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患有多发性硬化症的老年退伍军人患痴呆症的风险
Nathaniel H Fleming1, Amber Bahorik2, Feng Xia3
1Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, 505 Parnassus Ave, Box 0114, San Francisco, CA 94143, United States; San Francisco Veterans Affairs Health Care System, 4150 Clement Street, San Francisco, CA 94121, United States.
Multiple sclerosis and related disorders
|December 17, 2023
概括
与没有多发性硬化症的退伍军人相比,患多发性硬化症 (MS) 的退伍军人患痴呆症的风险明显更高. 这种风险在北方地区和年轻患者中被放大,这凸显了积极查的必要性.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 流行病学 流行病学
背景情况:
- 众所周知,多发性硬化症 (MS) 导致认知功能障碍,但其发展为痴呆症并未得到充分理解.
- 现有研究表明,多发性硬化症患者的痴呆症很少见,需要进一步调查.
研究的目的:
- 要确定与普通人群相比,MS患者是否面临痴呆症的风险较高.
- 识别可能影响MS和痴呆症之间的关联的因素,例如地理度.
主要方法:
- 1999-2019年55岁以上的美国退伍军人的队列研究.
- 通过使用人口因素和并发症,将4084名多发性硬化症患者与4084名非多发性硬化症对照进行了匹配.
- 利用考克斯的比例危险和细灰分区危险模型来分析痴呆风险.
主要成果:
- 与对照人群相比,患有多发性硬化症的退伍军人患痴呆症的风险增加了56% (调整后HR为1.56).
- 多发性硬化和痴呆风险之间的关联在更高的地理度和年轻患者中更强.
- 在MS患者中,痴呆的累积发病率为16.7%,对照组为12.4%.
结论:
- 患有多发性硬化症的老年退伍军人患痴呆症的风险更高,独立于并发性疾病.
- 地理度和基线较年轻的年龄是MS痴呆风险的显著修饰因素.
- 临床医生应该考虑老年多发性硬化症患者的痴呆症查和管理.
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