Reed D M, Brody J A
Am J Epidemiol. 1975 Apr;101(4):287-301. doi: 10.1093/oxfordjournals.aje.a112097.
An overview of the epidemiologic studies of amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia (PD) from 1945 through 1972 is presented. During this period 350 cases of ALS were documented. PD, which is apparently unique to the native Chamorro population, was not recognized during the early years of the study. A total of 213 PD patients have now been seen. The rates of both diseases have declined by approximately 50 per cent since 1965. In the early years incidence per 100,000 for ALS males approached 60; for females it was about 40. For PD males it was about 50; for females it was close to 20. The declines in both diseases have occurred in both sexes and at all age groups and no cohort phenomenon was observed. Marked geographic differences in the distribution of the diseases were observed with southern villages having the highest rates and western villages having the lowest rates; the remainder of the island was intermediate. Recent declines have been most marked in the southern high-rate villages. Chamorros living on the island of Rota have rates similar to those on Guam; those on Saipan have lower rates. A possible excess of ALS among Filipino residents ofGuam was noted; ALS has not been seen among other ethnic groups. Geographic mapping even in high incidence areas did not reveal true clusters or foci. Extensive case-control studies did not reveal any patterns of prior illness, life-style, or exposures distinguishing patients. A tendency for patients to be of somewhat lower socioeconomic level, have less education, eat more homegrown foods and raw meats, and more contact with animals was found. No Mendelian genetic patterns were observed; males were affected more frequently than female for both diseases. Cases did not occur before age 20, reached maximum frequency between ages 55 and 65 and there-after declined. Environmental factors associated with some aspects of the traditional way of life seem to be causally involved, but, since most aspects of the traditional life have changed in the past 50 years, the specific factors remain elusive.
本文介绍了1945年至1972年期间肌萎缩侧索硬化症（ALS）和帕金森痴呆症（PD）的流行病学研究概况。在此期间，记录了350例ALS病例。PD显然是查莫罗原住民特有的疾病，在研究初期未被识别。目前已确诊213例PD患者。自1965年以来，这两种疾病的发病率均下降了约50%。在早期，ALS男性发病率每10万人接近60；女性约为40。PD男性约为50；女性接近20。两种疾病的发病率下降在男女各年龄组均有发生，未观察到队列现象。观察到这两种疾病的分布存在明显的地理差异，南部村庄发病率最高，西部村庄最低；该岛其他地区发病率居中。最近，南部高发病率村庄的下降最为明显。居住在罗塔岛的查莫罗人的发病率与关岛相似；塞班岛的发病率较低。注意到关岛的菲律宾居民中ALS可能有过剩现象；在其他种族群体中未发现ALS病例。即使在高发病率地区进行地理绘图也未发现真正的聚集或病灶。广泛的病例对照研究未发现任何区分患者的既往疾病、生活方式或接触模式。发现患者往往社会经济水平略低、受教育程度较低、食用更多自家种植的食物和生肉，以及与动物接触更多。未观察到孟德尔遗传模式；两种疾病男性比女性更易患病。病例在20岁之前未出现，在55岁至65岁之间达到最高发病率，此后下降。与传统生活方式某些方面相关的环境因素似乎有因果关系，但由于传统生活的大多数方面在过去50年中已经改变，具体因素仍然难以捉摸。
