盐城 2008-6-27 23:42
Neurology：智商影响血管性痴呆患病率
英国《神经病学》月刊25日公布的一项研究结果显示，低智商人群罹患血管性痴呆的风险相对较高。
英国研究人员分析了172名苏格兰儿童在1932年接受的智商检测结果，他们当时11岁。研究人员把那些人后来罹患血管性痴呆的情况做比对后发现，当年智商相对较低的人群，几十年后患血管性痴呆的几率更高。
负责这项研究的爱丁堡大学 负责这项研究的爱丁堡大学老年病学家约翰·斯塔尔说：“你的智力水平可能关乎你患血管性痴呆的风险。”
血管性痴呆是仅次于阿尔茨海默氏症（老年痴呆症）的第二大常见痴呆病症，常由中风引起。吸烟和高血压也容易导致这一疾病。
与此同时，研究人员没有发现智商高低与阿尔茨海默氏症之间的联系。
原始出处：
Neurology，doi:10.1212/01.wnl.0000319692.20283.10，Brian McGurn, Ian J. Deary, and John M. Starr
Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia
Brian McGurn MRCP, Ian J. Deary PhD, and John M. Starr FRCPEd*
From the Geriatric Medicine Unit (B.M., J.M.S.), and Psychology (I.J.D.), University of Edinburgh, UK.
* To whom correspondence should be addressed. E-mail: [email]jstarr@staffmail.ed.ac.uk[/email] .
Background: Risk factors for dementia can be divided into those that lead to pathologic insults and those that render the brain more vulnerable to such insults. Dementia prevention strategies need to be informed as to whether to prioritize reducing risk of pathology or to reduce the vulnerability of the brain to pathologic insult. Lower premorbid cognitive ability is associated with both increased vascular risk and reduced cognitive reserve, a measure of brain vulnerability. We investigated differential effects of premorbid cognitive ability on dementia subtypes to clarify which causal pathway was predominant.
Methods: A total of 297 cases of late onset dementia were identified from local case registers, born in 1921, and thus may have participated in the Scottish Mental Survey of 1932 (SMS1932). A total of 183 had mental ability scores identified in the SMS1932. A total of 173 of these were matched by birth records to one set of controls (controls1) by date of birth, sex, and district of birth registration. A further set of controls (controls2) was generated additionally matched on paternal occupation.
Results: Vascular dementia cases had significantly lower premorbid cognitive ability (OR 0.62, 95% CI 0.41–0.94, for every 10-point increase [0.7 SD] in mental ability score vs controls2), but there was no significant difference in the premorbid cognitive ability of Alzheimer disease cases (OR 1.02, 95% CI 0.82–1.28) vs controls2.
Conclusion: Lower premorbid cognitive ability is a risk factor for vascular dementia, but not Alzheimer disease. This suggests its effect acts mainly through vascular pathology rather than brain vulnerability.