创伤后应激障碍与医疗保健系统成员的痴呆风险。
Post-traumatic stress disorder and risk of dementia among members of a health care delivery system.
机构信息
Institute for Health & Aging, University of California, San Francisco, San Francisco, CA, USA.
Kaiser Permanente Division of Research, Oakland, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
出版信息
Alzheimers Dement. 2018 Jan;14(1):28-34. doi: 10.1016/j.jalz.2017.04.014. Epub 2017 Jun 13.
INTRODUCTION
Post-traumatic stress disorder (PTSD) is associated with an increased risk of dementia in male veterans, but little is known in females and civilians.
METHODS
PTSD and comorbidities were abstracted from medical records from 1/1/1996 to 12/31/2001. Dementia incidence from 1/1/2002 to 12/31/2014 in 499,844 health care members aged 60+ years over an average of 8.2 years. Cox proportional hazard models were adjusted for age, demographics, and comorbidities.
RESULTS
PTSD was associated with increased risk of dementia over an average of 8 years of follow-up (females: hazard ratio [HR] = 1.59, 95% confidence interval [CI] = 1.30-1.95; males: HR = 1.96, 95% CI = 1.51-2.55). There was a two-fold risk of dementia in those with both PTSD and depression (females: HR = 2.08; 95% CI = 1.66-2.59; males: HR = 2.06; 95% CI = 1.47-2.91) versus those without.
DISCUSSION
PTSD was a risk factor for dementia in both sexes, with a heightened risk in those with comorbid depression.
简介
创伤后应激障碍（PTSD）与男性退伍军人痴呆风险增加相关，但女性和普通人群中知之甚少。
方法
从 1996 年 1 月 1 日至 2001 年 12 月 31 日的医疗记录中提取 PTSD 和合并症。在 499844 名 60 岁以上的医疗保健成员中，从 2002 年 1 月 1 日至 2014 年 12 月 31 日，平均随访 8.2 年，记录痴呆的发病率。Cox 比例风险模型调整了年龄、人口统计学和合并症。
结果
在平均 8 年的随访中，PTSD 与痴呆风险增加相关（女性：风险比 [HR] = 1.59，95%置信区间 [CI] = 1.30-1.95；男性：HR = 1.96，95% CI = 1.51-2.55）。在同时患有 PTSD 和抑郁症的人群中，痴呆的风险增加了一倍（女性：HR = 2.08；95% CI = 1.66-2.59；男性：HR = 2.06；95% CI = 1.47-2.91），而非两者均无。
讨论
PTSD 是两性痴呆的危险因素，在合并抑郁症的人群中风险更高。
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