在老年人中创伤性脑损伤,和认知障碍
Yiqi Zhu1, Jonathan Williams2, Kebede Beyene3
1School of Social Work, Adelphi University, Garden City, New York.
JAMA network open
|August 8, 2024
概括
创伤性脑损伤 (TBI) 和发作显著增加了老年人认知障碍的风险. 某些药物和种族差异可能进一步加剧这种风险,突出了针对性干预的必要性.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 认知障碍和痴呆的患病率随着年龄的增长而增加.
- 创伤性脑损伤 (TBI) 和是众所周知的神经系统疾病.
- 了解TBI,发作,药物和多种不同人群的认知衰退的相互作用至关重要.
研究的目的:
- 检查TBI与发作之间的关联以及认知正常的老年人认知障碍的风险.
- 调查抗发作药物,抗抑郁药物和抗精神病药物在这种协会中的缓和作用.
- 探索TBI和发作后认知障碍风险的潜在种族和种族差异.
主要方法:
- 一项多中心队列研究的二次分析,使用来自国家阿尔茨海默氏症协调中心 (2005-2020) 的数据.
- 包括7180名认知正常的老年人 (≥65岁) 与全面的人口统计和健康史数据.
- 倾向性得分权重被用于调整选择偏差,统计分析在2024年进行.
主要成果:
- 发作增加了认知障碍风险40% (HR,1.40),TBI25% (HR,1.25) 和两者都增加了57% (HR,1.57).
- 与其他群体相比,患有TBI和的西班牙裔参与者患病风险更高.
- 抗抑郁药 (HR, 1.32) 和抗精神病药 (HR, 2.15) 与风险增加有关,而抗焦虑剂/镇静剂 (HR, 0.88) 与风险降低有关.
结论:
- 创伤和是老年人认知障碍的重要危险因素.
- 药物使用 (抗抑郁药,抗精神病药) 可能会影响认知能力下降.
- 解决健康和健康差异的社会决定因素对于预防和管理痴呆症至关重要.
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