摘要
背景:中风是导致老年人残疾的主要原因,使得老年人患痴呆的风险大大增加,是残疾的另一个重要来源。本文以人群为基础进行研究,旨在调查那些与未中风但具有类似并发症患者相比而言,中风患者患有痴呆风险。 方法:使用涵盖了2001~2007年间的台湾全民健康保险数据库进行回顾性队列研究,评估10884名首次中风且无痴呆史的患者患有年老年痴呆症的风险。在本项研究中,我们对人口统计数据和相关危险因素进行估计,得出病例的估计倾向分数,并基于此估计倾向分数对病例进行1:5的匹配病例对照分析,减少选择性误差,最后采用Cox比例风险回归分析评估中风患者患痴呆的风险。 结果:经过5年的随访调查发现,1487名中风患者(13.74%)和1402名未中风患者(2.59%)病人都遭受了痴呆症,中风与痴呆发病率是独立相关的,中风5年后患痴呆的风险增加到6.09倍(95%置信区间(CI),5.66~6.55) ;年龄越大,中风患者痴呆的发病率越高;每种中风的类型对痴呆的发生有不同的影响;出血性中风患者遭受痴呆的风险率远高于缺血性中风和对照组的患者。 结论:本研究结果表明,中风会使得老年痴呆症的风险增加,尤其是老年人和出血性中风患者。因此我们提倡,需要对中风患者仔细地观察,并且增强健康教育项目使中风患者受益。
关键词: 脑血管意外;痴呆;残疾;流行病学;以人群为基础的研究;中风
Current Alzheimer Research
Title:Stroke Suggests Increased Risk of Dementia
Volume: 12 Issue: 3
Author(s): Chih-Yuan Huang, Ying-Chun Li, Hao-Kuang Wang, Pi-Shan Sung, Liang-Chao Wang, Yuan-Ting Sun, Chia-Hsin Pan and Kuen-Jer Tsai
Affiliation:
关键词: 脑血管意外;痴呆;残疾;流行病学;以人群为基础的研究;中风
摘要: Background: Stroke is a major cause of disability in the elderly and considerably increases the risk of dementia, which is another important source of disability. This population-based study aimed to examine the risk of dementia in patients with stroke compared with non-stroke cases with similar comorbidities. Methods: Using the Taiwan National Health Insurance databank covering the period 2001-2007, this retrospective cohort study evaluated the risk of dementia in 10,884 patients with first stroke who had no history of dementia. In this study, we performed a 1:5 case-control matched analysis, in which cases were matched to controls based on their estimated propensity scores, which were estimated with demographics and associated risk factors. This approach reduced selection bias. Cox proportional hazards regression analysis was then used to estimate the risk of dementia in stroke patients. Results: During the 5-year follow-up period, 1,487 (13.74%) stroke and 1,402 (2.59%) non-stroke patients suffered dementia. Stroke was independently associated with a 6.09 (95% confidence interval [CI], 5.66 to 6.55) times greater risk of dementia 5 years after stroke. Older age was associated with a higher incidence of dementia after stroke. Each stroke type had different impacts on the occurrence of dementia. The hazard ratio of dementia among hemorrhagic stroke patients was much higher than those of ischemic stroke and controls. Conclusion: The findings of this study suggest that stroke confers an increased risk of dementia, especially in the elderly and in patients with hemorrhagic stroke. We advocate the need for close observation and enhanced health education programs to benefit patients with stroke.
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Chih-Yuan Huang, Ying-Chun Li, Hao-Kuang Wang, Pi-Shan Sung, Liang-Chao Wang, Yuan-Ting Sun, Chia-Hsin Pan and Kuen-Jer Tsai , Stroke Suggests Increased Risk of Dementia, Current Alzheimer Research 2015; 12 (3) . https://dx.doi.org/10.2174/1567205012666150302155536
DOI https://dx.doi.org/10.2174/1567205012666150302155536 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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