Neurology:心血管风险变化轨迹与认知能力下降和痴呆事件之间的关系

2022-04-22 MedSci原创 MedSci原创

目前的研究结果表明,心血管风险的纵向、累积变化轨迹可以预测痴呆风险,并与记忆衰退有关。

血管危险因素与认知能力下降和痴呆之间的关系最近被研究证实,然而大多数研究通过横断面数据来评估这种关系,缺乏对这种风险的纵向动态的了解。当前的研究旨在探索心血管风险的持续轨迹如何影响随后的痴呆和记忆衰退风险。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在验证一个假设即由弗雷明汉风险评分(FRS)确定的心血管风险的加速、长期积累将比稳定的心血管风险更不利于认知和痴呆状态的结局。

研究人员评估了从前瞻性队列研究中招募的最初健康的社区居民样本。心血管疾病风险由Framingham风险评分进行评估。研究人员在每5年时间点(T)评估了情景记忆表现和痴呆状态,共计评估20-25年。研究人员采用贝叶斯加性回归检验(BART)进行分析,BART作为一种半参数机器学习方法,作为一种多状态生存分析方法。

在1244名参与者中,60%的样本的心血管风险随着时间适当增加,研究人员观察到18%的参与者风险快速增加,22%的参与者变化最小。与稳定的心血管风险轨迹相反,加速的心血管风险变化轨迹可预测患阿尔茨海默氏病痴呆(平均风险比(RR)为3.3-5.7, 95%CI为2.6-17.5, T5为1.9-6.7)或血管性痴呆(平均风险比为3.3-4.1,T2时为95%CI为1.1-16.6,T5时为1.5-7.6),且与记忆衰退风险增加相关(平均RR为1.4-1.2,T2时为95%CI为1-1.9,T5时为1-1.5)。稳定的心血管风险轨迹似乎可以部分降低APOE4携带者的阿尔茨海默病痴呆风险。

由此可见,目前的研究结果表明,心血管风险的纵向、累积变化轨迹可以预测痴呆风险,并与记忆衰退有关。

原始出处:

Bryn Farnsworth von Cederwald,et al.Association of Cardiovascular Risk Trajectory With Cognitive Decline and Incident Dementia.Neurology.2022.https://n.neurology.org/content/early/2022/04/20/WNL.0000000000200255

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    2022-06-06 yinhl1978
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    2022-04-22 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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