新研究在AAIC 2020(阿尔茨海默氏症协会国际会议)上发表。下面的专题突出了会议中出现的一些研究。

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接种流感疫苗和降低AD发病率

由于缺乏有效的治疗方法,预防仍然是对抗阿尔茨海默病(AD)的一种有价值的方法,研究人员试图从统计学上检验流感疫苗接种和AD之间的关系,希望找到一种预防AD的候选者。研究小组使用表明AD诊断的ICD-9编码的患者EHR数据集,并排除60岁以下的患者,评估接种疫苗和未接种疫苗的患者。为了分析疫苗接种频率的影响,他们用疫苗接种次数除以从第一次接种到AD发病或观察结束的时间长度。接种流感疫苗显著降低研究人群AD患病率(优势比[OR], 0.8309),接种流感疫苗的频率对抑制AD发病有显著影响(OR, 0.8736)。时间-事件分析显示,与年龄较大时接种流感疫苗相比,早期接种流感疫苗导致AD风险较小,首次接种疫苗年龄增加1年,风险比增加1.0924。该研究的作者写道:“这一结果提供了证据,证明流感疫苗可能是[AD]危险因素流行病学研究的混杂因素。”

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磷酸盐Tau217作为广告的生物标志物

In order to evaluate whether cerebrospinal fluid (CSF) tau phosphorylated at threonine 217 (p-tau217) or plasms p-tau217 are even better biomarkers of Alzheimer’s disease (AD) than p-tau181, study investigators compared CSF p-tau217 and CSF p-tau81 among a cohort of nearly 200 and evaluated plasma p-tau217 and plasma p-tau181 in three cohorts with 1,438 participants. CSF p-tau217 had stronger correlations with the tau-PET tracer, and more accurately identified individuals with abnormal tau-PET scans than CSF P-tau181. CSF P-tau217 correlated better than p-tau181 with CSF and PET measures of neocortical amyloid-β burden and more accurately distinguished AD dementia from non-AD neurodegenerative disorders. Antemortem plasma P-tau217 differentiated individuals with intermediate-to-high likelihood of AD according to neuropathology from those without AD and performed significantly better than plasma P-tau181. Plasma P-tau217 also differentiated clinical AD dementia from non-AD neurodegenerative diseases significantly better than plasma P-tau181, plasma neurofilament light, and established MRI measures, and similar to CSF P-tau217, CSF P-tau181, CSF Aβ42/40, and tau-PET. Increased plasma P-tau217 was observed already in the pre-symptomatic stages of AD. In PSEN1 mutation carriers, the increase started at age 25, about 20 years prior to estimated onset of mild cognitive impairment. Plasma P-tau217 correlated with cerebral tau tangle densities in subjects with neuritic plaques. It predicted abnormal tau-PET scans significantly better than plasma P-tau181, plasma neurofilament light, CSF P-tau181 and CSF Aβ42/Aβ40, and similar to CSF P-tau217.

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用于最新消息和更新

早期生活教育质量与老年痴呆风险

对于一项研究,研究人员将国家级行政学校质量的指标视为认知下降和痴呆症的预测因素,以通过性/性别跨越种族/民族的后期生命。与会者包括近2,500名男女,在美国上小学出席了长达21年。在调整年龄,儿童社会经济地位和童年居住状态之后,发现早期的早期教育质量与各组织的级别和语言表现的变化有关,黑人女性中的内存表现水平,以及记忆中的记忆力非西班牙裔男女和女人和黑人女性。高等教育质量与非西班牙裔女性和黑人男女的痴呆风险较低,但在会计协调会后,与非西班牙裔白人的痴呆症风险无关。当模型包括多年的教育时,学校质量对痴呆症的影响,以及内存和语言表现的水平和变化,对黑人男子完全衰减,部分减少了非西班牙裔男女和妇女和黑人女性。“这些调查结果提供了证据表明后期生命脑部健康受到早期国家教育政策的影响,”写作研究作者。

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睡眠太少或太多都有风险

随着研究表明,睡眠障碍是常见的,睡眠健康与脑健康之间复杂联系的常见和提高意识,调查人员评估了自我报告的睡眠性状,夜间睡眠,白天嗜睡,睡眠呼吸暂停诊断,打鼾和小睡—among more than 500,000 individuals who were free from Alzheimer’s disease (AD) at baseline and follow for up to 12 years. When compared with those who slept an average of 6-9 hours per night, those who slept more than 9 hours had a higher risk of AD (hazard ratio [HR], 2.05) during a mean follow-up of 6.4 years. Sleep apnea (HR, 2.05) and daytime sleepiness (HR, 1.56) also raised the risk for AD significantly, with both remaining predictive of AD after controlling for sleep duration. However, no associations were observed between snoring and AD risk or between napping and AD risk. Among the 932 participants who developed AD during follow-up, the average time to diagnosis was more than 6 years, a possibly “significant window of time to intervene,” said the lead author of the study.

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血浆置换的令人鼓舞的结果

血浆置换疗法已经用于治疗各种神经、免疫和代谢疾病几十年了,其治疗方法包括血浆置换法,即从血细胞中分离血浆并清除或去除有毒物质。血浆中的白蛋白与血浆淀粉样蛋白结合,用从健康供体血浆中提取的新鲜白蛋白替代。研究人员假设,通过将白蛋白和淀粉样蛋白一起去除,并定期用更新的白蛋白替换它,他们可能能够从脑脊液中去除淀粉样蛋白,最终从大脑中去除。为了验证这一假设,他们将55-85岁的可能患有阿尔茨海默氏症的男性和女性随机分为两组,一组接受假药治疗,另一组接受三种剂量的白蛋白和静脉注射免疫球蛋白替代疗法(等量替换,一半替换,只替换白蛋白)。在6周内,参与者每周接受2.5-3升血浆的假手术或常规血浆置换治疗,随后12个月每月接受低量(700-800毫升)血浆置换或假手术治疗。在三个积极治疗组之间没有明显的差异,阿尔茨海默病合作研究-日常生活活动量表显示,与假手术组相比,血浆交换治疗组从基线到14个月下降了52%。而阿尔茨海默氏病评估量表-认知亚量表则下降了66%。