南昌市区老年期痴呆的现况调查

目的了解南昌市区老年期痴呆的患病率。方法采用整群分层抽样方法，对南昌市区4个居委会，共计2126名≥60周岁老年人进行老年期痴呆的流行病学调查。结果老年期痴呆的患病率4．19％，其中阿尔茨海默病(AD)患病率3．39％，血管性痴呆0．66％，其他原因所致痴呆0．33％。结论老年期痴呆已成为危害老年人健康的重要疾病之一，且对社会和家庭的影响非常大．应引起高度重视。     

社区老年期痴呆的发病率及相关因素研究

目的 了解社区老年期痴呆的发病率及相关因素。方法 以１９９２年上海县８个乡（镇）老年期痴呆患病率调查时的１５１５例样本对象（按整群分层随机抽样方法抽出的实访样本数）,４．５年后进行老年性痴呆的发病率调查,并对初筛中ＭＭＳＥ分值较低者２２６人作载脂蛋白Ｅ基因分型。结果在５５岁以上老年人群中,痴呆的年发病率为０．５３％,其中ＡＤ的年发病率为０．３４％,ＶＤ（血管性痴呆）为０．１５％,其它痴呆为０．０４     

老年期痴呆和帕金森病患病率调查

目的：了解社区老年期痴呆和帕金森病患病率及相关因素。方法：采用整群随机抽样法,对社区55岁及以上老年人进行调查。采用二阶段调查法,以简易智能状态检查量表（MMSE）、日常生活能力量表（ADL）、帕金森病筛查问卷为筛查工具：以Pfewffer功能活动调查表（POD）、Fud物体记忆测数（FOM）、快速词汇测验（RVR）、Hachinski缺血指数量表（HIS）为细查工具。按ICD－10老年期痴呆诊断标准确诊病例。结果：在1186人55岁及以上老年人中,痴呆患病率2．61％,其中阿尔茨海默病（AD）0．76％,血管性痴呆（VD）0．42％,混合型痴呆1．43％。帕金森病患病率为0．17％。结论 老年期痴呆和帕金森病是危害老年人健康和消耗卫生资源较高的慢性疾病。     

青浦农村老年期痴呆患病率的随访研究

目的 了解农村老年期痴呆患病率及相关因素，并对调查方法的可重复性进行验证。方法 1998年8月在上海市青浦农村老年期痴呆监控基地，对60岁以上老年人，运用简易精神状态量表(MMSE)作筛选，根据DSM-Ⅲ-R痴呆诊断标准，参照局部缺血量表(HIS)进行诊断和分型。1999年8月、2000年8月采用同样方法复查。结果1998、1999、2000年老年期痴呆的患病率分别为1．13％、1．19％、1．43％，三年中患病率相对稳定，在女性、高龄、低文化程度者中，老年期痴呆的患病率较高。结论 农村老年期痴呆患病率相对稳定，表明本次调查方法经得起重复验证，痴呆患病率与性别、年龄、文化程度密切相关。     

新疆石河子城区血管性痴呆和老年性痴呆的流行病学调查

目的探讨新疆石河子城区老年人血管性痴呆及老年性痴呆的发病情况。方法于1995年1～3月对石河子城区50岁以上老年人群进行随机抽样调查。共调查6个住宅小区计2687人，其中尼佳1380人，女性1307人。结果发现血管性痴呆的患病率为1．38％（37／2687），老年性痴呆患病率为0．41％（11／2687），老年性痴呆无性别及职业差异。血管性痴呆男性患病率（1．88％，26／1380）明显高于女性（0．84％，11／1307）（x2=4．6310，P＜0．05），无职业差异。随年龄增长，两种痴呆患病率均有明显增加，且两者均有显著性意义（P＜0．01）。调查结果还表明，无论哪种痴呆，文化程度低的人群患病率高。结论降低痴呆的重要措施是提高人群的教育、文化水平。     

