Contribution of vascular risk factors to the progression in Alzheimer disease.
Contribution of vascular risk factors to the progression in Alzheimer disease.
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DOI：
10.1001/archneur.66.3.343
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发表时间：
2009-03
影响因子：
--
通讯作者：
Stern, Yaakov
中科院分区：
文献类型：
--
作者：
Helzner, Elizabeth P.;Luchsinger, Jose A.;Scarmeas, Nikolaos;Cosentino, Stephanie;Brickman, Adam M.;Glymour, M. Maria;Stern, Yaakov
确定诊断前血管危险因素是否与阿尔茨海默病进展相关。初始队列纵向随访平均3.5年（最长10.2年）。华盛顿高地Inwood哥伦比亚老龄化项目，纽约市156例AD患者（诊断时平均年龄83岁）血管因素，包括病史（心脏病、中风、糖尿病、高血压）、吸烟和诊断前血脂测量（总胆固醇、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）和甘油三酯）。在广义估计方程（GEE）模型（根据年龄、种族/民族和教育调整）中，较高的胆固醇（总胆固醇和LDL-C）和糖尿病史与认知能力下降较快相关。胆固醇和LDL-C每增加10个单位，每年随访认知评分标准差降低10%（总胆固醇p<0.001，LDL-C p=0.001）。HDL和甘油三酯与下降率无关。糖尿病史与认知评分每年额外降低50%的标准差相关（p=0.05）。只有APOE-ε4携带者的心脏病史和中风史与认知能力下降相关。在包括HDL-C，LDL-C和糖尿病的最终GEE模型中，只有更高的LDL-C与更快的认知下降独立相关。较高的诊断前总胆固醇、LDL-C和糖尿病与AD患者的认知能力下降较快相关，为血管危险因素在阿尔茨海默病病程中的作用提供了进一步的证据。
To determine whether pre-diagnosis vascular risk factors are associated with Alzheimer’s disease progression. Inception cohort followed longitudinally for a mean of 3.5 (up to 10.2) years. Washington Heights Inwood Columbia Aging Project, New York City 156 incident AD patients (mean age 83 years at diagnosis) Vascular factors including medical history (heart disease, stroke, diabetes, hypertension), smoking, and pre-diagnosis blood lipid measurements (total cholesterol, High density lipoproteins (HDL-C), Low density lipoproteins (LDL-C) and triglycerides). Change in a composite score of cognitive ability from diagnosis on. In Generalized Estimating Equation (GEE) models (adjusted for age, race/ethnicity and education), higher cholesterol (total and LDL-C), and diabetes history were associated with faster cognitive decline. Each 10-unit increase in cholesterol and LDL-C was associated with a 10% of a standard deviation decrease in cognitive score per year of follow-up (p<0.001 for total cholesterol, p=0.001 for LDL-C). HDL and triglycerides were not associated with rate of decline. Diabetes history was associated with an additional 50% of a standard deviation decrease in cognitive score per year (p=0.05). History of heart disease and stroke were associated with cognitive decline among APOE-ε4 carriers only. In a final GEE model that included HDL-C, LDL-C and diabetes, only higher LDL-C was independently associated with faster cognitive decline. Higher pre-diagnosis total cholesterol, LDL-C, and diabetes were associated with faster cognitive decline among incident AD patients, providing further evidence for the role of vascular risk factors in Alzheimer’s disease course.
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影响因子：
5.8
作者：
Luchsinger, Jose A;Mayeux, Richard
通讯作者：
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影响因子：
9.9
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5
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作者：
Luchsinger, JA;Tang, MX;Mayeux, R
通讯作者：
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