天津市北辰区某社区医院服务老人痴呆患病率流行病学调查

Epidemiological investigation on the prevalence of senile dementia among the patients served by a community hospital in Beichen District,Tianjin City

目的了解天津市北辰区某社区医院服务范围内老年性痴呆患病率。方法对天津市北辰区某社区医院服务范围内采取整群随机抽样方法,对该社区≥60岁人群基本情况进行调查,用简易精神量表(MMSE)测试和日常生活能力量表(ADL)进行初筛。初筛阳性者由神经内科医师进行诊断性检查,并根据美国神经疾病诊断和统计手册第4版(DSM-IV),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(NINDS-ADRDA)痴呆诊断和美国国立神经病与卒中研究所/瑞士神经科学研究国际会议标准(NINDS-AIREN)做出最后诊断。结果本次调查痴呆患病率为9%(228/2 532)。其中AD 144例(占5.69%),VD 59例(占2.33%),混合性痴呆22例(占0.87%),其他类型痴呆3例(占0.12%)。AD患病率随年龄增长而逐渐增加(P<0.01)。文盲痴呆患病率最高,其次为小学,初中及以上者最低(P<0.01)。结论天津市北辰区社区痴呆患病率较高,AD是老年期痴呆的主要亚型、VD次之。老年期痴呆患病率随年龄增长而升高。文盲老人痴呆患病率较高。

Objective To survey the prevalence of senile dementia among the patients served by a community hospital in Beichen District,Tianjin City. Methods With stratified cluster random sampling method,demographic characteristics regarding the elderly ≥60 years in the above-mentioned hospital were surveyed with questionnaires. The elderly were interviewed face to face with Mini-Mental State Examination（ MMSE） and Activities of Daily Living（ ADL） to screen out ones who had cognitive impairment. The elderly screened out in the first stage were evaluated with neuropsychological examination. The clinical diagnoses were made according to the criteria of Diagnostic and Statistical Manual of Mental Disorders-IV（ DSM-IV）,the National Institute of Neurological Disorders and Stroke and the Alzheimer＇s Disease and Related Disorders Association（ NINDS-ADRDA） and the National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l＇Enseignement en Neurosciences（ NINDS-AIREN）. Results The prevalence of dementia was 9%（ 228 /2,532）. Among the 228 patients,there were 144 cases of Alzheimer＇s Disease（ AD）,59 cases of vascular dementia（ VD）,22 cases of mixed dementia and 3 cases of other dementia,accounting for 5. 69%,2. 33%,0. 87% and 0. 12%,respectively. The prevalence of AD gradually increased with the advancing age（ P〈0. 01）. The prevalence of dementia was the highest in the illiterate elderly,followed by the elderly with elementary education and with middle school or higher education（ P〈0. 01）. Conclusions The prevalence of dementia is high in the community of Beichen District,Tianjin City. AD is the most common type of senile dementia,followed by VD. The prevalence of senile dementia increases with the increasing age,and dementia is highly prevalent among the illiterate elderly.