在没有痴呆症的人群中大脑粉样蛋白病理的患病率:元分析
Willemijn J Jansen1, Rik Ossenkoppele2, Dirk L Knol3
1Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands.
JAMA
|May 20, 2015
概括
大脑粉样蛋白病理在没有痴呆症的个体中很常见,随着年龄的增长而增加,并且与APOE基因型有关. 这表明在阿尔茨海默氏症发病之前有一个漫长的临床前阶段.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 老年学是一门学科.
背景情况:
- 大脑粉样β (Aβ) 聚合是一种早期阿尔茨海默病 (AD) 事件,在几十年之前出现痴呆症.
- 在非痴呆症患者中估计粉样蛋白病理的患病率对于理解AD发展和设计预防策略至关重要.
研究的目的:
- 用生物标志物估计正常认知,主观认知障碍 (SCI) 或轻度认知障碍 (MCI) 个体中的粉样蛋白病理的患病率.
- 分析粉样蛋白病理流行与年龄,APOE基因型,性别和教育等风险因素的关联.
主要方法:
- 55项研究的个人参与者数据元分析,其中2914名参与者具有正常认知能力,697名SCI,3972名MCI (18-100岁).
- 通过正子发射断层扫描或脑脊液评估的粉样蛋白病理,使用先验定义的切断值.
- 使用概括估计方程估计的患病率,考虑到风险因素.
主要成果:
- 粉样蛋白病理的患病率随着年龄 (50-90岁) 和认知状态的增加而增加:正常认知 (10%-44%),SCI (12%-43%),MCI (27%-71%).
- 携带APOE-ε4的患者患病率是非携带者患病率的2-3倍.
- 粉样蛋白阳性在受过高等教育的人群中更常见,但与性别或生物标志物类型无关.
结论:
- 在非痴呆症患者中,大脑粉样蛋白病理的患病率与年龄,APOE基因型和认知障碍有关.
- 研究结果表明,粉样蛋白阳性和痴呆症发病之间有20-30年的临床前窗口.
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