The Relationship between Framingham Stroke Risk Profile on Incident Dementia and Alzheimer's Disease: A 40-Year Follow-Up Study Highlighting Female Vulnerability.

IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY Annals of Neurology Pub Date : 2024-10-15 DOI:10.1002/ana.27108
Jing Yuan, Qiushan Tao, Ting Fang Alvin Ang, Chunyu Liu, Sherral Devine, Sanford H Auerbach, Jesse Mez, Lindsay A Farrer, Wei Qiao Qiu, Rhoda Au
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Abstract

Objective: Sex differences in the association between cardiovascular risk factors and the incident all-cause dementia and the subtype Alzheimer's disease (AD) risk are unclear.

Methods: Framingham Heart Study (FHS) participants (n = 4,171, 54% women, aged 55 to 69 years) were included at baseline and followed up to 40 years. The Framingham Stroke Risk Profile (FSRP) was dichotomized into 2 levels (cutoff: 75th percentile of the FSRP z-scores). Cause-specific hazard models, with death as a competing event, and restricted mean survival time (RMST) model were used to analyze the association between FSRP levels and incident all-cause dementia and AD. Interactions between FSRP and sex were estimated, followed by a sex-stratified analysis to examine the sex modification effect.

Results: High FSRP was significantly associated with all-cause dementia (hazard ratio [HR] = 1.25, robust 95% confidence interval [CI] = 1.21 to 1.29, p < 0.001) and AD (HR = 1.58, robust 95% CI = 1.57 to 1.59, p < 0.001) in cause-specific hazard models. High FSRP was significantly associated with incident dementia (HR = 2.81, robust 95% CI = 2.75 to 2.87, p < 0.001) and AD (HR = 2.96, robust 95% CI = 2.36 to 3.71, p < 0.001) in women, but not in men. Results were consistent in the RMST models. Current diabetes and high systolic blood pressure as FSRP components were significantly associated with dementia and AD in women but not in men.

Interpretation: High FSRP in mid- to early late life is a critical risk factor for all-cause dementia and AD, particularly in women. Sex-specific interventions and further research to elucidate underlying mechanisms are warranted. ANN NEUROL 2024.

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弗雷明汉卒中风险档案与痴呆症和阿尔茨海默病发病之间的关系:突显女性脆弱性的 40 年随访研究。
研究目的心血管风险因素与全因痴呆和亚型阿尔茨海默病(AD)发病风险之间的性别差异尚不清楚:弗雷明汉心脏研究(FHS)的参与者(n = 4,171 人,54% 为女性,年龄在 55 岁至 69 岁之间)被纳入基线研究并随访 40 年。弗雷明汉卒中风险档案(FSRP)被分为两个等级(分界线:FSRP z分数的第75百分位数)。以死亡为竞争事件的特定病因危险模型和受限平均生存时间(RMST)模型用于分析FSRP水平与全因痴呆症和注意力缺失症之间的关系。对FSRP与性别之间的交互作用进行了估计,随后进行了性别分层分析,以检验性别修饰效应:结果:高FSRP与全因痴呆症有明显相关性(危险比[HR] = 1.25,稳健的95%置信区间[CI] = 1.21至1.29,P 解释:中年至晚年的高FSRP是全因痴呆症和注意力缺失症的关键风险因素,尤其是对女性而言。有必要采取针对不同性别的干预措施,并开展进一步研究以阐明其潜在机制。ann neurol 2024.
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来源期刊
Annals of Neurology
Annals of Neurology 医学-临床神经学
CiteScore
18.00
自引率
1.80%
发文量
270
审稿时长
3-8 weeks
期刊介绍: Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.
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