老年退伍军人中的阿尔茨海默病和相关痴呆症：创伤后应激障碍和创伤性脑损伤与基因-环境相互作用的研究。
Alzheimer's disease and related dementias among aging veterans: Examining gene-by-environment interactions with post-traumatic stress disorder and traumatic brain injury.
机构信息
National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.
Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
出版信息
Alzheimers Dement. 2023 Jun;19(6):2549-2559. doi: 10.1002/alz.12870. Epub 2022 Dec 22.
INTRODUCTION
Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) confer risk for Alzheimer's disease and related dementias (ADRD).
METHODS
This study from the Million Veteran Program (MVP) evaluated the impact of apolipoprotein E (APOE) ε4, PTSD, and TBI on ADRD prevalence in veteran cohorts of European ancestry (EA; n = 11,112 ADRD cases, 170,361 controls) and African ancestry (AA; n = 1443 ADRD cases, 16,191 controls). Additive-scale interactions were estimated using the relative excess risk due to interaction (RERI) statistic.
RESULTS
PTSD, TBI, and APOE ε4 showed strong main-effect associations with ADRD. RERI analysis revealed significant additive APOE ε4 interactions with PTSD and TBI in the EA cohort and TBI in the AA cohort. These additive interactions indicate that ADRD prevalence associated with PTSD and TBI increased with the number of inherited APOE ε4 alleles.
DISCUSSION
PTSD and TBI history will be an important part of interpreting the results of ADRD genetic testing and doing accurate ADRD risk assessment.
简介
创伤后应激障碍（PTSD）和创伤性脑损伤（TBI）会增加阿尔茨海默病及相关痴呆症（ADRD）的发病风险。
方法
这项来自百万退伍军人计划（MVP）的研究评估了载脂蛋白 E（APOE）ε4、PTSD 和 TBI 对欧洲血统（EA；n=11112 例 ADRD 病例，170361 例对照）和非裔美国人（AA；n=1443 例 ADRD 病例，16191 例对照）退伍军人队列中 ADRD 患病率的影响。使用交互归因超额相对危险度（RERI）统计量估计加性尺度交互作用。
结果
PTSD、TBI 和 APOE ε4 与 ADRD 均具有显著的主要效应关联。RERI 分析显示，在 EA 队列中，APOE ε4 与 PTSD 和 TBI 存在显著的加性交互作用，在 AA 队列中，TBI 与 APOE ε4 存在显著的加性交互作用。这些加性交互作用表明，与 PTSD 和 TBI 相关的 ADRD 患病率随着 APOE ε4 遗传等位基因数量的增加而增加。
讨论
PTSD 和 TBI 病史将是解释 ADRD 遗传检测结果和进行准确 ADRD 风险评估的重要部分。
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