摘要
目的:调查中年人群中患多种精神疾病与老年痴呆发展之间的关系。方法:采用西澳大利亚州际医院住院病人、门诊病人的心理健康和急诊记录与死亡记录匹配的病例对照研究。65-84岁的易发痴呆病例(2000-2009)与候选名单对照研究显示其与性别和年龄相关。早至1970年的记录就被用来评估患者在65岁之前所受的医疗风险因素。潜在精神病风险因素被要求至少在痴呆症发病的10年以前就被发现,才能确保其潜在的因果关系。发生几率用条件逻辑回归估算。结果:13,568例老年痴呆病例(平均年龄78.7,43.4%男性),根据与对照病例相匹配而获得。抑郁症、躁郁症、精神分裂症、焦虑症和酒精依赖症被认为是引发患有糖尿病、心脏病、脑血管疾病和吸烟的危险因素后老年痴呆重要的和独立的风险性因素。抑郁症,精神分裂症和酒精依赖病史对患老年痴呆的影响因年龄而异,对较早期出现的老年痴呆的影响最强,随着年龄增大而减弱。结论:在中年时期经精神病医院专家治疗过的严重的抑郁症、焦虑症、躁郁症、精神分裂症和酒精依赖症患者是患老年痴呆的重要的风险因素。这些精神方面的疾病需要被将来的老年痴呆的风险和防范研究所考虑。
关键词: 阿尔兹海默病,焦虑症,躁郁症,病例对照研究,痴呆,抑郁症,危险因素,精神分裂
Current Alzheimer Research
Title:Severe Psychiatric Disorders in Mid-Life and Risk of Dementia in Late- Life (Age 65-84 Years): A Population Based Case-Control Study
Volume: 11 Issue: 7
Author(s): Renate R. Zilkens, David G. Bruce, Janine Duke, Katrina Spilsbury and James B. Semmens
Affiliation:
关键词: 阿尔兹海默病,焦虑症,躁郁症,病例对照研究,痴呆,抑郁症,危险因素,精神分裂
摘要: Objective: To examine the association of mid-life exposure to several psychiatric disorders with the development of late-life dementia. Methods: A matched case-control study using Western Australian state-wide hospital inpatient, outpatient mental health and emergency records linked to death records. Incident dementia cases (2000-2009) aged 65 to 84 years were sex- and age-matched to an electoral roll control. Records as far back as 1970 were used to assess exposure to medical risk factors before age 65 years. Candidate psychiatric risk factors were required to be present at least 10 years before dementia onset to ensure direction of potential causality. Odds ratios were estimated using conditional logistic regression. Results: 13, 568 dementia cases (median age 78.7 years, 43.4 % male) were matched to a control. Depression, bipolar disorder, schizophrenia, anxiety disorder and alcohol dependence were found to be significant and independent risk factors for late-life dementia after adjusting for diabetes, heart disease, cerebrovascular disease and smoking risk factors. The effect of a history of depression, schizophrenia and alcohol dependency on dementia risk varied with age, being strongest for earlier onset late-life dementia and waning at older ages. Conclusion: Severe depression, anxiety disorder, bipolar disorder, schizophrenia and alcoholic dependency disorder treated by specialists in psychiatric facilities in mid-life are important risk factors for late-life dementia. These psychiatric conditions need to be considered in future studies of the risk and prevention of late-life dementia.
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Zilkens R. Renate, Bruce G. David, Duke Janine, Spilsbury Katrina and Semmens B. James, Severe Psychiatric Disorders in Mid-Life and Risk of Dementia in Late- Life (Age 65-84 Years): A Population Based Case-Control Study, Current Alzheimer Research 2014; 11 (7) . https://dx.doi.org/10.2174/1567205011666140812115004
DOI https://dx.doi.org/10.2174/1567205011666140812115004 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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