Article record

早发性阿尔茨海默病前的共病与医疗保健使用：一项基于人群的病例对照研究

Comorbidities and health-care use prior to early-onset Alzheimer's disease: A population-based case-control study.

临床研究耳科IF 14.3Q1

文献信息

PMID	42847312
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Laura Leppänen 查看其他 13 位作者 Adolfina Lehtonen；Mikko Aaltonen；Kalle Aho；Ave Kivisild；Abbe Ullgren；Iina Rinnankoski；Helmi Soppela；Annakaisa Haapasalo；Anne M Portaankorva；Päivi Hartikainen；Kasper Katisko；Eino Solje；Johanna Krüger
作者单位	Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland. 查看其他 8 条单位信息 Law School, University of Eastern Finland, Joensuu, Finland.；Institute of Clinical Medicine-Neurology, University of Eastern Finland, Kuopio, Finland.；Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Solna, Sweden.；A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland.；Clinical Neurosciences, University of Helsinki, Helsinki, Finland.；Neuro Center-Neurology, Kuopio University Hospital, Kuopio, Finland.；Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland.；Medical Research Center, Oulu University Hospital, Oulu, Finland.
期刊	Alzheimer's & dementia : the journal of the Alzheimer's Association
SCI 分区	Q1
IF	14.3
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

引言： 我们检验了后来被诊断为早发性阿尔茨海默病（EOAD）的个体与匹配对照在诊断前15年间，其共病和医疗保健使用是否存在差异。
方法： 这项基于人群的病例对照研究纳入了在两所芬兰大学医院（2010—2021年）诊断为EOAD的407例患者，以及4035名年龄和性别匹配的对照。既往诊断和医疗保健就诊情况来自全国性登记数据库。
结果： 在诊断前1—5年，EOAD患者的眩晕（5.9% 对 2.1%，p < 0.001）、抑郁（5.7% 对 2.3%，p < 0.001）、头痛（4.9% 对 1.6%，p < 0.001）、谵妄（1.5% 对 0.1%，p < 0.001）、脑损伤（2.9% 对 0.9%，p = 0.002）、甲状腺疾病（2.5% 对 0.8%，p = 0.008）、酒精相关障碍（3.4% 对 1.4%，p = 0.009）、癫痫（2.2% 对 0.7%，p = 0.009）、卒中（4.4% 对 2.0%，p = 0.008）以及耳鼻咽喉科疾病（5.2% 对 2.9%，p = 0.027）的患病率更高。仅在诊断前6至10年，耳鼻咽喉科疾病存在差异（4.7% 对 2.1%，p = 0.036），而在诊断前11至15年未见差异。高血压和血脂异常未显示组间差异。自EOAD诊断前一年起，医疗保健使用显著增加。
讨论： EOAD之前存在可识别的疾病模式及医疗保健使用增加，这可能有助于更早发现。

英文摘要

INTRODUCTION: We examined whether comorbidities and health-care use differ between individuals later diagnosed with early-onset Alzheimer's disease (EOAD) and matched controls during the 15 years preceding diagnosis.
METHODS: This population-based case-control study included 407 EOAD patients diagnosed at two Finnish university hospitals (2010-2021), and 4035 age- and sex-matched controls. Prior diagnoses and health-care visits were obtained from nationwide registers.
RESULTS: EOAD patients had higher prevalence of vertigo (5.9% vs. 2.1%, p < 0.001), depression (5.7% vs. 2.3%, p < 0.001), headache (4.9% vs. 1.6%, p < 0.001), delirium (1.5% vs. 0.1%, p < 0.001), brain injuries (2.9% vs. 0.9%, p = 0.002), thyroid disorders (2.5% vs. 0.8%, p = 0.008), alcohol-related disorders (3.4% vs. 1.4%, p = 0.009), epilepsy (2.2% vs. 0.7%, p = 0.009), strokes (4.4% vs. 2.0%, p = 0.008), and otorhinolaryngologic diseases (5.2% vs. 2.9%, p = 0.027) 1-5 years before diagnosis. Only otorhinolaryngologic diseases (4.7% vs. 2.1%, p = 0.036) differed 6 to 10 years prior, whereas no differences were seen 11 to 15 years before diagnosis. Hypertension and dyslipidemia showed no between-group differences. Health-care use increased markedly from year before EOAD diagnosis.
DISCUSSION: EOAD is preceded by recognizable patterns of morbidity and increased health-care use, which may support earlier detection.