Unverzagt F W, Gao S, Baiyewu O, Ogunniyi A O, Gureje O, Perkins A, Emsley C L, Dickens J, Evans R, Musick B, Hall K S, Hui S L, Hendrie H C
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202-5266, USA.
Neurology. 2001 Nov 13;57(9):1655-62. doi: 10.1212/wnl.57.9.1655.
The epidemiology and natural history of cognitive impairment that is not dementia is important to the understanding of normal aging and dementia.
To determine the prevalence and outcome of cognitive impairment that is not dementia in an elderly African American population.
A two-phase, longitudinal study of aging and dementia. A total of 2212 community-dwelling African American residents of Indianapolis, IN, aged 65 and older were screened, and a subset (n = 351) received full clinical assessment and diagnosis. Subsets of the clinically assessed were seen again for clinical assessment and rediagnosis at 18 and 48 months. Weighted logistic regression was used to generate age-specific prevalence estimates.
The overall rate of cognitive impairment among community-dwelling elderly was 23.4%. Age-specific rates indicate increasing prevalence with increasing age: 19.2% for ages 65 to 74 years, 27.6% for ages 75 to 84 years, and 38.0% for ages 85+ years. The most frequent cause of cognitive impairment was medically unexplained memory loss with a community prevalence of 12.5%, followed by medical illness-associated cognitive impairment (4.0% prevalence), stroke (3.6% prevalence), and alcohol abuse (1.5% prevalence). At 18-month follow-up, 26% (17/66) of the subjects had become demented.
Cognitive impairment short of dementia affects nearly one in four community-dwelling elders and is a major risk factor for later development of dementia.
非痴呆性认知障碍的流行病学和自然史对于理解正常衰老和痴呆至关重要。
确定老年非裔美国人中非痴呆性认知障碍的患病率和转归。
一项关于衰老和痴呆的两阶段纵向研究。对印第安纳州印第安纳波利斯市2212名年龄在65岁及以上的非裔美国社区居民进行了筛查，其中一部分（n = 351）接受了全面的临床评估和诊断。对接受临床评估的部分人群在18个月和48个月时再次进行临床评估和重新诊断。采用加权逻辑回归生成特定年龄的患病率估计值。
社区居住老年人中认知障碍的总体发生率为23.4%。特定年龄发生率表明，患病率随年龄增长而增加：65至74岁为19.2%，75至84岁为27.6%，85岁及以上为38.0%。认知障碍最常见的原因是医学上无法解释的记忆丧失，社区患病率为12.5%，其次是与医学疾病相关的认知障碍（患病率4.0%）、中风（患病率3.6%）和酒精滥用（患病率1.5%）。在18个月的随访中，26%（17/66）的受试者已发展为痴呆。
非痴呆性认知障碍影响近四分之一的社区居住老年人，是后期发生痴呆的主要危险因素。
