Vascular health, diabetes, APOE and dementia the Aging, Demographics, and Memory Study 英文参考文献.docVIP

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Vascular health, diabetes, APOE and dementia the Aging, Demographics, and Memory Study 英文参考文献.doc

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Vascular health, diabetes, APOE and dementia the Aging, Demographics, and Memory Study 英文参考文献

Llewellynetal.Alzheimer’sResearchTherapy2010,2:19 /content/2/3/19 RESEARCH OpenAccess Vascularhealth,diabetes,APOEanddementia: theAging,Demographics,andMemoryStudy DavidJLlewellyn1,IainALang1,FionaEMatthews2,BrendaLPlassman3,MaryAMRogers4,5, LewisBMorgenstern6,GwenithGFisher7,MohammedUKabeto4andKennethMLanga4,5,7* Abstract Introduction:Evidencefromclinicalsamplesandgeographicallylimitedpopulationstudiessuggeststhatvascular health,diabetesandapolipoproteinε4(APOE)areassociatedwithdementia. Methods:Apopulation-basedsampleof856individualsaged71yearsorolderfromallcontiguousregionsofthe UnitedStatesreceivedanextensivein-homeclinicalandneuropsychologicalassessmentin2001-2003.Therelation ofhypertension,diabetes,heartdisease,stroke,medicationusage,andAPOEε4todementiawasmodelledusing adjustedmultivariablelogisticregression. Results:Treatedstroke(oddsratio[OR]3.8,95%confidenceinterval[CI]2.0,7.2),untreatedstroke(OR3.5,95%CI 1.7,7.3),andAPOEε4(OR2.8,95%CI1.7,4.5)allincreasedtheoddsofdementia.Treatedhypertensionwas associatedwithloweroddsofdementia(OR0.5,95%CI0.3,1.0).Diabetesandheartdiseasewerenotsignificantly associatedwithdementia.AsignificantinteractionwasobservedbetweenAPOEε4andstroke(P=0.001). Conclusions:DatafromthefirstdementiastudythatisrepresentativeoftheUnitedStatespopulationsuggest thatstroke,theAPOEε4alleleandtheirinteractionarestronglyassociatedwithdementia. Introduction pressure[5].Incidencestudiessuggestthatmidlifehyper- Identification ofmodifiable riskfactors forAlzheimer’s tensionisariskfactorfordementiainlate-life,andthat disease(AD),vasculardementia(VaD),andotherdemen- lowdiastolic andveryhighsystolic pressure inlate-life tiascould potentially leadtoareduction inthehuman mayalsoberiskfactors[4,5].Observationalstudiesand and economic costs these conditions place on aging randomizedcontrolledtrialsprovidelimitedevidencefora populations. Better prevention ofvascular disease and protectiveeffectofantihypertensivetherapy[4-9].How- better treatment