南京地区老年期痴呆流行病学调查

目的：了解南京地区老年期痴呆的流行病学情况。方法：采用三阶段调查方法,对南京地区４个居委会和１个乡,共计３２６８名６０岁以上老年人进行老年期痴呆的流行病学调查。结果：老年期痴呆的患病率为１．４７％,Ａｌｚｈｅｉｍｅｒ病（ＡＤ）为０．９５％。脑血管性痴呆（ＶＤ）为０．４９％,其他痴呆为０．０３％。结论：老年期痴呆已成为危害老年人健康的重要疾病之一,而且对社会和家庭的影响非常大,应引起高度重视。     

北京市城乡痴呆及其主要亚型的患病率

目的：研究北京市城乡居民老年期痴呆及其主要型的患病率和流行特征。方法：通过分层多级整群抽样,以北京市12个城市居委会和17个村委会全部5913名55岁和以上的居民为样本,分期入户检查,实查5743名,受访率96．1％,第一期于1997年应用简易智能状态检查（MMSE）进行筛查。第二期对筛查阳性和部分阴性者进行成套的诊断性检查,按国际标准诊断痴呆、可能或很可能的阿尔茨默痴呆（AD）和血管性痴呆（VaD)。第三期始于1998年,随访进入第二期调查的全部对象,进一步评估诊断。结果：痴呆患者病率及年龄标化患病率55岁及以上者分别为4．6％和4．2％,AD两率分别为2．2％和2．0％,VaD则分别为1．6％和1．5％。AD比VaD发病年龄晚,病程长,病死率低,AD和VaD的年龄别患病率均随年龄而升高,AD每5岁增高约1倍,VaD则缓慢上升。AD年龄标化患病率55岁及上女性高于男性,分别为1．7％和2．1％;VaD则男性高于女性,分别为1．7％和1．3％。AD年龄标化患病率的城乡差异不明显（1．8％：2．2％）,VaD农村高于城市（2．2％;1．0％）。无论AD或VaD,与受教育程度的关系均未显示规律性变化。结论：本次调查的北京市城乡居民老年期痴呆及主要亚型的患病率高于既往调查的估计,AD的临床和流行特征不同于VaD,类似于西方白人,揭示AD的跨文化差异可能不大。     

广州市城乡65岁及其以上人群痴呆患病率调查

目的调查广州市城乡≥65岁人群痴呆的患病率。方法采用分层随机整群抽样方法对广州市城乡人群进行抽样，用筛查和确诊两阶段法进行调查，实查14个居委会、2个村委会中≥65岁人群共3780人。按美国精神障碍诊断与统计手册第4版的标准诊断痴呆，阿尔茨海默病（AD）诊断采用美国神经病学、语言障碍和卒中研究所及阿尔茨海默病与相关障碍协会的标准。结果（1）查出痴呆患者182例，粗患病率为4．81％；其中AD128例（3．39％），血管性痴呆（VD）44例（1．16％）；经2000年广州市人口年龄构成进行标化，痴呆、AD和VD患病率分别为4．54％、3．17％和1．11％。（2）女性痴呆患者134例，粗患病率（5．98％）高于男性（48例，3．12％；P〈0．001），经年龄标化患病率分别为6．03％和2．74％。（3）痴呆患病率随年龄增长急剧上升。结论广州地区年龄≥65岁老人的痴呆患病率为4．81％，AD患病率高于VD。老年期痴呆患病率随年龄的增长而急剧升高。     

北京市门头沟区老年期痴呆流行病学调查

目的针对北京市门头沟区1756名60岁以上老年人老年期痴呆患病率及不同类型痴呆患病率进行调查。方法2007年5-9月,运用多阶段、分层、整群随机抽样的方法,抽取居住地位于北京市门头沟区、具有北京市户籍且年龄≥60周岁,签知情同意书自愿参与调查的老人1756人,由经过培训的调查员逐户访问,完成调查问卷及简易痴呆筛查量表（MMSE）,对阳性病例460人及5%阴性病例62人由精神科医师按照国际疾病分类第十版（ICD-10）中痴呆的诊断标准做出痴呆的临床诊断。结果门头沟区老年期痴呆7.16%的患病率中,阿尔茨海默病与脑血管性痴呆总患病率比较无明显差别;男性阿尔茨海默病患病率低于女性,而脑血管性痴呆患病率高于女性;城镇阿尔茨海默病患病率及脑血管性痴呆患病率均高于农村;年龄越大越容易患老年期痴呆,文化程度越低越容易患老年期痴呆。结论高龄、低教育水平是老年期痴呆的高发人群,全科医师或社区护士可有计划的进行调查,掌握情况,早期预防,及时发现,积极治疗。     

