北京市城乡痴呆及其主要亚型的患病率

Prevalence of dementia and major subtypes in urban and rural communities of Beijing

目的 研究北京市城乡居民老年期痴呆及其主要亚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 5 913名 5 5岁和以上的居民为样本 ,分期入户调查。实查 5 74 3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海默痴呆 (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 痴呆患病率及年龄标化患病率 5 5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 5 5岁及以上女性高于男性 ,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 。

Objective To investigate epidemiological pattern of dementia and major subtypes,we conducted a prevalence survey in Beijing,China. Methods A door to door three phase procedure was used to ascertain dementia A Chinese version of Mini Mental State Examination (CMMSE) was administered to all participates in 1997 Then,those who failed the screening tests and those of the normal,but having a suspected history of cognitive impairment were interviewed by neurologists or psychiatrists for a diagnostic assessment of dementia,Alzheimer′s dementia (AD) and vascular dementia (VaD) using the DSM IV,NINCDS ADRDA,and NINCDS AIREN criteria Validity of the diagnostic approach was confirmed by a follow up study in 1998 Participants a total of 5 913 residents aged 55 years and over from 12 urban and 17 rural communities was drawn through a stratified multiple stage cluster sampling 5 743 (96 1%) were interviewed. Results A total of 262 cases of mild to severe dementia were identified The crude and age standardized prevalence in individuals aged 55 years and over were 4 6% and 4 2% for dementia (all causes),2 2% and 2 0% for AD,and 1 6% and 1 5% for VaD,respectively The prevalence of AD increased doubling every 5 years with age,but the prevalence of VaD increased low and slow The age standardized prevalence of AD was 1 7% in men lower than 2 1% in women,but the prevalence of VaD was 1 7% in men higher than 1 3% in women for individuals aged 55 years and over The difference in age standardized prevalence of AD between urban and rural communities was not significant that was 1 8% versus 2 2% in individuals aged 55 years and over; but the corresponding figures of VaD in rural (2 2%) was significantly higher than that in urban (1 0%) Either for AD or for VaD,there were no significant relationships between age standardized prevalence rates and educational levels Conclusion Our overall prevalence of dementia and its subtypes is considerably higher than previously reported estimates from China and similar to those reported in whites The epidemiological and clinical patterns for AD differed from VaD,but it was similar to those reported in whites It suggests that there are no substantial differences across cultures for AD