可改变的风险因素减少对未来痴呆负担的影响:一项微观模拟建模研究。

IF 5.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Chiara C Brück, Koen de Nijs, M Arfan Ikram, Frank J Wolters, Inge M C M de Kok
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引用次数: 0

摘要

大约30%-50%的痴呆病例可归因于可改变的风险因素,但在人群水平上,风险降低策略对痴呆发病率的影响尚不确定。干预效果的可靠估计需要在干预风险因素时考虑预期寿命的变化,并模拟考虑风险因素共同发生的现实减少情景。使用微观模拟模型MISCAN-Dementia,我们评估了干预中年高血压和晚年吸烟对痴呆和死亡风险的影响。我们建立了风险因素减少的模型,从小幅度减少到完全消除,并评估了对痴呆发病率和患病率、病例数以及有和没有痴呆的寿命年的影响。所有风险因素的减少导致痴呆发病率和患病率降低,痴呆病例减少,无痴呆生活年数增加。在他们的一生中,戒烟导致女性痴呆症病例减少1.4%,男性减少2.5%。消除高血压可使女性和男性的痴呆病例分别减少1.1%和3.3%。痴呆症病例数和患痴呆症的生命年数在90岁左右之前有所下降,此后由于预期寿命随着减少而延长,观察到略有增加。减少吸烟和高血压将增加无痴呆症的寿命,并适度减少总体痴呆症病例,其中老年痴呆症病例会增加一些。这些发现强调了降低痴呆风险策略的潜力,以及在评估降低风险因素时考虑死亡率同时变化的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of modifiable risk factor reduction on future dementia burden: a microsimulation modeling study.

Approximately 30%-50% of dementia cases are attributable to modifiable risk factors, but the impact of risk reduction strategies on dementia incidence at a population level is uncertain. Reliable estimates of intervention effects require accounting for changes in life expectancy when intervening on risk factors, and model realistic reduction scenarios that consider co-occurrence of risk factors. Using the microsimulation model MISCAN-Dementia, we assessed the effect of interventions on mid-life hypertension and late-life smoking on dementia and mortality risk. We modeled risk factor reductions, from small reductions to complete elimination, and evaluated effects on dementia incidence and prevalence, number of cases, and life years with and without dementia. All risk factor reductions resulted in lower dementia incidence and prevalence, fewer dementia cases, and more dementia-free life years. Eliminating smoking resulted in 1.4% fewer dementia cases for women and 2.5% for men over their lifetime. Eliminating hypertension reduced dementia cases by 1.1% for women and 3.3% for men. The number of dementia cases and life years with dementia decreased until around age 90, after which a slight increase was observed due to prolonged life expectancy with the reductions. Reducing smoking and hypertension will result in additional life years without dementia and a modest reduction in overall dementia cases, with some additional dementia cases in the oldest old. These findings emphasize the potential of dementia risk reduction strategies and the importance of considering concurrent changes in mortality when evaluating risk factor reductions.

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来源期刊
European Journal of Epidemiology
European Journal of Epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
21.40
自引率
1.50%
发文量
109
审稿时长
6-12 weeks
期刊介绍: The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.
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