老年精神科115例重症监护病人临床特征初步分析

人口老龄化是21世纪一大社会问题，目前我国60岁以上的老年人已达1．26亿，约占总人口的10％，已经进入了老年型国家的行列，并且还将以每年3．2％的速度增长，据估计到2025年将达到2．9亿。另据流行病学调查发现65岁以上老年人痴呆的患病率为7．2％，其中阿尔茨海默病（AD）为4．2％，老年期抑郁症的患病率为1．78％。老年病人躯体疾病较多，老年精神科住院病人躯体疾病的处理也是临床工作的重点之一，目前对老年精神科危重病人的监护和及时处理的情况在国内罕见有相关报道，所以我们对上述人群的相关临床特征进行初步分析，希望能对老年精神科危重病人的处理提供一些资料。     

A three-year follow-up study of age-related dementia in an urban area of Beijing

A 3-year follow-up study of 1090 people aged 60 years or over in an urban area of Beijing, China, was conducted to determine the incidence of dementia and its characteristics of distribution. This cohort has been studied first in a cross-sectional survey of dementia in 1986. The follow-up examination employed the same interviewers, psychiatrists, instruments (Mini-Mental State Examination and the Crichton Royal Behavior Rating Scale) and diagnostic criteria for dementia (modified DSM-III) in 1989. The respondent rate in this study was 75.7%. The average annual incidence rate of moderate and severe dementia for greater than or equal to 60 years was 0.3% (95% confidence interval 0.08-0.52%). As expected, the rate increased sharply with aging. No sex difference was found. The prevalence rate of moderate and severe dementia was 1.10% among those aged greater than or equal to 65 years, similar to that (1.82%) in the first survey. Our results showed that the multi-infarct dementia was somewhat more common than primary degenerative dementia (ratio 3:2), both among incident cases and current prevalent ones. The average duration of dementia in the community was 8.0 years (SD 3.4). The risk for death in demented patients was 3 times higher than in the whole cohort (standardized mortality ratio = 2.95), and no specific cause of death was observed. In addition, our study showed that elderly people with less education, a history of consistent unemployment, limited physical activity and stroke history had a higher risk for developing dementia.     

Prevalence of Dementia among Elderly People Living in Cotonou, an Urban Area of Benin (West Africa)

Background/Aims: The population of Benin is, like those of most developing countries, aging; dementia is therefore a major concern. Our goal was to estimate the prevalence of dementia in an elderly population living in urban Benin. Methods: In a cross-sectional community-based study, people aged 65 years and above were screened using the Community Screening Interview for Dementia and the Five-Word Test. Results: The prevalence of dementia was 3.7% (95% CI 2.6-4.8) overall. The figure increased with age and was higher among women than men. Conclusion: Dementia was slightly more prevalent than previously reported in a rural area of Benin, but the rate was similar to that recorded in other cities in developing countries.     

老年痴呆与老年抑郁症的临床探讨

目的 探讨老年痴呆与老年抑郁症的不同表现及早期诊断治疗的重要性。方法 对24例老年痴呆症和26例老年抑郁症患分别进行临床比较和分组治疗。结果 24例老年痴呆症治疗好转率：早期组81．8％(9／11)，中期组66．7％(6／9)，晚期组25％(1／4)，老年抑郁症根据哈密尔顿(Ham—ilton)抑郁量表分为轻度、中度、重度。治疗好转率：轻度组100％(6／6)，中度组75％(9／12)，重度组37．5％(3／8)。结论 老年痴呆和老年抑郁症是老年人病因不相同的两类常见疾病，两的临床表现均具有神经心理活动的障碍和异常性，早期临床症状有许多相似之处，在临床鉴别中常有一定困难，若能早期诊断，早期治疗，是提高老年人生活质量的唯一途径，也是解除社会和家庭压力的一大措施。     

