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。     

北京市抑郁症的患病率调查

目的掌握北京市常住人口中抑郁症的患病率及其特征。方法以复合性国际诊断交谈检查核心本1．0版为主要调查工具，按多阶段分层系统随机抽样原则，对北京市18个区县≥15岁人口5926人进行抑郁症的现况调查。结果（1）时点患病率为3．31％（196例），终生患病率为6．87％（407例）。（2）时点和终生患病率中，均为女性（分别为4．40％和8．46％）高于男性（2．45％和5．01％），年龄≥55岁者高，农村（4．19％和7．98％）高于城市（2．50％和6．07％），文盲（6．02％和10．87％）和小学文化程度者（5．42％和10．64％）高，再婚（9．52％和28．57％）、离婚（6．15％和13．85％）和丧偶者（5．43％和11．27％）高，不在业者（3．96％和7．95％）、月收入≤300元者（5．52％和9．13％）及有家庭暴力者（6．51％和15．38％）高，均P〈0．01～0．05。结论抑郁症是一种患病率较高的常见精神障碍，预防控制抑郁症应成为我国医疗卫生工作的重点之一。     

合并静止性震颤的原发性震颤患者临床特点分析

目的了解北京地区社区中老年人原发性震颤(essential tremor,ET)的临床特征及其与预后的关系。方法2000年在北京城区、近郊平原、远郊山区调查了2835名55岁以上中老年人,采用筛查和临床诊断两步法确诊患者。发现ET患者135例,对其中合并静止性震颤的患者进行分析,并于2004年对其进行随访。结果其中合并上肢静止性震颤患者17例,占12.6%,合并静止性震颤组震颤总分、头部震颤的比例、肢体震颤总分均明显高于对照组。两组年龄、性别组成、病史无显著性差异,姿势性震颤和动作性震颤的程度差异不明显。4年后随访到13例(13/17),其中3例死亡,实际调查的10例中有9例仍诊断为ET,另1例诊断为临床很可能ET。结论有相当部分社区ET患者可以合并静止性震颤,合并静止性震颤的患者提示病情较重。     

拉萨市区55岁以上藏族人群简易精神状态检查结果分布状态

目的：调查拉萨市区藏族中老年人简易精神状态检查结果分布状态。方法：以拉萨市区55岁及以上藏族人群3776名作为调查对象。采用深入到居民区集中和家访相结合的普查方法。利用简易精神状态检查量表（MMSE）、日学活动功能量表（ADL）进行面对面问卷及配合必要的其他检查等。结果：中老年人MMSE结果低于分界值分布率为7．2％，其中男性为9．3％，女性为6．3％。结论：拉萨市区中老年人MMSE结果低于分界值分布率结果与国内其他市区报道大致相似，但在年龄、教育程度、性别等分布上有其不同点，可能与西藏特殊的地理环境、生活习惯和历史文化风俗有关。     

西安地区老年人帕金森病患病率调查

目的：了解西安地区55岁以上老年人帕金森病（PD）的流行状况，方法：E要用多级分层随机整群抽样方法，于1997－09－1998－12在西安地区调查了4850名55岁以上的老年人。结果：发现PD38例，55岁以上老年人的患病率为783．5／10万。男女患病率分别为1029．4／10万、605．0／10万，男女患病率之比为1．70：1，统计学处理差异无显著性（P＝0．098）；但同一年龄组，患病率男性均高于女性；随年龄的增大，PD患病率随之升高，但女性在85岁以上未发现PD患者；城市与农村PD的患病率分别为634．5／10万，980．0／10万，两者之间差异无显著性（P＞0．05）；随文化程度升高，男性PD患病率随之降低，结论：西安地区帕金森病的患病率处于较高水平，患病率随年龄增大而升高，PD患者男性略高于女性，女性85岁以上患病率低有待于进一步研究，文化程度对男性PD患病率可能有一定影响，职业对PD患病率影响不大。     

北京市城区中学生人格障碍倾向的分布特点

目的了解北京市中学生人格障碍倾向的检出率及其年龄、性别分布。方法以现况调查整群抽样的方法，采用人格诊断问卷（PDQ－R）调查北京市海淀区1148名中学生。结果IDQ－R总分为23．94±7．42，总分大于均值1信标准差的问卷占14．3％，年龄和性别对PDQ-R总分有交互作用；表演型与反社会型人格障碍倾向阳性率分别为最高（25．4％）和最低（4％）。结论北京市城区中学生人格障碍倾向的检出率较高，年龄和性别对其有交互作用。对青少年出现的人格障碍倾向应引起重视。     

