西安地区中老年人的痴呆患病率调查

Study of the prevalence of senile dementia among elderly people in Xi'an, China

目的 了解西安地区中老年人痴呆的流行现状。 方法 采用分层、多级、随机、整群抽样 ,以简易智能状态量表 (MMSE)为筛查工具 ,对西安地区 485 0例 5 5岁及以上中老年人进行了痴呆患病率调查。 结果 符合美国精神疾病诊断和统计手册第 4版 (DSM Ⅳ )和美国国立神经病学、语言交流障碍和卒中 老年性痴呆及相关疾病学会 (NINCDS ADRDA)痴呆诊断标准者 171例 ,痴呆患病率 3 5 3 %。其中Alzheimer病痴呆 (AD) 10 0例 ,患病率 2 0 6 % ,占 5 8 48% ;血管性痴呆 (VD) 5 4例 ,患病率 1 11% ,占 31 5 8%。痴呆及VD患病率男女间差异无显著性 (P >0 0 5 ) ,而AD患病率女性明显高于男性 (P <0 0 1)。痴呆及AD、VD患病率均随增龄而显著增高 (P <0 0 1) ,年龄每增长 5岁 ,患病率约增高 1倍。文盲组痴呆及AD患病率高于小学和初中以上组 (P <0 0 1)。各种职业之间痴呆及AD、VD患病率用年龄分层后差异均无显著性 (P >0 0 5 )。城市和农村痴呆、AD、VD患病率差异亦无显著性 (P >0 0 5 )。 结论 我国痴呆患病率并不低 ,基本与欧美国家持平 ;高龄、女性、低文化水平 。

Objective In order to explore the prevalence of senile dementia among elderly people in Xi'an, China population aged 55 years and over was investigated from September 1997 to December 1998. Methods 4 850 residents (aged 55 years and over) were studied in urban and rural areas in Xi'an by stratified multi stage cluster sampling method with the Mini Mental State Examination (MMSE) as screening tool and DSM IV and NINCDS ADRDA as clinical diagnostic criteria. Results The prevalence of total dementia was 3 53%(171 patients); the prevalence of Alzheimer's disease (AD) and vascular dementia (VD) was 2 06%(100 patients) and 1 11%(54 patients) ( P >0 05) , repectively. Of all dementia, AD and VD accounted for 58 48% and 31 58%, respectively. The AD prevalence in female was higher than that in male( P <0 01), but there was no statistical difference between female and male in the prevalence in total dementia and VD( P >0 05). The prevalence of total dementia, AD and VD tended to increase with aging( P <0 01)and showed no statistical difference among all occupations when stratified with age( P >0 05). The prevalence of dementia increased one fold every five year of age increasing. The prevalence of dementia and AD in illiterate group was higher than in educated people with elementary school level and above junior high school level ( P <0 01). Conclusions The prevalence of dementia in China is not lower than that in other countries and it is basically equal to that in European and American countries. AD is one of the main causes of dementia. Senility, lower educational level and female elders seemed to be risk factors of AD.