天水市65岁及以上人群老年性痴呆患者的流行病学现况调查

Epidemiological status investigation of senile dementia in the people aged 65 and older of Tianshui city

目的：为了解天水市65岁及以上人群老年性痴呆患者的患病率及相关因素。方法：采用多阶段分层整群抽样方法随机抽取甘肃省天水市≥65岁人群1 873人为调查对象,用长谷川痴呆量表（HDS）、一般健康问卷（GHQ）进行筛查,将调查对象分为痴呆高、中、低危险3组,再以缺血指数量表（HIS）、临床痴呆评定量表（CDR）、美国精神障碍诊断与统计手册（DSM-IV）轴Ⅰ障碍定式临床检查患者版进行诊断检查。结果：1 859例完成调查,老年性痴呆患者的患病率为13.66%（95%CI为10.38%～17.98%）;老年性痴呆患者的患病率男性（16.20%）高于女性（11.09%）,老年性痴呆患者的患病率农村（12.91%）高于城市（9.09%）,但差异无显著性（P〉0.05）;老年性痴呆患者的患病率随年龄的增长而不断上升（P〈0.01）,65～70岁为7.44%,71～75岁为17.48%,76～80岁为20.08%,81～85岁为21.22%,86岁以上为30.23%;高龄、家庭收入低、婚姻状况不良、独居、文化程度低等为老年性痴呆患病的危险因素。结论：甘肃省天水市老年性痴呆患者的患病率较高,影响因素较多,应采取针对性措施予以干预。

Objective To understand the prevalence of senile dementia in the people aged 65 and older of Tianshui, and explorethe risk factors of senile dementia. Methods： Using the multistage stratified cluster sampling method, 1873 subjects aged 65 orolder were identified in Tianshui city. These subjects were screened with the Hasegawa dementia scale （HDS） and the expanded versionof the general health questionnaire （ GHQ） and classified as high, moderate or low risk dementia groups. Different proportions ofthe three groups were assessed with the Hachinski ischemic score （ HIS） , the clinical dementia rating （ CDR） and the fourth edition ofthe diagnostic and structured clinical interview for DSM-IV-TR axis I disorders （SC ID -I/P）. Results： Totally 1859 subjects completedthe survey. The prevalence of senile dementia was 13. 66% （95% CI = 10. 38 % -17. 98% ）. The prevalence of senile dementiawas higher in males （16. 20% ） than in females （11. 09% ） , and higher in rural residents （12. 91% ） than in urban residents（9.09% ） ; however, the differences were not significant （ P 〉 0.05）. The prevalence of senile dementia increased with the age （ P 〈0 .0 1 ）, wherein 7.44 of those aged 65-70, 17.48% of those aged 71-75, 20. 08% of those aged 76-80, 21. 22% of those aged 81-85 , and 30.23 of those aged 86 and older. Advanced age, low family income, bad marriage, living alone and low education levelwere the risk factors of senile dementia. Conclusions ： The elderly in Tianshui have a higher prevalence of senile dementia, and manyfactors affect the incident of senile dementia. Therefore, specific intervention measures should be carried out.