期刊
NEUROLOGY
卷 58, 期 2, 页码 209-218出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.58.2.209
关键词
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资金
- NIA NIH HHS [R01 AG011380, AG-11380] Funding Source: Medline
- NIMH NIH HHS [MH-14592, T32 MH014592] Funding Source: Medline
Objective: To characterize the incidence of AD among the elderly population of Cache County, UT, noted for its longevity and high response rates; to explore sex differences; and to examine whether AD incidence plateaus or declines in extreme old age. Methods: Using a multistage screening process in 1998 and 1999, and reexamining 122 individuals who had been identified 3 years earlier as cognitively compromised but not demented, the authors found 185 individuals with incident dementia (123 with AD) among 3,308 participants who contributed 10,541 person-years of observation. Adjusting for nonresponse and screening sensitivity, the authors estimated the incidence of dementia and of AD for men and women in 3-year age intervals. Multivariate discrete time survival analysis was used to examine influences of age, sex, education, and genotype at APOE, as well as interactions of these factors. Results: The incidence of both dementia and AD increased almost exponentially until ages 85 to 90, but appeared to decline after age 93 for men and 97 for women. A statistical interaction between age and the presence of two APOE-epsilon4 alleles indicated acceleration in onset of AD with this genotype; the interaction of age and one epsilon4 suggested more modest acceleration. A statistical interaction of sex and age indicated greater incidence of AD in women than in men after age 85. Conclusions: The incidence of AD in the Cache County population increased with advancing age, but then peaked and declined among the extremely old, The presence of APOE-epsilon4 alleles accelerated onset of AD, but did not appreciably alter lifetime incidence apparent over a span of 100 years.
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