军队老年人阿尔茨海默病危险因素的病例对照研究

目的 探讨军队老年人阿尔茨海默病(AD)的危险因素,初步分析早年电磁暴露与AD的关系。方法 采用病例对照研究。选择解放军总医院近年来确诊的62例军队AD患者为病例组,在同一医院住院治疗的离退休老干部中按照年龄段分层抽样(按1:2比例)选取124例对照。调查方式为电话访谈。结果 单因素分析结果显示,病例组社会活动情况明显少于对照组,早年电磁暴露、体育锻炼情况、负性生活事件、慢性阻塞性肺病病史、既往癌症病史、痴呆家族史在两组间差异有显著性。在调整相关影响因素后,负性生活事件、痴呆家族史、社会活动量的OR值(95％CI)分别为3.27(1.53～6.97)、5.78(1.39～24.10)和0.81(0.72～0.92),早年电磁暴露的OR值(95％CI)为2.49(0.96～6.45),而既往癌症病史和吸烟似与AD呈负相关。结论 负性生活事件、痴呆家族史、社会活动减少是AD的独立危险因素,早年电磁暴露是其可能的危险因素;吸烟和既往癌症病史与AD呈负相关的原因可能与该老年人群的“生存偏性”有关。

A case-control study on the risk factors of Alzheimer's disease in military elderly men

Objective To investigate the risk of Alzheimer's disease (AD) associated with life style, early exposure to magnetic fields, family history of dementia and other risk factors. Methods We conducted a case-control study among the inpatients of Chinese PLA General Hospital in 2000-2003. Sixty-two AD cases and 124 controls were selected and matched for age. Univariate and multivariate analyses were conducted using logistic regression model. Results All subjects were males aged 66 to 102. In univariate analysis, lack of social activities, more physical exercises, early exposure to magnetic fields, suffering from negative life events and family history of dementia were statistically different between two groups (P<0.05). Multivariate analysis showed that after adjusting for potential confounders, suffering from negative life events, family histories of dementia increased the risk of AD with odds ratio(OR)and 95% confidence interval(CI)3.27(1.53-6.97) and 5.78(1.39-24.10). Early exposure to magnetic fields seemed a possible risk factor for AD, with OR(95%CI)2.49(0.96-6.45). The amount of social activities, cigarette smoking and history of cancers were negatively correlated with AD and their ORs (95%CI)were 0.81(0.72-0.92), 0.46(0.21-1.00)and 0.31(0.12-0.82)respectively. Conclusion The study demonstrated that suffering from negative life events and family history of dementia were risk factors for AD, and the early exposure to magnetic fields might also play a role.