痴呆
危险系数
医学
四分位间距
比例危险模型
内科学
认知功能衰退
队列
队列研究
前瞻性队列研究
认知
阿尔茨海默病
老年学
疾病
置信区间
精神科
作者
Zhen Zhou,Joanne Ryan,Andrew Tonkin,Sophia Zoungas,Paul Lacaze,Rory Wolfe,Suzanne G Orchard,Anne M. Murray,John J McNeil,Chenglong Yu,Gerald F. Watts,Sultana Monira Hussain,Lawrence J. Beilin,Michael E. Ernst,Nigel Stocks,Robyn L. Woods,Chao Zhu,Christopher M. Reid,Raj C. Shah,Trevor T.‐J. Chong,Ajay Sood,Kerry M. Sheets,Mark Nelson
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2023-11-28
卷期号:101 (22)
被引量:1
标识
DOI:10.1212/wnl.0000000000207923
摘要
It has been suggested that higher triglyceride levels were associated with a lower risk of Alzheimer disease. This study aimed to examine the association of triglycerides with dementia and cognition change in community-dwelling older adults.This prospective longitudinal study used data from the Aspirin in Reducing Events in the Elderly (ASPREE) randomized trial of adults aged 65 years or older without dementia or previous cardiovascular events at enrollment. The main outcome was incident dementia. Other outcomes included changes in composite cognition and domain-specific cognition (global cognition, memory, language and executive function, and psychomotor speed). The association between baseline triglycerides and dementia risk was estimated using Cox proportional hazard models adjusting for relevant risk factors. Linear mixed models were used to investigate cognitive change. The analysis was repeated in a subcohort of participants with available APOE-ε4 genetic data with additional adjustment for APOE-ε4 carrier status and an external cohort (UK Biobank) with similar selection criteria applied.This study included 18,294 ASPREE participants and 68,200 UK Biobank participants (mean age: 75.1 and 66.9 years; female: 56.3% and 52.7%; median [interquartile range] triglyceride: 106 [80-142] mg/dL and 139 [101-193] mg/dL), with dementia recorded in 823 and 2,778 individuals over a median follow-up of 6.4 and 12.5 years, respectively. Higher triglyceride levels were associated with lower dementia risk in the entire ASPREE cohort (hazard ratio [HR] with doubling of triglyceride: 0.82, 95% CI 0.72-0.94). Findings were similar in the subcohort of participants with APOE-ε4 genetic data (n = 13,976) and in the UK Biobank cohort (HR was 0.82 and 0.83, respectively, all p ≤ 0.01). Higher triglycerides were also associated with slower decline in composite cognition and memory over time (p ≤ 0.05).Older adults with higher triglyceride levels within the normal to high-normal range had a lower dementia risk and slower cognitive decline over time compared with individuals with lower triglyceride levels. Higher triglyceride levels may be reflective of better overall health and/or lifestyle behaviors that would protect against dementia development. Future studies are warranted to investigate whether specific components within the total circulating pool of plasma triglycerides may promote better cognitive function, with the hope of informing the development of new preventive strategies.
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