AD文献阅读第12期：Alzheimers Dement——酒精使用障碍增加阿尔茨海默病和帕金森病的发病风险

中文摘要

引言：酒精使用障碍（AUD）在美国老年人中发病率很高，然而AUD与不良大脑结局之间的关联仍不确定。

方法：在一项使用美国保险索赔数据（2007-2020）的回顾性队列设计中，129182名AUD患者按照年龄、性别、种族和临床特征与129182名对照组进行了匹配。科学家使用Cox分析、Kaplan-Meier分析和对数秩检验研究了AUD与不良脑功能预后之间的相关性。

结果：经校正协变量后，在总体样本中，AUD与阿尔茨海默病风险（女性校正风险比[HR]=1.78，95%置信区间[CI]:1.68-1.90，p<0.001；男性校正风险比=1.80，95%CI:1.71-1.91，p<0.001）和帕金森病风险升高相关（女性校正HR=1.49，95%CI:1.32-1.68，p<0.001；男性校正HR=1.42，95%CI:1.32-1.52，p<0.001）。在对黑人、白人和西班牙裔个体的单独分析中，AUD患者患阿尔茨海默病的风险较高（调整后的HR≥1.58; Ps（压力）≤ 0.001). 但仅在白人亚群中发现帕金森氏症的风险显著升高（女性调整后的HR=1.55，95%CI:1.36-1.77，p<0.001；男性调整后的HR=1.45，95%CI:1.33-1.57，p<0.001）。

结论：AUD与阿尔茨海默病相关。AUD与白人的帕金森病有关。老年AUD患者的认知筛查和神经检查有望早期发现阿尔茨海默病和帕金森病。

亮点：酒精使用障碍与阿尔茨海默病和痴呆症有关。在白人中，酒精使用障碍与帕金森病有关。

英文摘要

Introduction: Alcohol use disorder (AUD) is on the ascendancy in the US older adult population. The association between AUD and adverse brain outcomes remains inconclusive.

Method: In a retrospective cohort design using US insurance claim data (2007-2020), 129,182 individuals with AUD were matched with 129,182 controls by age, sex, race, and clinical characteristics. We investigated the association between AUD and adverse brain outcomes using Cox analysis, Kaplan-Meier analysis, and log-rank test.

Results: After adjusting for covariates, AUD was associated with a higher risk of Alzheimer's disease (female adjusted hazard ratio [HR] = 1.78, 95% confidence interval [CI]: 1.68-1.90, p < 0.001; male adjusted HR = 1.80, 95% CI: 1.71-1.91, p < 0.001) and a higher risk of Parkinson's disease (female adjusted HR = 1.49, 95% CI: 1.32-1.68, p < 0.001; male adjusted HR = 1.42, 95% CI: 1.32-1.52, p < 0.001) in the overall sample. In separate analyses of Black, White, and Hispanic individuals, those with AUD had higher risk of Alzheimer's disease (adjusted HRs ≥1.58; Ps ≤0.001). A significantly elevated risk for Parkinson's disease was found only in the White subpopulation (female adjusted HR = 1.55, 95% CI: 1.36-1.77, p < 0.001; male adjusted HR = 1.45, 95% CI: 1.33-1.57, p < 0.001).

Conclusions: AUD is associated with Alzheimer's disease. AUD is associated with Parkinson's disease in White people. Cognitive screening and neurological examination among older adults with AUD hold the promise for early detection of Alzheimer's disease and Parkinson's disease.

Highlights: Alcohol use disorder is associated with Alzheimer's disease and dementia.Alcohol use disorder is associated with Parkinson's disease in White people.

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参考文献：Alcohol use disorder is associated with higher risks of Alzheimer's and Parkinson's diseases: A study of US insurance claims data. Alzheimers Dement (Amst). 2022 Nov 21;14(1):e12370. doi: 10.1002/dad2.12370. eCollection 2022.