终生婚姻可降低患痴呆症的风险

最近的一项大型研究表明，离婚或单身会增加患痴呆症的风险。 然而，研究人员也发现了一些意想不到的结果。

根据最近发表的一项研究分析了来自北特伦德拉格省 HUNT 研究健康调查的数据，在中年期间长时间连续结婚可以降低晚年患痴呆症的可能性。

“结婚会对痴呆症的危险因素产生影响，”挪威公共卫生研究所 (NIPH/FHI) 的 Vegard Skirbekk 说。

在 24 年的时间里，从 44 岁到 68 岁，研究人员检查了个体的各种婚姻状况，并探讨了这些状况与 70 岁以后痴呆或轻度认知障碍 (MCI) 临床诊断之间的潜在相关性。

结果显示，在整个时期内持续结婚的那组人痴呆症的发病率最低。 离婚和单身人士的发病率最高。

儿童降低风险

Asta Håberg 是圣奥拉夫医院的医生和挪威科技大学 (NTNU) 的教授，同时也是 NIPH/FHI 的研究员。 她说，调查结果令人吃惊。

“导致痴呆症的确切原因是个谜。 这项调查表明，已婚与患痴呆症的风险较低有关，但我们不知道为什么，”Håberg 说。

“有一种理论认为，已婚人士过着更健康的生活，这解释了各种疾病风险的差异。 在这项调查中，我们没有发现已婚和未婚人士之间的健康差异可以解释痴呆症风险的差异。”

在 HUNT 调查中，约有 150,000 名生活在前北特伦德拉格国家的人同意将他们的健康信息用于研究。 研究人员使用这些数据来检查痴呆症的发病率与吸烟、高血压、肥胖、缺乏运动、糖尿病、心理问题和有亲密朋友等健康因素的关系。

“我们认为这些因素会有所作为，但它们并没有解释任何事情，”Håberg 说。

然而，研究人员发现，在研究中的未婚人群中，生育孩子具有重要意义，可将患痴呆症的风险降低 60%。

“有些人认为，如果你有孩子，你的认知能力就会更强。 例如，您必须与人打交道并参加原本不必参加的活动。 这会刺激您的大脑，使其更好地工作。 这样你就建立了一种认知储备，”Håberg 说。

还有很多未使用的数据

大脑中的这种“储备”不是结构性的。 它不会出现在 MRI 扫描中，也不会通过打开大脑并查看内部来显示。 这是“痴呆症之谜”的一部分。 但 Håberg 希望能够通过这项研究揭开其中的一些谜团。

“我们不知道是否结婚或生孩子可以防止痴呆症，或者是否是预选的情况，例如。 这意味着患痴呆症概率较低的人也更有可能找到伴侣并生孩子。 但我们拥有 HUNT 研究这一事实意味着我们有大量可用数据尚未用于进一步调查，”Håberg 说。

作为一名医生，她不相信痴呆症是衰老的必然结果。

“人们普遍认为‘如果你活得够久，迟早会患上痴呆症’。 考虑到我们可能有认知储备的理论，我不太确定我是否同意这一点，”她说。 “可能是某些条件可能有助于建立这种储备，这意味着你从大脑中的更多连接开始。 例如，我们观察到教育是一个因素，你受的教育越多，你建立的“储备”就越好。”

然而，当一个受过高等教育的人得到

” 数据-gt-翻译-属性=”[{” attribute=””>Alzheimer’s, the disease progresses just as quickly as for anyone else. The reserves thus have a delaying effect – but only until the disease strikes.

Make it easier to have children

The study results are part of the research project REFAWOR (Cognitive reserve work and family) funded by the NIH in the USA, which is part of the program “Changing lives, changing brains” under the auspices of the Norwegian Institute of Public Health.

REFAWOR has a budget of almost three million euros and aims to study how changes in living and working conditions affect the risk of Alzheimer’s, dementia, and cognitive impairment in older people. These diseases are expected to triple by 2050.

The researchers are now taking a closer look at the significance of having children for dementia risk, the types of work people have, and how retirement age can affect the risk.

Dementia is a collective term for various diseases and injuries in the brain. Memory weakens, and the ability to think logically is affected. Eventually, it becomes difficult to manage on your own and carry out everyday activities. No medical treatment for dementia is currently available.

“We’ve dreamt of finding a medicine for dementia for a long time, but we haven’t yet succeeded. So we’re looking at social determinants. What can society do to reduce the risk? The state could facilitate having children, for example,” says Håberg.

Genes can make us more susceptible

One of the next steps is to look at genetic connections, says Skirbekk.

“We know that certain genes increase the risk of dementia, but people with these genes can still live to be 90 years old without experiencing cognitive problems,” he says.

“You could say that the increased risk inherent in the genes can be regarded as a vulnerability, where having a stable family life might possibly reduce this vulnerability.

He emphasizes that this study says nothing about the biological mechanisms behind dementia.

“But it shows that being married can have an influence on risk factors. You become more cognitively active, you cope better with adversity, and are less subject to stress. The partner represents a security that provides a buffer.”

The study does not consider whether any difference exists between being an unmarried versus a married couple. Less than one percent of unmarried people in the survey were cohabiting with a partner.

“There are very few cohabitants in this age group in HUNT,” says Håberg.

Reference: “Marital Histories and Associations With Later-Life Dementia and Mild Cognitive Impairment Risk in the HUNT4 70+ Study in Norway” by Vegard Skirbekk, Ph.D., Catherine E. Bowen, Ph.D., Asta Håberg, MD, Ph.D., Astanand Jugessur, Ph.D., Bo Engdahl, Ph.D., Bernt Bratsberg, Ph.D., Ekaterina Zotcheva, Ph.D., Geir Selbæk, Ph.D., Hans-Peter Kohler, Ph.D., Jordan Weiss, Ph.D., Jennifer R. Harris, Ph.D., Sarah E. Tom, Ph.D., Steinar Krokstad, MD, Ph.D., Yaakov Stern, Ph.D. and Bjørn Heine Strand, Ph.D., 2 November 2022, Journal of Aging and Health.
DOI: 10.1177/08982643221131926

The study was funded by the National Institutes of Health and the Research Council of Norway.