Neurology:确定痴呆的血管危险因素和中老年痴呆风险预测:Framingham心脏研究

2022-07-02 Naomi MedSci原创

血管危险因素与痴呆之间的关联因年龄而异,这使得痴呆风险预测规则对不同年龄个体的普适性具有挑战性。近日,一项发表在Neurology上的研究确定了年龄特定的痴呆症风险评分中包含的最重要的血管危险因素。

血管危险因素与痴呆之间的关联因年龄而异,这使得痴呆风险预测规则对不同年龄个体的普适性具有挑战性。近日,一项发表在Neurology上的研究确定了年龄特定的痴呆症风险评分中包含的最重要的血管危险因素。

 弗雷明翰心脏研究原始和后代队列参与者在中年(55岁;n=4899,57%女性)、晚年(65岁或70岁)或晚年(75或80岁[n=2386,62%女性])获得弗雷明翰中风风险概况(FSRP)数据,从65岁、70岁、75岁和80岁开始跟踪调查10年的痴呆症事件风险。

  • 年龄和性别调整后的中年危险因素包括FSRP(HR 1.16,95%CI 1.06~1.26,每1-SD对数转换分数增量)、糖尿病(DM,HR 4.31,95%CI 1.97~9.43)和收缩压(SBP,HR 1.12,95%CI 1.02~1.24,每10 mm Hg增量)。
  • 与65岁或70岁的10年痴呆事件相关的晚年危险因素包括FSRP(65岁:HR 1.06,95%CI 1.021.10),使用抗高血压药物(65岁报告:HR 1.66,95%CI 1.12-2.46),糖尿病(65岁报告:HR 1.96,95%CI 1.09-3.52),心房颤动(65岁报告:HR 2.30,95%CI 1.00-5.27),非中风心血管疾病(nsCVD,65岁报告:HR 1.95,95%可信区间1.24~3.07)和卒中(仅70岁:HR 3.61,95%可信区间2.21~5.92)。
  • 与10年相关的晚年风险因素75岁或80岁发生的痴呆症包括使用抗高血压药物(80岁:HR 0.74,95%CI 0.62-0.89)、糖尿病(80岁报告:HR 1.40,95%CI 1.04-1.89)、房颤(80岁报告:HR 1.43,95%CI 1.07-1.92)和中风(80岁报告:HR 1.63,95%CI 1.13-2.35)。
  • 在逐步模型中,55岁的SBP和DM,65岁的NsCVD,70岁和75岁的DM和中风,以及80岁的DM、中风和使用抗高血压药物(保护性)是痴呆症最重要的血管危险因素。

该研究发现支持使用年龄特定的痴呆症风险评分,这些评分应该优先包括55岁时,SBP和DM;65岁,nsCVD;70和75岁,DM和中风;以及80岁,DM,中风和抗高血压药物的使用。 

文献来源:McGrath ER, Beiser AS, O'Donnell A, et al. Determining Vascular Risk Factors for Dementia and Dementia Risk Prediction Across Mid- to Later-Life: The Framingham Heart Study [published online ahead of print, 2022 May 18]. Neurology. 2022;10.1212/WNL.0000000000200521. doi:10.1212/WNL.0000000000200521

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    2023-04-03 yinhl1978
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    2022-07-04 叶子12

    学习了

    0

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    2022-07-01 neuro.Dr

    老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!

    0

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