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。     

有机磷农药中毒206例临床分析

有机磷农药中毒的病死率高，本交通过对1983－1992年我院收治的有机磷农药中毒206例的临床分析，探讨影响救治成功率的某些因素。1临床资料本组男108例，女98例；死亡28例，病死率为13．6％。各种因素与预后的关系如下：1．1性别男108例，死亡17例，病死率15．7％，女98例，死亡11例，病死率11．2％。二者病死率无显著差异（P＞0．05）。1．2年龄本组15岁以下者23例，死亡1例（4．3％），16－34岁70例，死亡12例（17．1％）；35－59岁85例，死亡11例（12．9％）；60岁以上者28例，死亡4例（14．3％）各年龄组病死率无显著差异（P＞0．05）…     

不同年龄正常人群的扩瞳试验比较研究

目的了解不同年龄正常人群的扩瞳试验结果，探索阿尔茨海默病（AD）的可能病因。方法将496名正常人群按年龄分成6组。分别进行扩瞳试验，比较各个年龄阶段人群扩瞳试验的阳性率。结果扩瞳试验的阳性率与性别无关，但是与年龄有明显关系。〈35岁、35～44岁、45岁～54岁、55岁-64岁、65岁～74岁和≥75岁组扩瞳试验的阳性率分别为0％、11．7％、22．4％、35．1％和40．2％。从45岁开始，扩瞳试验阳性率逐渐增加。65岁以下受试者扩瞳试验的阳性率与65岁以上受试者有明显差异。结论AD可能是一部分人老化加速的结果。     

Prevalence of dementia in China

To obtain prevalence estimates of dementia in China, an analysis of 17 studies published in Chinese from 1990-1999 was carried out. The prevalence rates for the population aged 60 years and older were 1.26% for Alzheimer's disease (AD) and 0.74% for vascular dementia (VD). The prevalence of AD was 2.10% in women and 0.76% in men, while the prevalence of VD was 0.71 and 0.69%, respectively. The prevalence of AD among the three educational levels in our study (illiterate, primary school and high school) were 1.79, 0.45 and 0.15%, respectively, and those of VD were 0.26, 0.58 and 0.26%, respectively. Although the prevalence of AD (2.29%) was higher in urban than in rural areas (1.67%), the difference was not statistically significant. The difference between the prevalence of VD in urban (0.67%) and in rural areas (1.13%) was not significant either. The prevalence of AD increased with age, and gender was found to be associated with Alzheimer's disease. The prevalence of VD also increased with age, but there was no association between VD and gender.     

Prevalence of neurological disorders in Bangalore, India: a community-based study with a comparison between urban and rural areas

A population-based neuroepidemiological survey of 102,557 individuals in urban and rural Bangalore in Southern India was conducted to determine the prevalence and pattern of neurological disorders. The study population included subjects from urban (51,502) and rural (51,055) areas, identified through a two-stage stratified random sampling method. Trained social workers administered the screening questionnaire, which had been tested and validated in an earlier pilot study and a neurologist examined the individuals who screened positive. Adults, children (<15 years) and elderly adults (>60 years) constituted 61, 34 and 5% of the study group, respectively. There was a distinct difference in education, occupation and income levels between urban and rural areas with all these parameters being lower in the rural population. In the surveyed population, 3,206 individuals with neurological disorders were detected resulting in crude and age-adjusted prevalence rates of 3,126 and 3,355 per 100,000 population, respectively. The prevalence rate among children, middle-aged (31-40 years) and elderly adults was 2,653, 3,932 and 5,012 per 100,000 population, respectively. The prevalence of neurological disorders among women (3,617) was higher compared with men (2,657). The prevalence rate in urban and rural populations was 2,190 and 4,070/1,00,000, respectively, implying that neurological disorders were twice as frequent in rural areas as in urban areas. The prevalence rates per 100,000 population of the most frequent disorders in the descending order of frequency were: headache (1,119), epilepsy (883), febrile convulsions (330), cerebrovascular disorder (150), and mental retardation (142). This large-scale population-based survey provides data that will be crucial for developing hospital and community-based neurological services in India and other developing countries.     

