适应负荷与全因和病因特异性痴呆的关联:一项前瞻性队列研究

IF 6.8 Q1 CLINICAL NEUROLOGY
Yifan Gou, Xin Qi, Chen Liu, Jingni Hui, Ye Liu, Meijuan Kang, Ruixue Zhou, Bingyi Wang, Panxing Shi, Feng Zhang
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引用次数: 0

摘要

适应负荷(AL)作为一种有价值的工具,可以客观评估慢性应激的生物学影响,并与痴呆风险有关。本研究旨在探讨AL与全因痴呆、阿尔茨海默病(AD)、血管性痴呆(VaD)和非阿尔茨海默病非血管性痴呆(NAVD)之间的关系。方法:这项前瞻性研究包括来自英国生物银行的361,920名成年人,观察期从2006年3月13日延长到2022年10月31日,排除了先前诊断为痴呆的参与者。通过与代谢、心血管和炎症系统失调相关的10个生物标志物来估计AL。诊断依据国际疾病分类第十版(ICD-10)。我们采用Cox比例风险模型来评估阿尔茨海默病与痴呆之间的关系。此外,我们对性别、汤森剥夺指数(TDI)和吸烟进行了亚组分析,并进行了敏感性分析。结果中位随访时间为12.88年。在随访期间,6155名(1.70%)参与者发展为全因痴呆,2762名(0.76%)参与者发展为AD, 1316名(0.36%)参与者发展为VaD, 3790名(1.05%)参与者发展为NAVD。在完全调整后的模型中,高AL与全因痴呆(风险比[HR]: 1.269, 95%可信区间[CI]: 1.159-1.390)、VaD(风险比:1.934,95% CI: 1.569-2.384)和NAVD(风险比:1.253,95% CI: 1.116-1.408)的风险增加相关。AL高的女性和非吸烟个体易患VaD,而AL与全因痴呆的相关性在TDI高的人群中更强。AL与痴呆风险升高呈正相关,强调其在引发痴呆的神经退行性过程中作为风险因素的作用。本研究通过10个生物标志物估计适应负荷(AL)指数。评估了AL与全因和病因特异性痴呆之间的关系。AL升高是全因痴呆和血管性痴呆的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Association of allostatic load with all-cause and cause-specific dementia: A prospective cohort study

Association of allostatic load with all-cause and cause-specific dementia: A prospective cohort study

INTRODUCTION

Allostatic load (AL) serves as a valuable tool for objectively assessing the biological impact of chronic stress and has been implicated in dementia risk. This study aims to investigate the association between AL and all-cause dementia, Alzheimer's disease (AD), vascular dementia (VaD), and non-Alzheimer non-vascular dementia (NAVD).

METHODS

This prospective study included 361,920 adults from the UK Biobank, with an observation period extending from March 13, 2006, to October 31, 2022, excluding participants with prior dementia diagnoses. AL was estimated through 10 biomarkers related to the dysregulation of metabolic, cardiovascular, and inflammatory systems. Diagnoses were based on the International Classification of Diseases, 10th Revision (ICD-10). We performed Cox proportional hazards models to assess the relationship between AL and dementia. Additionally, we conducted subgroup analyses for sex, Townsend Deprivation Index (TDI), and smoking, along with sensitivity analyses.

RESULTS

The median follow-up period was 12.88 years. Over the follow-up period, 6155 (1.70%) participants developed all-cause dementia, 2762 (0.76%) developed AD, 1316 (0.36%) developed VaD, and 3790 (1.05%) developed NAVD. In the fully adjusted model, high AL was associated with an increased risk of all-cause dementia (hazard ratio [HR]: 1.269, 95% confidence interval [CI]: 1.159–1.390), VaD (HR: 1.934, 95% CI: 1.569–2.384), and NAVD (HR: 1.253, 95% CI: 1.116–1.408). Women and non-smoking individuals with high AL were vulnerable to VaD, and the associations between AL and all-cause dementia were stronger in people with high TDI.

DISCUSSION

AL is positively associated with an elevated risk of dementia, underscoring its effect as a risk factor in the neurodegenerative process that provokes dementia.

Highlights

  • This study estimated allostatic load (AL) index through 10 biomarkers.
  • The associations between AL and all-cause and cause-specific dementia were evaluated.
  • Elevated AL is a risk factor for all-cause dementia and vascular dementia.
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来源期刊
CiteScore
10.10
自引率
2.10%
发文量
134
审稿时长
10 weeks
期刊介绍: Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.
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