由加州大学戴维斯分校与凯撒医疗集团合作开展的LifeAfter90研究表明，即便成功跨过90岁仍未患痴呆症，年长者面临的疾病风险仍受性别、种族和遗传因素的显著影响。1该项研究纳入800多名参与者，中位年龄92岁，代表首项在高度多样化队列中进行的90岁后痴呆症研究。1
性别和种族差异在痴呆症风险中表现突出。190岁及以上女性的痴呆症风险约为同龄男性的两倍，1而黑人参与者的风险相比亚洲参与者高出75%。1遗传因素同样关键——携带APOE2基因变异的参与者痴呆症风险降低60%，1但在黑人参与者中，携带APOE4变异者的风险大约翻倍。1
研究还揭示了个体差异的复杂性。1尽管某些参与者在60至70岁时已患有高血压和高胆固醇等风险因素，但数十年后仍保持认知健康，1为理解大脑在极端衰老中的抗痴呆机制提供了线索。该研究由美国国立卫生研究院老龄化研究所资助。1全球90岁及以上人口预计到2100年将达约2.3亿人。1
A new study from the University of California, Davis and Kaiser Permanente reveals that dementia risk among people over 90 remains significantly influenced by gender, race, and genetic factors, even for those who have avoided cognitive decline so far.1 The LifeAfter90 research, which enrolled more than 800 participants with a median age of 92, represents the first major dementia study conducted in a highly diverse cohort of people aged 90 and older.1
The findings demonstrate substantial disparities in dementia vulnerability. Women aged 90 and above face roughly twice the dementia risk of men in the same age group.1 Black participants showed a 75% higher dementia risk compared to Asian participants.1 The APOE gene emerged as a critical factor: those carrying the APOE2 variant experienced a 60% reduction in dementia risk, while Black participants carrying the APOE4 variant had approximately double the dementia risk.1 Notably, some study participants who had risk factors such as high blood pressure and high cholesterol in their 60s and 70s maintained cognitive health decades later, offering clues to how the brain resists dementia during extreme aging.1 With the global population aged 90 and above projected to reach approximately 230 million by 2100, understanding these protective mechanisms becomes increasingly important.1 The research was supported by the National Institute on Aging at the U.S. National Institutes of Health.1
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