Modifiable cardiovascular disease risk factors as predictors of dementia death: pooling of ten general population-based cohort studies.

G David Batty, Tom C Russ, John M Starr, Emmanuel Stamatakis, Mika Kivimäki
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Abstract

Background: With drug treatment for dementia being of limited effectiveness, the role of primary prevention, in particular the predictive value of modifiable cardiovascular disease risk factors, may warrant exploration. The evidence base is, however, characterised by discordant findings and is modest in size. Accordingly, we examined the association of modifiable cardiovascular disease risk factors with dementia death.

Design and methods: We pooled raw data from 10 UK general population-based prospective cohort studies within the context of an individual participant meta-analysis.

Results: A total of 103,764 men and women were followed up for a mean of 8 years giving rise to 443 dementia-related deaths and 2612 cardiovascular disease deaths. Cardiovascular disease mortality was, as anticipated, associated with the full range of risk factors under study, including raised blood pressure, smoking, diabetes, physical inactivity. By contrast, dementia death was related to very few of the cardiovascular disease risk factors: of those classified as modifiable, only smoking was associated with a raised risk and higher levels of non-HDL with a lower risk.

Conclusions: In the present individual participant meta-analysis, there was limited evidence that cardiovascular disease risk factors were related to dementia death.

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可改变的心血管疾病风险因素是痴呆症死亡的预测因素:汇集十项基于普通人群的队列研究。
背景:由于药物治疗痴呆症的效果有限,因此有必要探讨一级预防的作用,特别是可改变的心血管疾病风险因素的预测价值。然而,证据基础的特点是研究结果不一致,而且规模不大。因此,我们研究了可改变的心血管疾病风险因素与痴呆症死亡之间的关系:设计与方法:我们在个体参与者荟萃分析的背景下,汇集了英国 10 项基于普通人群的前瞻性队列研究的原始数据:共对 103,764 名男性和女性进行了平均为期 8 年的跟踪调查,结果显示与痴呆症相关的死亡人数为 443 人,心血管疾病死亡人数为 2612 人。正如预期的那样,心血管疾病死亡与研究中的所有风险因素有关,包括血压升高、吸烟、糖尿病和缺乏运动。相比之下,痴呆症的死亡与极少数心血管疾病风险因素有关:在被归类为可改变的风险因素中,只有吸烟与风险升高有关,而非高密度脂蛋白水平升高与风险降低有关:在本项个体参与者荟萃分析中,只有有限的证据表明心血管疾病风险因素与痴呆症死亡有关。
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