{"title":"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","authors":"Yifan Gou, Xin Qi, Chen Liu, Jingni Hui, Ye Liu, Meijuan Kang, Ruixue Zhou, Bingyi Wang, Panxing Shi, Feng Zhang","doi":"10.1002/trc2.70108","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> INTRODUCTION</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> METHODS</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> RESULTS</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> DISCUSSION</h3>\n \n <p>AL is positively associated with an elevated risk of dementia, underscoring its effect as a risk factor in the neurodegenerative process that provokes dementia.</p>\n </section>\n \n <section>\n \n <h3> Highlights</h3>\n \n <div>\n <ul>\n \n <li>This study estimated allostatic load (AL) index through 10 biomarkers.</li>\n \n <li>The associations between AL and all-cause and cause-specific dementia were evaluated.</li>\n \n <li>Elevated AL is a risk factor for all-cause dementia and vascular dementia.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":53225,"journal":{"name":"Alzheimer''s and Dementia: Translational Research and Clinical Interventions","volume":"11 2","pages":""},"PeriodicalIF":6.8000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/trc2.70108","citationCount":"0","resultStr":"{\"title\":\"Association of allostatic load with all-cause and cause-specific dementia: A prospective cohort study\",\"authors\":\"Yifan Gou, Xin Qi, Chen Liu, Jingni Hui, Ye Liu, Meijuan Kang, Ruixue Zhou, Bingyi Wang, Panxing Shi, Feng Zhang\",\"doi\":\"10.1002/trc2.70108\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> INTRODUCTION</h3>\\n \\n <p>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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> METHODS</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> RESULTS</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> DISCUSSION</h3>\\n \\n <p>AL is positively associated with an elevated risk of dementia, underscoring its effect as a risk factor in the neurodegenerative process that provokes dementia.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Highlights</h3>\\n \\n <div>\\n <ul>\\n \\n <li>This study estimated allostatic load (AL) index through 10 biomarkers.</li>\\n \\n <li>The associations between AL and all-cause and cause-specific dementia were evaluated.</li>\\n \\n <li>Elevated AL is a risk factor for all-cause dementia and vascular dementia.</li>\\n </ul>\\n </div>\\n </section>\\n </div>\",\"PeriodicalId\":53225,\"journal\":{\"name\":\"Alzheimer''s and Dementia: Translational Research and Clinical Interventions\",\"volume\":\"11 2\",\"pages\":\"\"},\"PeriodicalIF\":6.8000,\"publicationDate\":\"2025-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/trc2.70108\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alzheimer''s and Dementia: Translational Research and Clinical Interventions\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/trc2.70108\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer''s and Dementia: Translational Research and Clinical Interventions","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/trc2.70108","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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.
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.