法国巴黎大学Séverine Sabia课题组探讨了50岁时理想心血管健康与痴呆发生率的关系：白厅II队列研究进行了25年随访。 相关论文于2019年8月10日发表于国际顶尖学术期刊《英国医学杂志》上。

本研究的目的是探讨50岁时心血管健康7项生活简易评分与痴呆发病率的关系。7899名参与者在50岁时进行了心血管健康评分，包括四项行为指标（吸烟、饮食、体育活动、体重指数）和三项生物指标（空腹血糖、血胆固醇、血压），每项0、1、2分。根据总分将患者分为心血管健康最佳组、中等组和不佳组。

中位随访24.7年后，共有347例参与者患上痴呆症。心血管健康不佳组中痴呆发病率为每1000人年3.2，中等组为1.7，最佳组为1.3。心血管健康评分越高，痴呆风险越低。随访期间还发现50岁时心血管健康与痴呆的相关性也适用于没有心血管疾病的人群。

研究结果表明，中年时坚持理想心血管健康七项生活简易建议，可有效降低老年痴呆症的风险。

研究称，痴呆症的病理生理特征出现在临床症状出现前的15-20年，突出了长期随访来确定危险因素和保护因素的必要性。痴呆预防指南建议针对中年心血管危险因素。

附：英文原文

Title: Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study

Author: Séverine Sabia, Aurore Fayosse, Julien Dumurgier, Alexis Schnitzler, Jean-Philippe Empana, Klaus P Ebmeier, Aline Dugravot, Mika Kivimki, Archana Singh-Manoux

Issue&Volume: vol 366, issue 8210

Abstract: 

Objectives To examine the association between the Life Simple 7 cardiovascular health score at age 50 and incidence of dementia.

Design Prospective cohort study.

Setting Civil service departments in London (Whitehall II study; study inception 1985-88).

Participants 7899 participants with data on the cardiovascular health score at age 50.

Exposures The cardiovascular health score included four behavioural (smoking, diet, physical activity, body mass index) and three biological (fasting glucose, blood cholesterol, blood pressure) metrics, coded on a three point scale (0, 1, 2). The cardiovascular health score was the sum of seven metrics (score range 0-14) and was categorised into poor (scores 0-6), intermediate (7-11), and optimal (12-14) cardiovascular health.

Main outcome measure Incident dementia, identified through linkage to hospital, mental health services, and mortality registers until 2017.

Results 347 incident cases of dementia were recorded over a median follow-up of 24.7 years. Compared with an incidence rate of dementia of 3.2 (95% confidence interval 2.5 to 4.0) per 1000 person years among the group with poor cardiovascular health, the absolute rate differences per 1000 person years were −1.5 (95% confidence interval −2.3 to −0.7) for the group with intermediate cardiovascular health and −1.9 (−2.8 to −1.1) for the group with optimal cardiovascular health. Higher cardiovascular health score was associated with a lower risk of dementia (hazard ratio 0.89 (0.85 to 0.95) per 1 point increment in the cardiovascular health score). Similar associations with dementia were observed for the behavioural and biological subscales (hazard ratios per 1 point increment in the subscores 0.87 (0.81 to 0.93) and 0.91 (0.83 to 1.00), respectively). The association between cardiovascular health at age 50 and dementia was also seen in people who remained free of cardiovascular disease over the follow-up (hazard ratio 0.89 (0.84 to 0.95) per 1 point increment in the cardiovascular health score).

Conclusion Adherence to the Life Simple 7 ideal cardiovascular health recommendations in midlife was associated with a lower risk of dementia later in life.

DOI: https://doi.org/10.1136/bmj.l4414

Source: https://www.bmj.com/content/366/bmj.l4414