成都地区1997年和2000年两次老年期痴呆患病率调查结果的比较

目的了解老年期痴呆和阿尔茨海默病（AD）患病率在不同时间的变化。方法分别于1997年6月至1998年4月（第1次）和2000年11月至2001年3月（第2次），在成都地区用多层分级整群抽样方法，对调查时年龄≥55岁的社区人口进行痴呆患病率调查，两次调查的程序和使用工具相同。采用美国精神障碍诊断与统计手册第3版修订本的标准诊断痴呆。结果第1次调查实查5353人，失访202人，漏查率3．64％；诊断痴呆患者143例。第2次调查实查3908人，失访407人，漏查率9．43％；诊断痴呆患者107例。第1次与第2次调查现场诊断不一致的患者6例，均为轻度痴呆。第1次调查的痴呆、AD和血管性痴呆（VD）患病率分别为2．67％、2．04％和0．39％，第2次调查为2．74％、2．00％和0．46％，差异均无统计学意义（P〉0．05）。结论≥55岁的人口中，痴呆、AD和VD患病率在一定时期内保持稳定。对界于轻微认知功能损害与轻度痴呆之间的患者诊断较为困难，随访对明确诊断是必要的。

Comparison of prevalence of dementia between in 1997 and 2000 surveys in the urban and rural community in Chengdu

Objective To investigate the alteration of the prevalence of senile dementia with time in community.Methods Between June 1997 to April 1998, the first prevalence survey was carried out in the urban and rural areas in Chengdu, China. Using the stratified random sampling method, 5 353 residents aged 55 years or over were sampled out. The second survey was carried out from November 2000 to March 2001 with the same investigation instruments and method, and 3 908 subjects were sampled out. The clinical diagnosis of dementia and Alzheimer disease (AD) were made according to the Diagnosis and Statistical Manual of Mental Disorder, Revised Third Edition and National Institute of Neurological and Communicative Disorders and Stroke Alzheimer disease and Related Disorders Association criteria.Results In the first survey, 202 (3.64%) of the 5 353 sampled subjects were withdrawal, and 143 patients met with diagnostic criteria for dementia. In the second survey, 407 (9.43%) of 3 908 subjects were withdrawal, and 107 subjects were diagnosed as dementia. The 6 patients that were given different diagnosis between both the surveys were diagnosed with mild dementia eventually. The prevalence rate of dementia was 2.67% in the first survey, with AD of 2.04% and vascular dementia (VD) of 0.39%, and the respective rates were 2.74%, 2.00%, and 0.46% in the second survey; there was no significant difference between two surveys (P>0.05).Conclusion The results indicate that prevalence of dementia in the aged is stable across time. It is difficult to identify patients with mild dementia from the ones with mild cognitive impairment, and follow-up is necessary to make certain diagnosis.