高齢者の脳健康に関する伝統的リスク要因に挑む研究 (UC Irvine-led study challenges traditional risk factors for brain health in the oldest-old)

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2025-01-07 カリフォルニア大学アーバイン校

カリフォルニア大学アーバイン校(UC Irvine)の研究チームは、90歳以上の高齢者において、若年層で脳血管損傷のリスク要因とされる高血圧や糖尿病が、同様のリスクを増加させない可能性があることを発見しました。さらに、降圧薬の使用が特定の脳損傷のリスク低減と関連していることも示唆されています。この研究は、血圧、血管の健康、脳の老化の関係が従来考えられていたよりも複雑であることを示しています。

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剖検における血管危険因子と脳血管病理学的変化:90+研究 Vascular risk factors and cerebrovascular pathologic changes on autopsy: The 90+ Study

Ravi Rajmohan, Zeinah Al-Darsani, Chu-Ching Ho, Joey Wong, Annlia Paganini-Hill, Thomas Montine, Maria Corrada, Claudia Kawas
Alzheimer’s & Dementia  Published: 07 January 2025
DOI:https://doi.org/10.1002/alz.14454

高齢者の脳健康に関する伝統的リスク要因に挑む研究 (UC Irvine-led study challenges traditional risk factors for brain health in the oldest-old)

Abstract

INTRODUCTION
Cerebrovascular pathologic changes (CVPC) are prevalent and associated with dementia in those ≥ 90 years. However, CVPC associations to traditional risk factors (hypertension, diabetes, and hyperlipidemia) are variable. We hypothesized that neither traditional risk factors nor related medications would be associated with CVPC presence.

METHODS
In autopsy volunteers from The 90+ Study, odds ratios (OR) of CVPC presence to self-reported vascular risk factors and cardiovascular medication classes were calculated using logistic regressions adjusted for age of death, sex, and education.

RESULTS
In 267 participants (mean age at death 98 (±3.5) years; 75% female), CVPC presence was not related to traditional risk factors. Lower odds of atherosclerosis with diuretics [OR 0.55] and lower odds of cerebral amyloid angiopathy (CAA) with B-blocker [OR 0.57] or vasodilator [OR 0.40] use were observed.

DISCUSSION
Our findings suggest that vascular risk factors are not risk factors for CVPC at this age, medications have mitigated risks, or survival bias obscures associations.

Highlights

  • Cardiovascular risk factors are thought to contribute to cerebrovascular diseases.
  • Risk factors were generally not associated with cerebrovascular changes.
  • Lower odds of certain cerebrovascular changes were associated with antihypertensive use.
医療・健康
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