早发型阿尔茨海默病发病的可调控危险因素分析

Clinical analysis of modifiable risk factors for early onset Alzheimer's disease

目的分析早发型阿尔茨海默病(EOAD)患者发病的可调控危险因素,为EOAD的一级预防提供依据。方法选择福建省立医院神经内科自2015年1月至2020年4月收治的40例EOAD患者作为EOAD组,选择门诊同期体检、年龄、性别和受教育程度与EOAD组患者相匹配的健康对照者120例作为对照组。回顾性比较EOAD组与对照组人口学特征和临床资料,多因素Logistic回归分析确定EOAD发病的独立危险因素。结果与对照组比较,EOAD组患者伴有高血压、非外伤性牙齿松动和(或)脱落、颅脑外伤史、听力障碍、慢性应激和(或)焦虑及睡眠障碍者所占比例增高,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高血压(OR=4.559,95%CI:1.523~13.643,P=0.007)、非外伤性牙齿松动和(或)脱落(OR=5.345,95%CI:1.989~14.346,P=0.001)、听力障碍(OR=9.336,95%CI:2.033~27.850,P=0.000)、慢性应激和(或)焦虑(OR=7.375,95%CI:2.612~20.822,P=0.000)以及睡眠障碍(OR=4.875,95%CI:1.520~15.625,P=0.002)是EOAD发病的独立危险因素。结论有高血压、非外伤性牙齿松动和(或)脱落、听力障碍、慢性应激和(或)焦虑及睡眠障碍者易发生EOAD,重视上述危险因素的筛查和干预可作为EOAD的一级预防策略。

Objective To analyze the modifiable risk factors for early-onset Alzheimer's disease(EOAD),and provide evidence for primary prevention of EOAD.Methods Forty patients with EOAD,admitted to our hospital from January 2015 to April 2020,were selected as EOAD group,and 120 healthy controls accepted physical examination and matched with EOAD patients in age,gender and education level were selected.Demographic characteristics and clinical data of patients from the EOAD group and subjects from the control group were compared retrospectively,and multivariate Logistic regression was used to analyze the independent risk factors for onset of EOAD.Results As compared with the control group,the EOAD group had significantly higher proportion of patients with hypertension,non-traumatic tooth loosening or loss,history of traumatic brain injury,hearing impairment,chronic stress and/or anxiety,and sleep disorder(P<0.05).The results of multivariate Logistic regression analysis showed that hypertension(OR=4.559,95%CI=1.523-13.643,P=0.007),non-traumatic loss or loosing of tooth(OR=5.345,95%CI=1.989-14.346,P=0.001),hearing impairment(OR=9.336,95%CI=2.033-27.850,P=0.000),chronic stress and/or anxiety(OR=7.375,95%CI=2.612-20.822,P=0.000),and sleep disorder(OR=4.875,95%CI=1.520-15.625,P=0.002)were independent risk factors for onset of EOAD.Conclusion Hypertension,non-traumatic loss or loosing of tooth,hearing impairment,chronic stress and/or anxiety,and sleep disorders are risk factors for onset of EOAD;the screening and intervention of these risk factors can be used as a primary prevention strategy for EOAD.