：
6.3
通讯作者：
Suzuki, G
中科院分区：
文献类型：
--
作者：
Yamada, M;Kasagi, F;Suzuki, G
目的：探讨中年危险因素与25 ~ 30年后血管性痴呆（VaD）或阿尔茨海默病（AD）发生的关系。设计：纵向队列研究中的患病率研究。（一项始于1958年的前瞻性队列研究）在日本广岛进行了两年一次的医学检查。1932年9月之前出生于日本广岛的1774例受试者（1，660例无痴呆，114例痴呆（51例AD，38例VaD），根据精神障碍诊断和统计手册第四版标准，1992年至1997年诊断）。研究对象的性别、年龄、受教育程度、原子弹辐射剂量以及与风险相关的中年因素对痴呆的影响（吸烟、饮酒、体力活动、饮食习惯、收缩压、体重指数、糖尿病史）。结果：VaD患病率随年龄、SBP升高和牛奶摄入量降低而显著增加。年龄（以5岁为增量）、SBP（以10 mmHg为增量）和牛奶摄入量（几乎每天/每周少于4次）的VaD比值比分别为1.29、1.33和0.35。在本研究人群中，VaD的风险因素与卒中的风险因素一致。随着年龄和教育程度的降低，AD患病率显着增加。其他中年因素和辐射剂量没有显示出任何显着的关联与VaD或AD。结论：增加SBP和低牛奶摄入量在中年与VaD检测25至30年后。对血管疾病危险因素的早期行为控制可能会降低痴呆的风险。
OBJECTIVES: To investigate the association between midlife risk factors and the development of vascular dementia (VaD) or Alzheimer's disease (AD) 25 to 30 years later.DESIGN: A prevalence study within a longitudinal cohort study.SETTING: Subjects in the Adult Health Study (a prospective cohort study begun in 1958) have been followed through biennial medical examinations in Hiroshima, Japan.PARTICIPANTS: One thousand seven hundred seventy-four subjects in Hiroshima, Japan born before September 1932 (1,660 with no dementia, 114 with dementia (51 with AD, and 38 with VaD) diagnosed from 1992 to 1997 according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria).MEASUREMENTS: The subjects were examined for effect on dementia of sex, age, education, atomic bomb radiation dose, and midlife factors associated with risk (smoking, alcohol intake, physical activity, dietary habits, systolic blood pressure (SBP), body mass index, and history of diabetes mellitus) that had been evaluated in 1965-1970.RESULTS: VaD prevalence increased significantly with age, higher SBP, and lower milk intake. The odds ratios of VaD for age (in 5-year increments), SBP (10 mmHg increments), and milk intake (almost daily/less than four times a week) were 1.29, 1.33, and 0.35, respectively. The risk factors for VaD were compatible with the risk factors for stroke in this study population. AD prevalence increased significantly with age and lower education. Other midlife factors and radiation dose did not show any significant association with VaD or AD.CONCLUSION: Increased SBP and low milk intake in midlife were associated with VaD detected 25 to 30 years later. Early behavioral control of the risk factors for vascular disease might reduce the risk of dementia.