广州市城乡55岁及以上人群痴呆患病率调查

目的调查广州市城乡≥55岁人口痴呆的患病率。方法采用分层整群抽样方法,将广州市12个区市分为老城区、新城区、郊区,根据各层≥55岁的人口数占广州市相应年龄段人口总数的比例确定各层应查人数,实查5276人。调查采用筛查和确诊两阶段法,按美国精神障碍诊断和统计手册第4版的标准诊断痴呆。结果①查出痴呆患者183人,粗患病率为3.47%,其中阿尔茨海默病(AD)、血管性痴呆(VD)和其他痴呆的粗患病率分别为2.43%、0.85%和0.19%。年龄标化后的痴呆、AD和VD患病率分别为1.94%、1.28%和0.55%。②女性痴呆粗患病率高于男性(4.35%vs2.21%,P<0.001),二者的年龄标化患病率分别为1.12%、2.72%。痴呆患病率随年龄增长而上升。③农村人口的痴呆患病率(4.32%)高于城镇人口(3.27%),差异有统计学意义(P<0.01)。④文盲者的痴呆患病率(6.17%)较小学(2.68%)和初中及其以上(1.41%)文化程度者高(P<0.001)。结论AD是广州地区老人中主要的痴呆类型,VD次之。老年期痴呆患病率随年龄的增长而升高。文化程度低者痴呆患病率较高。     

Comparative Epidemiology of Epilepsy in Pakistan and Turkey: Population-Based Studies Using Identical Protocols

Summary: Purpose: To determine comparative prevalence rates, demographics, phenomenology, seizure classification, presumptive etiology, treatment status, and selected socioan-thropological aspects of epilepsy in Pakistan and Turkey. Methods: A population-based, cross-cultural comparative study of epilepsy was designed with identical protocols to be performed simultaneously in Pakistan and Turkey. The essential feature of the design was an unselected population, with reference to their previous medical contact, and use of standardized International Community-Based Epilepsy Research Group (ICBERG) protocols to assess cross-cultural differences. Results: In all, 24,130 persons in Pakistan and 11,497 persons in Turkey (both urban and rural, of all ages and both sexes) were studied. The crude prevalence rate of epilepsy was 9.98 in 1,000 in Pakistan and 7.0 in 1,000 in Turkey (14.8 in 1,000 in rural and 7.4 in 1,000 in urban areas of Pakistan; 8.8 in 1,000 in rural and 4.5 in 1,000 in urban areas of Turkey). In both countries, epilepsy was twice as prevalent in rural areas than in urban areas. Mean age of onset of epilepsy was 13.3 years in Pakistan and 12.9 years in Turkey. Overall frequency of seizure types was similar in both countries, with no urban/rural differences. The frequency distribution in Pakistan and Turkey, respectively, was as follows: generalized tonic-clonic, 80.5 and 65.4%; simple partial, 5 and 7.4%; complex partial, 5 and 12.3%; generalized absence, 0.8 and 4.9%; tonic and atonic, 5.8 and 3.7% each; and myoclonic, 5.8 and 1.2%. A putative cause for the epilepsy could be attributed in 38.4% of cases in Pakistan and 35.7% of cases in Turkey. Only 3% of patients in Pakistan, but 71% of patients in Turkey, believed that their illness was due to supernatural causes. The treatment status was very poor. In Pakistan, 27.5% of people with epilepsy in urban areas and 1.9% of people with epilepsy in rural areas were receiving antiepileptic drugs (AEDs) at the time of the survey. In, Turkey 30% of patients were receiving AEDs (marginally higher in rural areas). Conclusions: The prevalence of epilepsy is slightly higher in Pakistan than in Turkey; some marginal differences in age and sex distribution, are not statistically significant. The results are comparable to those in Ecuador, where the same epidemiologic protocol was used.     

Mental illness in a rural area

Objectives Few epidemiological studies have compared less well-integrated urban areas with well-integrated rural areas with the same methods. The aim of this study was to explore the prevalence of mental disorder in a socially stable demographic western region of Norway and make comparison with previously observed prevalence figures of mental illness in Oslo, the capital of Norway. Method A random sample of the 107,738 residents of Sogn and Fjordane, a western rural region of Norway, age 18–65 years, was drawn from the Norwegian Population Register. A total of 1,080 subjects, 63% of the original sample, were interviewed with the Composite International Diagnostic Interview. Results The mean age of the subjects was 39.2 years. The 12-month prevalence of mental illness was 16.5% and the lifetime prevalence was 30.9%. Simple phobia and social phobia had the highest 12-month prevalence whereas alcohol abuse and major depression had the highest lifetime prevalence. All mental disorders were more prevalent in women than in men, with the exception of alcohol and drug abuse. Severe psychopathology was found in 2.2% (12 month prevalence) and 5.1% (lifetime prevalence). These observations show that the 12-month and the lifetime prevalence of mental illness in this western area is approximately half the rate of figures observed for Oslo. Conclusion Epidemiological figures for a western rural region of Norway showing 12-month and the lifetime prevalence of mental disorder are considerably lower than figures obtained in studies from the capital of Norway. However, the same basic pattern of mental illness can be observed in the rural as in the urban area of Oslo, with alcohol abuse/dependence and major depression being the most common disorders at both sites. The sex pattern is also the same with higher figures for women both in rural and urban areas with the exception of alcohol and drug abuse being higher in men.     

