Statins, incident Alzheimer disease, change in cognitive function, and neuropathology
Statins, incident Alzheimer disease, change in cognitive function, and neuropathology
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DOI：
10.1212/01.wnl.0000288181.00826.63
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发表时间：
2008-05-06
期刊：
影响因子：
9.9
通讯作者：
Bennett, D. A.
中科院分区：
文献类型：
--
作者：
Arvanitakis, Z.;Schneider, J. A.;Bennett, D. A.
目的：研究他汀类药物与阿尔茨海默病（AD）事件的关系和认知和neuropathics.Methods的变化：参与者是929名老年天主教神职人员（68.7%的妇女，平均基线年龄74.9岁，教育18.2年，迷你精神状态检查28.5）免费痴呆症，参加了宗教秩序研究，AD的纵向临床病理研究。所有人都同意在死亡时进行脑尸检，并进行年度结构化临床评估，以进行AD分类和认知评估（基于19项神经心理学测试）。他汀类药物通过直接药物检查鉴别。262名参与者的神经病理学数据可用。记录所有肉眼可见的慢性脑梗死。从银染中获得AD总体病理学指标，并基于免疫组织化学单独测量淀粉样蛋白和缠结。我们采用考克斯比例风险、混合效应模型和Logistic和线性回归分析了他汀类药物与AD事件的关系、认知变化和病理指标。结果：基线时他汀类药物的使用（12.8%）与AD事件（191人，随访12年）、整体认知变化或5个独立的认知领域（所有p值> 0.20）无关。死亡前任何时间使用他汀类药物（17.9%）与总体AD病理学无关。服用他汀类药物的人不太可能有淀粉样蛋白（p = 0.02）。然而，在淀粉样蛋白患者中，他汀类药物与淀粉样蛋白负荷无关。他汀类药物与缠结或infarct.Conclusions：总体而言，他汀类药物与阿尔茨海默病（AD）或认知变化，或AD病理或梗死的连续措施无关。
Objective: To examine the relation of statins to incident Alzheimer disease (AD) and change in cognition and neuropathology.Methods: Participants were 929 older Catholic clergy (68.7% women, mean baseline age 74.9 years, education 18.2 years, Mini-Mental State Examination 28.5) free of dementia, enrolled in the Religious Orders Study, a longitudinal clinical-pathologic study of AD. All agreed to brain autopsy at time of death and underwent annual structured clinical evaluations, allowing for classification of AD and assessment of cognition (based on 19 neuropsychological tests). Statins were identified by direct medication inspection. Neuropathologic data were available on 262 participants. All macroscopic chronic cerebral infarctions were recorded. A measure of global AD pathology was derived from silver stain, and separate measures of amyloid and tangles were based on immunohistochemistry. We examined the relation of statins to incident AD using Cox proportional hazards, change in cognition using mixed effects models, and pathologic indices using logistic and linear regression.Results: Statin use at baseline (12.8%) was not associated with incident AD (191 persons, up to 12 follow-up years), change in global cognition, or five separate cognitive domains (all p values > 0.20). Statin use any time prior to death (17.9%) was not related to global AD pathology. Persons taking statins were less likely to have amyloid (p = 0.02). However, among those with amyloid, there was no relation of statins to amyloid load. Statins were not related to tangles or infarction.Conclusions: Overall, statins were not related to incident Alzheimer disease (AD) or change in cognition, or continuous measures of AD pathology or infarction.