Alzheimer’s Disease Factors And Risk Prediction Research

Objective: Study factors affecting the pathogenesis of Alzheimer’s disease, using a nested case-control study to explore urban community crowd sensitive indicator of early Alzheimer disease(AD), and Initial fitting AD competition Risk model,for providing guidance for the early screening and diagnosis of AD.Methods: Between January 2013 to December 2014, the follow-up study was carried out during the 60 years older population in Nanchang community. Using international standards and a two-stage survey(screening cases and cases diagnosed) to diagnosis and differential diagnosis of AD. 86 persons were diagnosed as AD. A 1: 2 matched nested case-control study, according to the same residence, same sex, age difference(± 3 years) were compared principle of selection, 172 people enrolled in the control group. Survey collected basic information and related factors AD information via a questionnaire, and to collect their urine and blood biochemical parameters were detected. Finally, chi-square test was used for Univariate analysis of influencing factors AD. For AD factors’ Multivariate model analysis, We Used Conditional Logistic analysis method. Then, we used R software for the preliminary fitting of AD competition risk model.Results:(1) The basic situation of follow-up queue: the study were collected 9733 follow-up crowd, of whom 4784 were male and 4949 were female. The research obtained a total of 612 Dementia, and the prevalence was 6.29%. Of which 432 cases were AD patients, the prevalence was 4.44%, female prevalence(4.59%) Slightly higher than men’s(4.29%). Simultaneously, AD prevalence increased with age, and it approximately doubled every five years.(2) The result of Univariate analysis for queue basic information showed: Age(χ2=364.530,P<0.001), gender(χ2=4.413, P=0.036), educational level(χ2=261.308, P<0.001), smoking(χ2=8.927, P=0.003), physical activity(χ2=42.918, P<0.001), social / area Activities(χ2= 184.287, P<0.001), family history of dementia(χ2=5029.16, P<0.001) were have statistically significant; and marital status(χ2=2.990, P=0.084) and alcohol consumption(χ2= 0.117, P=0.732) have no significant difference.(3) The basic objects of Nested case-control study : Follow the same sex, age difference(±3 years), the ratio of 1 : 2, the case group have 86 persons, with an average age of 72.25±6.79 years old; 172 people in the control group, the average age was 74.13±8.16 years old, male to female ratio was 1:1.32.The biochemical indexes between cases group and control group have significant difference. The AD7c-NTP average value is respectively(2.32±1.38) ng/ml,(0.86 ±0.62)ng/ml. The Serum SOD value on average is respectively(15.14 ± 6.58) U/ml,(23.15±9.16) U/ml.(4) The Single factor Conditional Logistic regression analysis results suggest that: Cultural level, family history of dementia, smoking, drinking, social activities, the content of urine AD7c-NTP, and serum SOD content factors for AD state transition by the state without of AD to have statistical significance. Which level of education(OR = 0.824, 95% CI: 0.660 ~ 1.029), smoking(OR = 0.501, 95% CI: 0.295 ~ 0.853), drinking(OR = 0.627, 95% CI: 0.394 ~ 0.998), physical exercise(OR = 0.875, 95% CI: 0.657 ~ 1.165), and social activities(OR = 0.603, 95% CI: 0.460 ~ 0.789), serum SOD content(OR = 0.424, 95% CI: 0.272 ~ 0.661) for the protection of the AD factors; Marital status(OR = 1.345, 95% CI: 0.878 ~ 2.061), family history of dementia(OR = 2.817, 95% CI: 1.614 ~ 4.916), urine AD7c- the NTP content(OR = 2.710, 95% CI: 1.755 ~ 4.186) as a risk factor for AD.(5) Multivariate Conditional Logistic regression analysis showed that: urine AD7c-NTP(OR=14.738, P<0.001), educational level(OR=2.171, P=0.003) is a risk factor for AD.(6) Initial fitting AD competition risk model prompted that: the cumulative incidence of AD with follow-up increased with the extension of time. The family history of dementia, and social activities, AD7c-NTP content in urine and serum SOD levels were relevant with it.Conclusion:(1) The prevalence rate of AD in Nanchang city community is still at a high level, and the prevalence increases with age, showed an increasing trend, women more prone to disease than men.(2) Low education level, smoking, lack of physical exercise and social activities as well as those who have a family history of dementia had higher prevalence of AD.(3) The content of urine AD7c-NTP in patients with AD is higher than in people who without of AD, but the Serum superoxide dismutase(SOD) content is lower.(4) The Conditional Logistic regression analysis, with cultural degree, marital status, family history of dementia, smoking, drinking, exercise, social activities, serum SOD and urine AD7c- NTP, into Multiple factors analysis of a 1:2 matched data: urine AD7c-(NTP), family history of dementia as a risk factor for AD; Serum SOD and social activities for the protection of the AD.(5) The AD is a progress disease, with the longer duration of follow-up, cumulative incidence also gradually increased.