广州市城乡养老院60岁及其以上人群痴呆检出率的调查

The examining-out rate of dementia among residents aged 60 years or over in the urban and rural resthomes in Guangzhou

目的调查广州市城乡养老院老年人痴呆患病情况。方法采用分层整群抽样方法,将广州地区养老院分为市级、区级、民营、厂矿及农村乡镇,每层各抽取1个养老院进行调查。应查者为抽中养老院的入住者,年龄≥60岁。实查1105人,失访12人(1.07%)。按美国精神障碍诊断与统计手册第4版的标准诊断痴呆。结果 (1)检出率:在1105名老人中,查出痴呆患者324例,检出率为29.32%。其中阿尔茨海默病(AD)为20.36%(225例)、血管性痴呆(VD)为7.69%(85例)、混合性痴呆为0.45%(5例)、帕金森病痴呆为0.27%(3例)、其他类型痴呆为0.54%(6例)。(2)女性痴呆患者235例,检出率(31.8%)高于男性(89例,24.3%;P<0.05)。(3)痴呆检出率随年龄增长而上升。(4)痴呆患者中轻度71例(占21.9%)、中度103例(占31.8%)、重度150例(占46.3%)。结论广州地区养老院老人的痴呆检出率为29.32%,其中 AD 检出率高于 VD,女性高于男性,以重度者多见,且痴呆检出率随年龄的增长而升高。

Objective To study the prevalent situation of dementia and Alzheimer disease （AD） among residents aged 60 years or over in the urban and the rural resthomes in Guangzhou. Methods This study was conducted among residents aged 60 years or over in the urban and the rural resthomes selected by stratified sampling from area of Guangzhou. In the screening stage, each elderly was interviewed by face to face with the Mini-Mental State Examination. Then the subjects selected based on their performance on the screening tests were followed with a battery of neuropsychological examination to make diagnosis. The clinical diagnosis of dementia and AD was made according to the Diagnosis and Statistical Manual of Mental Disorder Fourth Edition and National Institute of Neurological and Communicative Disorders and Stroke Alzheimer disease and Related Disorders Association criteria A total of 1105 among 1117 subjects were interviewed, with the dropout rate of 1.07% （ 12 persons）. Results A total of 324 cases of mild to severe dementia was identified, in which 225 patients with AD, 85 with vascular dementia （VD）, 5 with mixed dementia （MD）, 3 with dementia due to Parkinson＇s disease （PD）, 6 with other organic dementia （OD）. The total examining-out rate of dementia was 29. 32% , with the respective rates of AD, VD, MD, PD and OD of 20. 36% , 7.69% , 0. 45% ,0. 27% and 0. 54%. The rate of dementia was significantly higher in women （31.8%） than in men （24.3% ; P 〈0. 05）, and increased consistently with advancing age. There were 71 （21.9%） mild, 103 （31.8%） moderate and 150 （46.3%） severe dementia in all patients with dementia. Conclusion The examining-out rate of dementia is 29. 32% in individuals aged 60 years or over in the urban and the rural resthomes in Guangzhou, which is higher than that in community.