晚年肥胖是预防痴呆和痴呆相关死亡率的保护因素
Ginny Natale1, Yun Zhang1, Douglas William Hanes1
1Program in Public Health and Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA.
概括
肥胖可能会保护老年人免受痴呆症的发展,并降低与痴呆症相关的死亡率. 这一发现表明,人体质量和认知能力下降之间存在复杂的关系,需要在痴呆症研究中进一步调查.
科学领域:
- 老年学是一门学科.
- 流行病学 流行病学
- 神经学 神经学
背景情况:
- 认知障碍和痴呆症是老年人群的重大健康问题.
- 体重指数 (BMI) 和认知衰退 (包括痴呆症) 之间的关系是复杂的,需要进一步澄清.
- 了解痴呆的风险因素和保护因素对于公共卫生战略至关重要.
研究的目的:
- 估计从认知正常到轻度认知障碍 (MCI) 和可能的痴呆症的转化率.
- 评估不同体重指数 (BMI) 类别 (体重不足,正常,超重,肥胖) 与老年人痴呆和痴呆相关死亡风险之间的关联.
- 调查检查时间对痴呆症严重程度评估的影响.
主要方法:
- 分析了国家健康与衰老趋势研究 (NHATS) 的六波数据.
- 从身高和体重测量结果计算身体质量指数 (BMI).
- 应用多状态生存模型 (MSM) 来检查错误分类概率,时间与事件比率以及认知衰退轨迹.
主要成果:
- 分析了77岁的6078名参与者的队列,其中62%的BMI超重或肥胖.
- 在对心脏代谢因素,年龄,性别和种族进行调整后,发现肥胖对发展痴呆症有保护作用 (调整后危险比率[aHR]=0.44;95% CI [0.290.67]).
- 肥胖也与痴呆相关死亡风险降低有关 (aHR=0.63; 95% CI [0.420.95]).
结论:
- 肥胖与老年人痴呆的发病率和痴呆相关死亡率之间存在显著的反向关系.
- 这一发现与一些先前的文献形成了鲜明对比,并突出了肥胖在这个背景下未被充分报道的保护作用.
- 持续的肥胖流行病可能会在痴呆症的诊断和管理方面带来挑战,需要采取细微的方法.
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