Félix Bermejo-Pareja1, Agustín Gómez de la Cámara1, Teodoro Del Ser2, Israel Contador3, Sara Llamas-Velasco4, Jesús María López-Arrieta5, Cristina Martín-Arriscado1, Jesús Hernández-Gallego1,6, Saturio Vega7, Julián Benito-León1,6. 1. Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain. 2. Alzheimer's Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofia Foundation Alzheimer Research Center, Madrid, Spain. 3. Department of Basic Psychology, Psychobiology and Methodology of Behavioural Science, University of Salamanca, Salamanca, Spain. 4. Research Institute (Imas12), Hospital Universitario 12 de Octubre, Avda. de Córdoba S/N, 28041, Madrid, Spain. laisset@hotmail.com. 5. Memory Unit, Department of Geriatrics, Hospital de Cantoblanco, Madrid, Spain. 6. Department of Medicine, Faculty of Medicine, Complutense University of Madrid (UCM), Madrid, Spain. 7. Geriatrician. Arevalo County, Ávila, Spain.
Abstract
BACKGROUND: The causes of the dementia decrease in affluent countries are not well known but health amelioration could probably play a major role. Nevertheless, although many vascular and systemic disorders in adult life are well-known risk factors (RF) for dementia and Alzheimer disease (AD), health status is rarely considered as a single RF. AIM: To analyse whether the health status and the self-perceived health (SPH) could be RF for dementia and AD and to discuss its biological basis. METHODS: We analysed different objective health measures and SPH as RF for dementia and AD incidence in 4569 participants of the NEDICES cohort by means of Cox-regression models. The mean follow-up period was 3.2 (range: 0.03-6.6) years. RESULTS: Ageing, low education, history of stroke, and "poor" SPH were the main RF for dementia and AD incidence, whereas physical activity was protective. "Poor" SPH had a hazard ratio = 1.66 (95% CI 1.17-2.46; p = 0.012) after controlling for different confounders. DISCUSSION: According to data from NEDICES cohort, SPH is a better predictor of dementia and AD than other more objective health status proxies. SPH should be considered a holistic and biologically rooted indicator of health status, which can predict future development of dementia and AD in older adults. CONCLUSIONS: Our data indicate that it is worthwhile to include the SPH status as a RF in the studies of dementia and AD incidence and to explore the effect of its improvement in the evolution of this incidence.
BACKGROUND: The causes of the dementia decrease in affluent countries are not well known but health amelioration could probably play a major role. Nevertheless, although many vascular and systemic disorders in adult life are well-known risk factors (RF) for dementia and Alzheimer disease (AD), health status is rarely considered as a single RF. AIM: To analyse whether the health status and the self-perceived health (SPH) could be RF for dementia and AD and to discuss its biological basis. METHODS: We analysed different objective health measures and SPH as RF for dementia and AD incidence in 4569 participants of the NEDICES cohort by means of Cox-regression models. The mean follow-up period was 3.2 (range: 0.03-6.6) years. RESULTS: Ageing, low education, history of stroke, and "poor" SPH were the main RF for dementia and AD incidence, whereas physical activity was protective. "Poor" SPH had a hazard ratio = 1.66 (95% CI 1.17-2.46; p = 0.012) after controlling for different confounders. DISCUSSION: According to data from NEDICES cohort, SPH is a better predictor of dementia and AD than other more objective health status proxies. SPH should be considered a holistic and biologically rooted indicator of health status, which can predict future development of dementia and AD in older adults. CONCLUSIONS: Our data indicate that it is worthwhile to include the SPH status as a RF in the studies of dementia and AD incidence and to explore the effect of its improvement in the evolution of this incidence.
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