Midlife risk factors for subtypes of dementia: A nested case-control study in Taiwan

被引：65

作者：

Chiang, Chun-Ju

Yip, Ping-Keung

Wu, Shiao-Chi

Lu, Chin-Song

Liou, Chia-Wei

Liu, Hsiu-Chih

Liu, Ching-Kuan

Chu, Ching-Hua

Hwang, Chi-Shin

Sung, Sheng-Feng

Hsu, Yaw-Don

Chen, Cheng-Chung

Liu, Shen-Ing

Yan, Sui-Hing

Fong, Chin-Shih

Chang, Shu-Feng

You, San-Lin

Chen, Chien-Jen

机构：

[1] Natl Taiwan Univ, Coll Publ Hlth, Grad Inst Epidemiol, Taipei 10764, Taiwan

[2] Natl Taiwan Univ Hosp, Dept Neurol, Taipei, Taiwan

[3] Natl Taiwan Univ, Taipei 10764, Taiwan

[4] Natl Yang Ming Univ, Inst Hlth & Welfare Policy, Taipei 112, Taiwan

[5] Chang Gung Univ Coll Med, Chang Gung Mem Hosp, Sect Movement Disorders, Neurol Sect, Taipei, Taiwan

[6] Chang Gung Univ Coll Med, Kaohsiung Med Ctr, Chang Gung Mem Hosp, Dept Neurol, Taipei, Taiwan

[7] Natl Yang Ming Univ, Sch Med, Dept Neurol, Taipei 112, Taiwan

[8] Taipei Vet Gen Hosp, Neurol Inst, Taipei, Taiwan

[9] Kaohsiung Med Univ, Dept Neurol, Kaohsiung, Taiwan

[10] Wei Gong Mem Hosp, Dept Neurol, Miaoli, Taiwan

[11] Taipei City Hosp, Chung Hsiao Branch, Taipei, Taiwan

[12] St Christophers Hosp Children, Dept Neurol, Chiayi, Taiwan

[13] Tri Serv Gen Hosp, Dept Neurol, Taipei, Taiwan

[14] Natl Def Med Ctr, Taipei, Taiwan

[15] Kaohsiung Med Univ, Dept Psychiat, Kaohsiung, Taiwan

[16] Tsyr Huey Mental Hosp, Kaohsiung, Taiwan

[17] Mackay Mem Hosp, Dept Psychiat, Taipei, Taiwan

[18] Taipei City Hosp, Dept Neurol, Ren Ai Branch, Taipei, Taiwan

[19] Buddhist Dalian Tzu Chi Gen Hosp, Chiayi, Taiwan

[20] Ming Jong Hosp, Dept Neurol, Pingtung, Taiwan

[21] Natl Taiwan Univ, Coll Publ Hlth, Grad Inst Epidemiol, Taipei 10764, Taiwan

[22] Acad Sinica, Ctr Gene Res, Taipei 115, Taiwan

来源：

AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY | 2007年 / 15卷 / 09期

关键词：

alzheimer disease; vascular dementia; body mass index; risk factors; epidemiology;

D O I：

10.1097/JGP.0b013e318050c98f

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Objective: To identify the midlife risk factors for subtypes of dementia newly developed later in life. Methods: A nested case-control study was conducted on 157 demented cases and 628 comparison cases selected from 40,636 men and women who were enrolled from 1982 to 1992. Four comparison cases were frequency-matched on age, time at enrollment ( within 6 months), gender, and residential township. Midlife risk factors included vascular risk factors ( body mass index [ BMI], total cholesterol, total triglycerides, blood glucose, cerebrovascular accident [ CVA] history, diabetes mellitus history, and hypertension history), cigarette smoking, and alcohol consumption. Dementia assessments were ascertained through the computerized data linkage from National Health Insurance Database from 2000 to 2002 and clinically confirmed by neurologists or psychiatrists. Conditional logistic regression analysis was used to estimate the matched odds ratio ( OR) and its 95% confidence intervals ( CI) for each risk factor. Results: A J-shaped relationship was observed between BMI ( kg/m(2)) and dementia. The multivariate-adjusted ORs ( 95% CI) of developing dementia were 1.84 ( 1.02-3.33), 1.87 ( 1.08-3.23) and 2.44 ( 1.39-4.28), respectively, for BMIs of <20.5, 23.0-25.4, >= 25.5 compared with a BMI of 20.5-22.9 as the referent group ( OR = 1.0). Similar findings were observed for Alzheimer disease ( AD) and vascular dementia ( VaD). The association between obesity ( BMI >= 25.5) and both AD and VaD was statistically significant among cigarette smokers but not among nonsmokers. Additionally, history of CVA was a significant risk factor for VaD, but not for AD. Conclusion: Being underweight, being overweight, and a cerebrovascular accident in midlife may increase the risk of dementia in late life.

引用

页码：762 / 771

页数：10

共 33 条

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