(1)重要性:阿尔茨海默病(AD)是复杂的,只有部分了解。分析其他更可治疗或可预防的疾病与AD之间的关系可能有助于AD治疗的预防和最终发展。高风险人群的风险评估,而不是已经受到AD影响的人群,可以减少风险估计中的一些偏差。(2)目的:探讨AD高危人群中各种合并症和癌症的发生率,但没有临床诊断,相对于来自具有正常AD风险的相同人群的个体。(3)设计,设置,和参与者:我们使用犹他州人口数据库(UDB)的数据进行了一项研究。UPDB包含来自犹他州癌症登记处的链接数据,犹他州死亡证明,山间健康患者人群,和犹他大学健康患者人群。根据祖先数据的可用性选择受试者,链接的健康信息,和自我报告的生物识别技术。(4)结果:总的来说,根据家族史,估计有75,877名参与者患有AD的高风险。但没有积极的AD诊断,进行了分析。糖尿病发病率较低(RR=0.95,95%CI[0.92,0.97],p<0.001),高血压(RR=0.97,95%CI[0.95,0.99],p<0.001),和心脏病(RR=0.95,95%CI[0.93,0.98],p<0.001)被发现。脑血管疾病或其他形式的痴呆的发生率没有差异。在分析的15种癌症类型中:乳腺癌(RR=1.23,95%CI[1.16,1.30],p<0.001);结直肠(RR=1.30,95%CI[1.21,1.39],p<0.001);肾脏(RR=1.49,95%CI(1.29,1.72),p<0.001);肺(RR=1.25,95%CI[1.13,1.37],p<0.001);非霍奇金淋巴瘤(RR=1.29,95%CI[1.15,1.44],p<0.001);胰腺(RR=1.34,95%CI[1.16,1.55],p<0.001);胃(RR=1.59,95%CI[1.36,1.86],p<0.001);和膀胱(RR=1.40,95%CI[1.25,1.56],p<0.001),在校正多项检测后,在AD高危人群中观察到的癌症显著过量.(5)结论与相关性:年龄是AD发病的最大危险因素。年龄较大的个体患AD的风险增加.与此一致,生活早期合并症较少的人更有可能达到AD风险较大的年龄.我们的发现表明,处于AD高危人群的各种其他疾病的发病率降低。我们的发现进一步支持了这一点,我们的高危人群也被发现各种癌症的发病率增加,风险也随着年龄的增长而增加。在这些各种合并症之间可能存在更有意义或病因关系。对AD与这些合并症之间的病因关系的进一步研究可能会阐明这些可能的相互作用。
(1) Importance: Alzheimer\'s disease (AD) is complex and only partially understood. Analyzing the relationship between other more treatable or preventable diseases and AD may help in the prevention and the eventual development of treatments for AD. Risk estimation in a high-risk population, rather than a population already affected with AD, may reduce some bias in risk estimates. (2) Objective: To examine the rates of various comorbidities and cancers in individuals at high-risk for AD, but without a clinical diagnosis, relative to individuals from the same population with normal AD risk. (3) Design, Setting, and Participants: We conducted a study using data from the Utah Population Database (
UPDB). The
UPDB contains linked data from the Utah Cancer Registry, Utah death certificates, the Intermountain Health patient population, and the University of Utah Health patient population. Subjects were selected based on the availability of ancestral data, linked health information, and self-reported biometrics. (4) Results: In total, 75,877 participants who were estimated to be at high risk for AD based on family history, but who did not have an active AD diagnosis, were analyzed. A lower incidence of diabetes (RR = 0.95, 95% CI [0.92,0.97], p < 0.001), hypertension (RR = 0.97, 95% CI [0.95,0.99], p < 0.001), and heart disease (RR = 0.95, 95% CI [0.93,0.98], p < 0.001) was found. There was no difference in rates of cerebrovascular disease or other forms of dementia. Of the 15 types of cancer analyzed: breast (RR = 1.23, 95% CI [1.16, 1.30], p < 0.001); colorectal (RR = 1.30, 95% CI [1.21, 1.39], p < 0.001); kidney (RR = 1.49, 95% CI (1.29, 1.72), p < 0.001); lung (RR = 1.25, 95% CI [1.13, 1.37], p < 0.001); non-Hodgkin\'s Lymphoma (RR = 1.29, 95% CI [1.15, 1.44], p < 0.001); pancreas (RR = 1.34, 95% CI [1.16, 1.55], p < 0.001); stomach (RR = 1.59, 95% CI [1.36, 1.86], p < 0.001); and bladder (RR = 1.40, 95% CI [1.25, 1.56], p < 0.001), cancers were observed in significant excess among individuals at high-risk for AD after correction for multiple testing. (5) Conclusions and Relevance: Since age is the greatest risk factor for the development of AD, individuals who reach more advanced ages are at increased risk of developing AD. Consistent with this, people with fewer comorbidities earlier in life are more likely to reach an age where AD becomes a larger risk. Our findings show that individuals at high risk for AD have a decreased incidence of various other diseases. This is further supported by our finding that our high-risk group was also found to have an increased incidence of various cancers, which also increase in risk with age. There is the possibility that a more meaningful or etiological relationship exists among these various comorbidities. Further research into the etiological relationship between AD and these comorbidities may elucidate these possible interactions.