A prospective cohort study in the US revealed that protective factors that influence Alzheimer disease pathophysiology (ADP: amyloid and AD-pattern neurodegeneration) are different. “Exceptional aging” without ADP may be possible with a greater number of protective factors across the lifespan. The study enrolled 942 elderly individuals (70-≥90 y, average about 80 y, 45% women) with magnetic resonance imaging and Pittsburgh compound B–positron emission tomography scans. Individuals 85 y or older without significant evidence of ADP were considered “exceptional aging” without ADP. Apart from known risk factors of demographics and the APOE genotype, only midlife dyslipidemia was associated with amyloid deposition. Obesity, smoking, diabetes, hypertension, and cardiac and metabolic conditions, but not intellectual enrichment, were associated with greater AD-pattern neurodegeneration. In the 85 y or older cohort, several variables except job score and midlife hypertension showed small to moderate effects in predicting exceptional aging without ADP. Source: http://jamanetwork.com/journals/jamaneurology/美国的前瞻性群组研究显示，影响阿尔茨海默病病理征象（淀粉样蛋白和阿尔茨海默病式神经退变）的保护因素是不同的。如果一生中有较多的保护因素，“特殊衰老” 而无阿尔茨海默病病理征象有可能。该研究纳入942名老年人（70岁≥90岁，平均约80岁，女性45％），经磁共振成像和匹兹堡复合B正电子发射断层扫描。 85岁以上没有阿尔茨海默病病理征象明显证据的个体被认为是无阿尔茨海默病病理征象的“特殊衰老”。除了人口统计学和APOE基因型等已知风险因素外，只有中年血脂异常与淀粉样蛋白沉积有关。肥胖，吸烟，糖尿病，高血压，以及心脏和代谢疾病，而非知识丰富，与更多的阿尔茨海默病式神经退变相关。在85岁或以上的群组中，除了职业评分和中年高血压之外，其他几个变量对预测不伴有阿尔茨海默病病理征象的特殊衰老显示出小至中等度的影响。来源：http://jamanetwork.com/journals/jamaneurology/
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