陕西省西安地区中老年人痴呆及其主要亚型发病率调查

目的 了解西安地区中老年人痴呆及其主要亚型的发病率,分析痴呆及其主要亚型的危险因素。方法 对1998年完成痴呆患病率调查的2919名西安地区居民进行随访,以简易智能量表(MMSE)作为筛查工具,应用三阶段诊断法确诊痴呆及其亚型。根据随访的人年数计算痴呆、Alzheimer病(AD)及血管性痴呆(VD)的年发病率。痴呆诊断按照美国精神疾病诊断、统计手册第三版(修订版)(DSM-Ⅲ-R)的标准,AD诊断按照美国国立神经疾病、语言交流障碍和卒中一老年性痴呆及相关疾病学会(NINCDS-ADRDA)的标准,VD诊断按照美国国立神经疾病和卒中研究所和瑞士国际神经科学研究协会(NINDSAIREN)标准的。结果 实际随访到2197人,平均随访3．2年,共计6886．43人年。新诊断痴呆47例,其中AD 37例,VD 8例,其他原因引起的痴呆2例。55岁以上人群痴呆及AD、VD年发病率分别为0．68％、0．54％、0．12％;65岁以上人群痴呆及AD、VD年发病率分别为0．89％、0．69％、0．17％。单因素分析和多因素logistic回归分析显示,AD发病率与年龄、文化程度密切相关;而VD发病率与年龄、卒中史和高血压密切相关。结论 高龄、低文化程度是AD的危险因素,而年龄、高血压和卒中是VD的危险因素。

The incidence of dementia among elderly people in Xi'an, China

OBJECTIVE: To explore the incidence of dementia among elderly people in Xi'an and its related risk factors. METHODS: Subjects that had been studied on the prevalence of dementia were follow-up, and the incidence of dementia, Alzheimer disease (AD) , and vascular dementia (VD) were counted by person-years. The clinical diagnosis on dementia,AD and VD were based upon the 3rd Edition of Diagnostic and Statistical of Manual of Mental Disorder, Revised version (DSM-III-R) and NINCDS-ADRDA criteria. RESULTS: 2197 subjects of non-dementia being identified in 1998, were re-surveyed in 2001. Out of them, 47 new cases of dementia including 37 cases of AD and 8 cases of VD were identified, with an annual incidence rates of dementia, AD and VD as 0.68%, 0.54% and 0.12% among those of 55 years and over and 0.89%, 0.69% and 0.17% in 65 years and over, respectively. Analysis from single factor logistic regression showed that age and education but not gender were closely related to the occurrence of AD. On the contrary, age, hypertension and stroke were closely related to the occurrence of VD. CONCLUSION: The incidence of dementia in the "Xi' an cohort" was similar to that being reported from other countries. AD and VD were an age-related diseases but education seemed to have had great protective effect while lack of formal education served as risk factor to AD.