INTRODUCTION:Many previous studies have been limited by self- or proxy-reported injury or short follow-up. We investigated whether head or brain injuries are associated with Alzheimer's disease (AD), possible modifying factors and dose-response relationship. METHODS:Nested register-based case-control study of all community dwellers who received clinically verified AD diagnosis in Finland in 2005 to 2011 (n = 70,719) and one to four matched controls for each case (n of controls = 282,862). RESULTS:The magnitude of association between hospital-treated head and/or brain injuries was strongly dependent on the lag time between exposure and outcome. With a 5-year lag time, head injury (adjusted odds ratio; 95% confidence interval 1.19; 1.15-1.23) or brain injury (1.23; 1.18-1.29) was associated with higher risk of AD. Dose-response relationship with number and severity of injuries was observed. Associations were stronger in those with earlier onset of AD. CONCLUSIONS:Stronger associations with shorter lag times indicate that head and/or brain injuries may also reflect the ongoing AD disease process.

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简介:许多先前的研究受到自我或代理人报告的伤害或短期随访的限制。我们调查了头部或脑部损伤是否与阿尔茨海默氏病(AD),可能的修饰因子和剂量反应关系有关。
方法:对2005年至2011年在芬兰接受临床验证的AD诊断的所有社区居民进行基于巢式病例对照研究(n = 70,719),每例匹配一到四个匹配的对照(n个对照= 282,862)。
结果:医院治疗的头部和/或脑部损伤之间的关联程度在很大程度上取决于暴露与结果之间的滞后时间。滞后时间为5年时,颅脑损伤(调整比值比; 95%置信区间1.19; 1.15-1.23)或脑损伤(1.23; 1.18-1.29)与AD风险较高相关。观察到剂量反应与伤害的数量和严重程度之间的关系。在AD发病较早的人群中,联想更强。
结论:滞后时间较短的更强关联表明,头部和/或脑部损伤也可能反映了正在进行的AD疾病过程。

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