多病态模式和从正常认知到痴呆和死亡的18年过渡:基于人口的研究
Martina Valletta1,2, Davide Liborio Vetrano1,3, Xin Xia1
1Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Journal of internal medicine
|June 12, 2023
概括
多种慢性疾病的特定模式显著改变了老年人的认知衰退轨迹. 这些多病态模式可以帮助预测认知障碍和痴呆症发病风险.
科学领域:
- 老年学是一门学科.
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 慢性疾病加快了认知能力的下降.
- 多病态模式对认知轨迹的影响尚不清楚.
研究的目的:
- 研究多病症和特定疾病模式如何影响正常认知,认知障碍无痴呆 (CIND),痴呆和死亡之间的过渡.
- 确定这些模式对预期寿命和在认知阶段花费的时间的影响.
主要方法:
- 利用模糊c-means集群分析,在3122名没有痴呆症的老年人中确定多病态模式.
- 采用多态马尔科夫模型来分析18年后的认知阶段和死亡的过渡.
- 计算过渡危险比率,预期寿命和在认知阶段花费的时间.
主要成果:
- 确定了五种不同的多病态模式:神经精神病,心血管,感官损伤/癌症,呼吸/代谢/肌肉骨和非特异性.
- 神经精神和感官损伤/癌症模式与从CIND恢复到正常认知的风险降低有关.
- 心血管模式增加了CIND的风险,导致痴呆症的进展和全因死亡率,减少了预期寿命,并预测了认知能力下降的开始.
结论:
- 多种疾病模式显著影响老年人的认知轨迹.
- 这些模式可以作为一种有价值的工具,用于认知衰退的风险分层.
- 了解这些模式对于个性化干预和公共卫生战略至关重要.
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