Urban–rural disparities in mild cognitive impairment and its functional subtypes among community-dwelling older residents in central China

BackgroundSubstantial variations in the prevalence of mild cognitive impairment (MCI) and its subtypes have been reported, although mostly in geographically defined developed countries and regions. Less is known about MCI and its subtypes in rural areas of less developed central China.AimsThe study aimed to compare the prevalence of MCI and its subtypes in residents aged 65 years or older in urban and rural areas of Hubei Province, China.MethodsParticipants aged 65 years or older were recruited between 2018 and 2019. Inperson structured interviews and clinical and neuropsychological assessments were performed at city health community centres and township hospitals.ResultsAmong 2644 participants without dementia, 735 had MCI, resulting in a prevalence of 27.8% for total MCI, 20.9% for amnestic MCI (aMCI) and 6.9% for non-amnestic MCI (naMCI). The prevalence of MCI in urban and rural areas was 20.2% and 44.1%, respectively. After adjusting for demographic factors, the prevalence of total MCI, aMCI and naMCI differed significantly between rural and urban areas (adjusted odds ratio (OR) 2.10, 1.44 and 3.76, respectively). Subgroup analysis revealed an association between rural socioeconomic and lifestyle disadvantage and MCI and its subtypes.ConclusionsOur findings suggest that the prevalence of MCI among urban residents in central China is consistent with that in other metropolis areas, such as Shanghai, but the prevalence in rural areas is twice that in urban areas. Prospective studies and dementia prevention in China should focus on rural areas.     

Epidemiology of long-term functional psychosis in three different areas in Stockholm County

This study is the first in a series investigating different aspects of living conditions and care utilization in a total population with long-term functional psychoses (LFP). The study cohort (n = 302) was defined as people that: were aged 18-64 years, were affected by a nonorganic psychosis continuously during at least 6 months, showed psychotic features or residual symptoms during 1984, and had their home address in the study area during 1984. The study area consists of one rural and one suburban municipality, and one urban parish (57,035 inhabitants aged 18-64 years). The LFP concept used shows a high interrater reliability (kappa = 0.93). The one-year prevalence in the rural, suburban and urban areas was 3.4, 5.6 and 6.6 per 1000 respectively, thus producing a gradient from the rural to the urban areas. The prevalence of schizophrenia (DSM-III) was 2.6, 3.8 and 5.0 per 1000 respectively. The other diagnoses covered by the LFP concept (paranoia, major affective disorder with psychotic features, and psychotic disorder not elsewhere classified) showed the same gradient, with the exception of paranoia, which showed a lower rate in the urban area. The prevalence of schizophrenia was higher among males, while for paranoia the prevalence was higher among females.     

湖南省岳阳市癫痫流行病学调查

目的了解湖南岳阳癫痫患病率及治疗缺口,为开展防治工作提供依据。方法采用多级整群随机抽样方法确定调查人群,运用WHO建议的癫痫流行病学专项调查问卷,采用国际统一的癫痫诊断标准,由经过统一培训的调查员入户调查,调查确诊或可疑为癫痫者均经神经科医师再次访查确诊。结果共调查32059人,确诊癫痫患者143例,癫痫患病率为4.5‰。男性患病率高于女性(P<0.05)。年龄组患病率分布存在20岁年龄组(8.4‰)和60岁年龄组(5.4‰)两个高峰。农村患病率明显高于城市(P<0.05)。继发全面性强直-阵挛发作占大多数(63.4%)。活动性癫痫的治疗缺口93.4%。结论湖南岳阳癫痫患病率农村地区较高、城市较低,患者中约有90%以上没有得到正确的治疗,应尽快制定合理的干预对策。