"Association Between Alcohol Use Disorders and Dementia in 262,703 Dementia-free Finnish Adults: Is Cardiovascular Disease a Mediator?"

作者全名："Hu, Yaoyue; Korhonen, Kaarina; Li, Peng; Bobak, Martin; Martikainen, Pekka; Bijlsma, Maarten J."

作者地址："[Hu, Yaoyue] Chongqing Med Univ, Sch Publ Hlth, 1 Yixueyuan Rd, Chongqing 400016, Peoples R China; [Korhonen, Kaarina; Martikainen, Pekka] Univ Helsinki, Fac Social Sci, Populat Res Unit, Helsinki, Finland; [Li, Peng; Martikainen, Pekka; Bijlsma, Maarten J.] Max Planck Inst Demog Res, Lab Populat Hlth, Rostock, Germany; [Bobak, Martin] UCL, Res Dept Epidemiol & Publ Hlth, London, England"

通信作者："Hu, YY (通讯作者)，Chongqing Med Univ, Sch Publ Hlth, 1 Yixueyuan Rd, Chongqing 400016, Peoples R China."

来源：JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000921669300001

JCR分区：Q1

影响因子：4.3

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Alcohol use disorders; Cardiovascular disease; Causal mediation; Dementia; g-formula

摘要："Background The possible mediating role of cardiovascular disease (CVD) in the relationship between alcohol use disorders (AUD) and the risk of early-onset (<age 65) and late-onset (>= age 65) dementia lacks formal investigation. Methods Using linked Finnish national register data, a population-based cohort study of 262,703 dementia-free Finnish men and women aged 40 + at baseline (December 31, 1999) was established. AUD and CVD in 1988-2014, and incident dementia in 2000-2014 were identified from Finnish Hospital Discharge Register and/or Drug Reimbursement Register. Causal association and mediation were assessed using mediational g-formula. Results AUD was associated with a substantial increase in the risk of early-onset dementia in both men (hazard ratio: 5.67, 95% confidence interval: 4.37-7.46) and women (6.13, 4.20-8.94) after adjustments for confounding; but the elevated risk for late-onset dementia was smaller (men: 2.01, 1.80-2.25; women: 2.03, 1.71-2.40). Mediational g-formula results showed that these associations were causal in men with no mediation by CVD as the virtually identical total effect of AUD (early-onset: 5.26, 3.48-7.48; late-onset: 2.01, 1.41-2.87) and direct effect of AUD (early-onset: 5.24, 3.38-7.64; late-onset: 2.19, 1.61-2.96) were found with no indirect effect via CVD. In women, the results were similar for late-onset dementia (total effect: 2.80, 1.70-4.31; direct effect: 2.92, 1.86-4.62) but underpowered for early-onset dementia. Conclusion AUD increased dementia risk, particularly the risk of early-onset dementia. This elevated risk of dementia associated with AUD was not mediated by CVD. Clinicians should consider the increased risk of dementia in the management of middle-aged and older adults with a history and/or current AUD."

基金机构："Max Planck Society; Academy of Finland [308247, 345219]; European Research Council under the European Union's Horizon 2020 Research and Innovation Programme [101019329]; Max Planck-University of Helsinki Center for Social Inequalities in Population Health"

基金资助正文："The research leading to this publication has been supported by the Max Planck Society within the framework of the project ""On the edge of societies: New vulnerable populations, emerging challenges for social policies and future demands for social innovation. The experience of the Baltic Sea States"" (2016-2021). P.M. was supported by the Academy of Finland (#308247, # 345219), the European Research Council under the European Union's Horizon 2020 Research and Innovation Programme (grant agreement No.101019329), and the Max Planck-University of Helsinki Center for Social Inequalities in Population Health. The funders played no role in study design, collection, ana-lysis, interpretation of data, writing of the report, or in the decision to submit the paper for publication."