目标:生活事件可能会带来压力,并对健康产生不利影响,但是关于生活事件和痴呆症风险的证据尚无定论。本研究测试生活事件是否与痴呆相关。经历多个事件是否具有累积效应,以及这些关联是否因年龄而异,性别,种族/民族,社会经济地位,和遗传脆弱性。
方法:英国生物银行参与者(N=493,787)报告了过去两年内发生的六项生活事件:严重疾病,损伤,攻击自己或近亲,配偶/伴侣或近亲死亡,婚姻分居/离婚,和财务问题。在16年的随访中,通过英国国家卫生服务的健康记录确定了全因痴呆症事件。
结果:严重疾病,损伤,或者攻击自己,婚姻分居/离婚,经济困难与患痴呆症的风险更高;严重疾病,损伤,或者对近亲的攻击与较低的痴呆风险相关。当组合时,经历3~4次事件与痴呆风险增加2倍以上相关.在随访的前五年内,婚姻分居/离婚的关联更强(与反向因果关系一致)。配偶/伴侣或近亲的死亡大多与痴呆风险无关。除了少数例外,不同年龄的关联相似,性别,种族/民族,社会经济地位,和APOEe4状态组。
结论:严重疾病,损伤,或者人身攻击,婚姻分居或离婚,经济困难可能会增加痴呆症的风险,特别是当这些事件一起发生时。
OBJECTIVE: Life events can be stressful and have a detrimental impact on health, but evidence is inconclusive regarding life events and dementia risk. The present study tests whether life events are associated with incident dementia, whether experiencing multiple events has cumulative effects, and whether the associations vary across age, sex, race/ethnicity, socioeconomic status, and genetic vulnerability.
METHODS: UK Biobank participants (N = 493,787) reported on 6 life events that occurred within the past 2 years: serious illness, injury, assault to yourself or close relative, death of a spouse/partner or close relative, marital separation/divorce, and financial problems. Incident all-cause dementia was ascertained through health records from the UK National Health Service over a 16-year follow-up.
RESULTS: Serious illness, injury, or assault to yourself, marital separation/divorce, and financial difficulties were associated with a higher risk of dementia; serious illness, injury, or assault of a close relative was associated with a lower risk of dementia. When combined, experiencing 3-4 events was associated with a more than 2-fold increase in dementia risk. The association for marital separation/divorce was stronger within the first 5 years of follow-up (consistent with reverse causality). Death of a spouse/partner or close relative was mostly unrelated to dementia risk. With few exceptions, the associations were similar across age, sex, race/ethnicity, socioeconomic status, and apolipoprotein E e4 status groups.
CONCLUSIONS: Severe illness, injury, or personal assault, marital separation or divorce, and financial hardships may raise risk of dementia, particularly when these events occur together.