TY -的T1 -编者注:认知活动和事件阿尔茨海默病痴呆的发病年龄JF -神经学乔-神经病学SP - 170 LP - 170 - 10.1212 / WNL。首页0000000000013125六世- 98 - 4盟James e . Siegler三世AU -史蒂文Galetta A2 Galetta Steven Ganesh Aravind刘易斯,阿丽亚娜Siegler, James e . Y1 - 2022/01/25 UR - //www.ez-admanager.com/content/98/4/首页170.1.abstract N2 -在他们的前瞻性队列研究,威尔逊博士等人探讨了痴呆认知活动和事件之间的关系在连续的拉什记忆和衰老项目的老年病人。研究人员推测,自述更高水平的认知活动,如阅读会与老年痴呆症患者发病的临床阿尔茨海默病(AD)。1903包括患者中,457(24%)开发可能或可能的广告在一个平均6.8年的随访(±4.6)。主要分析,更高的认知活动是独立与痴呆症发作后加速失效时间模型(估计为0.026,95%可信区间0.013 - -0.039)。这种关系保存在多个其他探索性模型,包括模型,占性别和教育水平,早期的模型调整认知活动(孔没有独立与痴呆),从结果和模型不包括患者可能的广告活动。当第十百分位的患者高认知活动与底部第十百分位相比,患者在前10百分比发达痴呆的意思是5年后(93.6 vs 88.6年)。克劳斯博士建议,假设的方向协会(更多认知活动→延迟痴呆诊断)可能被逆转,低水平的认知活动在后期生活可能是老年痴呆症的前兆。为了反驳这备择假设,研究者分析了广告的认知活动与标记之间的关系在登记,发现没有联系。作者同意克劳斯博士,他们的研究并不能完全证明反向因果关系的假说; however, these data complement previous research that continues to build the argument for an important relationship between cognitive activity and the subsequent symptoms of dementia.In their prospective observational cohort study, Dr. Wilson et al. explored the relationship between cognitive activity and incident dementia among consecutive elderly patients from the Rush Memory and Aging Project. The investigators hypothesized that self-reported higher levels of cognitive activity such as reading would be associated with older age of dementia onset in patients with clinical Alzheimer disease (AD). Of the 1903 included patients, 457 (24%) developed possible or probable AD over a mean of 6.8 years (±4.6) of follow-up. In the primary analysis, higher cognitive activity was independently associated with later dementia onset in the accelerated failure time model (estimate 0.026, 95% CI 0.013–0.039). This relationship persisted in multiple other exploratory models, including a model that accounted for sex and educational level, a model which adjusted for early-life cognitive activity (which bore no independent association with dementia), and a model excluding patients with possible AD from outcome events. When the top 10th percentile of patients with high cognitive activity were compared with the bottom 10th percentile, patients in the top 10th percentile developed dementia at a mean of 5 years later (93.6 vs 88.6 years). Dr. Krauss suggests that the hypothesized direction of the association (more cognitive activity → delay in dementia diagnosis) may possibly be reversed and that the low level of cognitive activity in late life may be an early sign of dementia. In an attempt to disprove this alternative hypothesis, the investigators analyzed the relationship between cognitive activity with markers of AD at enrollment and found no association. The authors agree with Dr. Krauss that their study cannot fully disprove the reverse causality hypothesis; however, these data complement previous research that continues to build the argument for an important relationship between cognitive activity and the subsequent symptoms of dementia. ER -