研究课题：摄入咖啡因能预防阿默氏病
供稿：精神病科，圣玛利雅医院；神经科学实验室，里斯本医院；葡萄牙

    主要内容：咖啡是西半球饮用最多的影响人体行为的饮料。各种实验模型均发现，低剂量缓慢使用咖啡因具有保护神经系统的作用。老年精神病是一个严重的公共卫生问题，AD则为其中的最常见疾病。假设咖啡因能防止阿默氏病人神经退化，那么在确诊发生了病理改变以前的相当长时间之前，与最终病人相比，应该在正常人群中检测到高水平的咖啡因摄入量。病例-对照方案如下：54例来自精神病科的AD可以病人，符合下列两项标准：国家神经和交流障碍与中锋研究所，AD与相关疾病协会。对照组为54例伴随个人，赶至正常，年龄和性别与实验组匹配（±3岁）。AD病人组在确诊前20年的日平均咖啡因摄入量为73.9±97.9mg，而对应的20年内对照组则为198.7±135.7mg（P<0.001,Wilcoxon分级检验）。根据逻辑回归模型，这段时间内的咖啡因摄入量与AD发病明显负相关（OR=0.40,95CI:0.25-0.67）。而高血压、糖尿病、中风、脑外伤、吸烟、饮酒、服用肺固醇类抗炎药、维生素E、胃病、心脏病、教育状况，以及家族性精神病史都与AD发病无明显统计学相关性。咖啡因摄入量与AD风险降低明显相关，不依赖于其他伴随因子。如果今后的前瞻性研究能证实上述结果，对于AD的预防会有很大意义。

    结论：摄入咖啡因能预防阿默氏病。

Does caffeine intake protect from Alzheimer's disease?
Maia L, de Mendonca A. Eur J Neurol. 2002 Jul;9(4):377-82.
Dementia Clinics, Hospital of Santa Maria and Laboratory of Neurosciences, Faculty of Medicine of Lisbon, Portugal.

    Caffeine is the most widely consumed behaviourally active substance in the western world. Neuroprotective effects of caffeine in low doses, chronically administered, have been shown in different experimental models. If caffeine intake could protect against neurodegeneration in Alzheimer's disease (AD), then higher levels of caffeine consumption in normal subjects as compared with AD patients should be detectable in the presumably long period before diagnosis when insidious pathogenic changes are taking place. A case-control study was used: cases were 54 patients with probable AD fulfilling the National Institute of Neurologic and Communicative Disorders and Stroke and the AD and Related Disorders Association criteria, in a Dementia Clinics setting. Controls were 54 accompanying persons, cognitively normal, matched for age (+/-3 years) and sex. Patients with AD had an average daily caffeine intake of 73.9 +/- 97.9 mg during the 20 years that preceded diagnosis of AD, whereas the controls had an average daily caffeine intake of 198.7 +/- 135.7 mg during the corresponding 20 years of their lifetimes (P < 0.001, Wilcoxon signed ranks test). Using a logistic regression model, caffeine exposure during this period was found to be significantly inversely associated with AD (odds ratio=0.40, 95% confidence interval=0.25-0.67), whereas hypertension, diabetes, stroke, head trauma, smoking habits, alcohol consumption, non-steroid anti-inflammatory drugs, vitamin E, gastric disorders, heart disease, education and family history of dementia were not statistically significantly associated with AD. Caffeine intake was associated with a significantly lower risk for AD, independently of other possible confounding variables. These results, if confirmed with future prospective studies, may have a major impact on the prevention of AD.

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