老年血管性痴呆患者血清HIF-1α、VEGF的变化及相关性研究

目的研究老年人血管性痴呆(Va D)患者血清低氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)水平的变化。方法检测88例老年Va D患者和30例健康老年人血清HIF-1α、VEGF水平的含量,比较两组间血清HIF-1α、VEGF水平的差异;分析血清HIF-1α、VEGF水平与痴呆程度的关系。结果老年人Va D患者血清HIF-1α、VEGF水平较正常健康老年人明显增高(P0.01)。不同痴呆程度的老年Va D患者血清HIF-1α、VEGF水平的比较差异没有统计学意义(P0.05)。结论血清HIF-1α、VEGF水平与老年人Va D有密切相关。     

Epidemiological investigation of senile dementia at home--with special reference to incidence and prevalence rate in Miki-cho, Kagawa Prefecture

Epidemiological investigation of senile dementia was performed in 1987 and 1988 on all the aged at home (3,754 persons at the ages of 65 years or more) in Miki-cho (M-cho), Kagawa Prefecture. The composition of the population in M-cho is similar to that in Kagawa Prefecture. M-cho has the most population among the towns or villages in Kagawa Prefecture. Urban areas, rural areas, and middle areas are distributed evenly in respect to the size in M-cho. Thus, it was possible to carry out the investigation reflecting the situation in Kagawa Prefecture. The results of the present investigation were as follows. 1) The prevalence rate was 4.1% in both the first year (1987) and the second year (1988). 2) The incidence rate was 1.01%. 3) The proportion of Alzheimer type dementia to cerebrovascular type dementia was 0.98 in the first year and 1.00 in the second year. 4) Although no statistically significant difference in the prevalence rate was noted between males and females, the prevalence rate of males was higher than that of females in the first half of senility, and the prevalence rate of females was higher than that of males in the second half of senility. 5) Although no statistically significant difference in the prevalence rate was noted between Alzheimer type dementia and cerebrovascular type dementia, the prevalence rate of cerebrovascular type was higher than that of Alzheimer type in the first half of senility, and the prevalence rate of Alzheimer type was higher than that of cerebrovascular type in the second half of senility. The epidemiological investigations of senile dementia have been often reported in all over the world. However, most of the investigations were made on nothing but the calculation of the prevalence rate of senile dementia, while the investigation of the incidence rate was hardly carried out. In respect to the incidence rate, it is desirable that the subjects should be more than 1,000 in number. When the number of subjects is less than 1,000, the occurrence of senile dementia will be noted yearly in approximately 10 cases. If the number of patients with senile dementia increases or decreases even by one, therefore, the incidence rate differs to a great extent. The past reports on the incidence rate were made in subjects of less than 1,000 in number. Accordingly, it may be possible to say that the present investigation was made by the exact methods accompanied by less errors.(ABSTRACT TRUNCATED AT 400 WORDS)     

Longitudinal changes in the prevalence of dementia in a Japanese rural area

Background: The increasing number of patients with dementia in Japan, together with the rapid aging of society, is currently considered to have a substantial impact on Japan's medical, economic and sociological systems. Therefore, the longitudinal estimation of changes in the prevalence of dementia based on accurate diagnostic evaluation has important implications. Methods: We undertook three separate epidemiological studies on long‐term changes, 10 years apart (1980, 1990 and 2000), in the prevalence of dementia in an elderly population using identical methods (DSM‐III and Hachinski's ischemic score) for the same rural area in Japan (Daisen‐cho). Results: The percentage of the population that was elderly (over 65 years of age) increased steadily from 16.0% in 1980 to 21.7% in 1990 and 27.1% in 2000. The prevalence of dementia (cases/100 people aged 65 years or older, adjusted to the population structure of 1980) in 1980, 1990 and 2000 was 4.4, 4.5 and 5.9, respectively, for all types of dementia, 1.9, 2.5 and 3.6, respectively, for Alzheimer‐type dementia (DAT) and 2.0, 1.7 and 2.2, respectively, for vascular dementia (VaD). Conclusions: These findings of an increase in the number of cases and prevalence of DAT and VaD in a Japanese rural community have important implications for interventional medicine.     

