血管性痴呆的可能心理社会危险因素

目的探索血管性痴呆(VD)可能的心理社会危险因素。方法在城市社区中分层整群抽样，10年间完成两次二阶段法调查的55岁及以上人群共5055人。工具为“上海市老年研究访问卷”中有关内容。1987年第一次调查非痴呆4896名老人多方面的心理社会因素资料，以及进行MMSE和ADL量表评定。10后复访，按DSM-Ⅲ-R和Hachinski缺血指数作出痴呆和VD的临床诊断，计算VD年发病率，以Logistic回归法分析VD老人10年前那些心理社会因素对10年后VD疾病发生产生可能的影响。结果10年后访到1206名老年人中有新发痴呆124名，其中VD36名。经统计分析相对危险度(RR)，发现VD的心理社会危险因素主要有不参加集体活动、对生活不满意、有不良生活事件和抑郁等4项(RR＞1)；此外，ADL总分有较好预测VD的作用。结论心理社会危险因素在VD的发生和发展中可能有一定的影响作用。

A study on psychosocialrisk factors of vascular dementia

Objective 　To explore the relationship between psychosocial factors and risk of vascular dementia. Methods　A cohort study of people 55 years old and over were followed up 10 years after a baseline screening. 5055 older subjects in Shanghai were stratified and cluster sampled from community. Information about psychosocial factors was collected during the baseline screening with an interview in 1987. The clinical diagnosis of dementia and vascular dementia (VD) were made according to DSM-Ⅲ-R and Hachinski Ischemic Score (HIS). In 1997,the elders who were not having dementia in 1987 were surveyed; Clinical diagnosis terms of that was made in above mentioned criteria. Then we analyzed the relationship between the psychosocial factors and VD in community elderly population by means of Logistic regression and estimated the incidence of VD.Results　1203 subjects were re-surveyed in 1997 and among them 124 new cases of dementia including 36 cases of VD were identified. By calculating the relative risk (RR) of psychosocial factors to the VD, we found that several psychosocial factors were correlated with the VD including not taking group activities, unsatisfying life, negative life events and depression (RR＞1). ADL total score are also good predictive points for VD.Conclusions　Psychosocial factor may play an important role in the vascular dementia developed.