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当代阿耳茨海默病研究

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ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

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Research Article

自身免疫性疾病和改善疾病的抗风湿药物(DMARDs)与阿尔茨海默病和/或痴呆风险的关联:一项使用医疗保险受益人数据的人群研究

卷 20, 期 10, 2023

发表于: 26 January, 2024

页: [725 - 737] 页: 13

弟呕挨: 10.2174/0115672050289966240110041616

价格: $65

摘要

目的:阿尔茨海默病(AD)和/或痴呆是一种流行的神经认知障碍，主要影响65岁以上的个体。确定AD和/或痴呆的具体原因可能具有挑战性，新出现的证据表明其与自身免疫性炎症条件(如类风湿性关节炎(RA))的潜在关联。本研究旨在评估报告自身免疫性疾病的医疗保险受益人中AD和/或痴呆的患病率。此外，本研究旨在确定使用疾病改善抗风湿药物(DMARDs)与不使用DMARDs的自身免疫性疾病患者AD和/或痴呆的比较患病率。 方法:对2017年和2018年医疗保险现行受益人调查(MCBS)数据进行横断面二次数据分析。MCBS数据包括全国代表性的医疗保险人口样本，主要是65岁及以上的人口，并提供去识别的患者信息。来自该数据集的自我报告自身免疫性疾病的患者被纳入分析。对人口统计学变量、慢性病和药物使用进行描述性分析。比较了患有和不患有自身免疫性疾病的患者之间AD和/或痴呆的患病率。采用后向逐步选择回归来确定与阿尔茨海默病和/或痴呆患病率相关的危险因素。 结果:该研究包括18929名医疗保险受益人，其中4405人被确定患有一种自身免疫性疾病。AD和/或痴呆的患病率在自身免疫性疾病患者中明显更高。多因素回归分析显示，RA与AD和/或痴呆的高风险显著相关。其他人口统计学因素，包括高龄、非裔美国人或西班牙裔、低体重指数、慢性缺血性心脏病、心肌梗死史、中风史、抑郁症、精神健康障碍和创伤性脑损伤，也显示出与AD和/或痴呆的统计学显著关联。与不使用DMARDs的患者相比，使用DMARDs的患者患AD和/或痴呆的可能性降低。 结论:本研究提供了RA与AD和/或痴呆风险增加之间关联的证据。研究结果表明，使用DMARD可能对自身免疫性疾病患者的AD和/或痴呆的发展有保护作用。

关键词: 痴呆症，阿尔茨海默病，自身免疫性疾病，类风湿关节炎，改善疾病的抗风湿药物，医疗保险当前受益人调查。

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