Mortality in elderly Canadians with and without dementia: a 5-year follow-up.

OBJECTIVES: Based on the national Canadian Study of Health and Aging (CSHA), to compare 5-year overall mortality and causes of death in elderly with and without dementia. To determine how frequently dementia was mentioned on the death certificate. METHODS: For people who underwent a clinical examination in 1991 (n = 2,923), overall and cause-specific mortality rate ratios were calculated by dementia status (AD; vascular dementia; other dementias/other cognitive impairment; and normal cognition), age group (65 to 74, 75 to 84, 85+ years), and sex, using the Canadian general population as the reference. Similar rate ratios were calculated for people in the community who screened negative for cognitive impairment and who did not undergo a clinical examination (n = 7,340). Among elderly diagnosed as having AD or vascular dementia through the CSHA and who later died, it was determined how frequently dementia was recorded on the death certificate. RESULTS: The subgroup without cognitive dysfunction had a survival rate similar to that of the overall Canadian population except in the oldest age group, where the survival rate was better than that of the general population, which includes people with dementia. People in the three groups with cognitive impairment had a poorer survival in all age/sex groups than those without cognitive impairment and the general Canadian population. The most common causes of death in all groups were from vascular diseases. People with vascular dementia had the highest relative mortality rates for heart and cerebrovascular disease. Most of the AD groups also had high relative vascular system mortality rates. Among patients clinically diagnosed with AD, only 14.3% had any dementing illness recorded as the underlying cause of death; 41.8% had any dementing illness recorded anywhere on the death certificate. For vascular dementia, the corresponding numbers were 5.8% and 23.3%. CONCLUSION: Elderly with dementia have clearly increased mortality rates relative to elderly without cognitive impairment in all age/sex categories. People with vascular dementia have a particularly poor prognosis. Studies of AD and vascular dementia using death certificate data will grossly underestimate the proportions of elderly with these diseases.     

The botany survey: A longitudinal study of depression and cognitive impairment in an elderly population

An 8-year-long longitudinal study of elderly people in Botany (Sydney) has provided data on the prevalence, incidence and outcome of cognitive impairment and depression in this population. In 1985, a random sample of 146 persons aged 65 years or more, living in their own homes, were assessed using the Brief Assessment Schedule, depression ratings and cognitive tests. Follow-up interviews were conducted after 2, 4, 6 and 8 years. Data from separate hostel and nursing home studies were used when estimating prevalence rates. The estimated prevalence and annual incidence of definite dementia in Botany were, respectively, 14% (3.5% severe) and 2.5%. Among elderly people living at home the prevalence of definite dementia was 11%; 23% of our community sample suffered dementia during the 8 years. The prevalence and minimum annual incidence of depressive disorders were, respectively, 12.5% and 2.0%. Among those living at home the prevalence was 12.3%. Dementia was associated with a high mortality rate, but the apparently increased mortality of depressed subjects did not reach significance, probably because numbers were relatively small; a high proportion of the deceased had comorbid cognitive impairment. Some depressions eventually remitted.     

The incidence of first-onset psychotic symptoms and paranoid ideation in a representative population sample followed from age 70-90 years. Relation to mortality and later development of dementia

BACKGROUND: Limited data are available on the incidence of psychotic symptoms in the elderly. OBJECTIVE: To elucidate the incidence of first-onset psychotic symptoms in the elderly and their relation to mortality and later development of dementia. METHOD: A population-sample (n = 392) born 1901-1902 was assessed from age 70-90 with psychiatric examinations, medical record reviews and from age 85, also with key-informant interviews. Individuals developing dementia were excluded. RESULT: The cumulative incidence of first-onset psychotic symptoms was 4.8% (8.0% including key-informant reports in the total sample) and 19.8 % in those who survived to age 85. Sixty-four percent of those with first-onset hallucinations later developed dementia, compared to 30% of those with delusions and 25% of those without psychotic symptoms. CONCLUSIONS: One fifth of non-demented elderly who survives up to age 85 develops first-onset psychotic symptoms. Hallucinations predict dementia, but most elderly individuals with first-onset psychotic symptoms do not develop dementia.