Fujishima Masatoshi, Kiyohara Yutaka
Department of Medicine and Clinical Sciences, Kyushu University Graduate School of Medical Sciences, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
Ann N Y Acad Sci. 2002 Nov;977:1-8. doi: 10.1111/j.1749-6632.2002.tb04793.x.
Vascular dementia (VaD) is more common than Alzheimer's disease (AD) in Japan, while AD is much more frequent in Western countries. The Hisayama study, an epidemiological study on dementia in a Japanese elderly population aged 65 years or older, has shown that the prevalence of VaD decreased for men, while AD remained unchanged in both sexes during a 7-year follow-up period (1985-1992). Decreased prevalence of VaD seems to be due to decreased incidence of stroke in recent years, resulting from the management of hypertension. The age-adjusted incidence of total dementia was approximately 20 per 1000 person-years in either sex; VaD was more frequent for men and AD for women. Risk factors for VaD were age, hypertension, previous stroke, and alcohol consumption, while age was only a significant risk factor for AD. Although the Hisayama study failed to demonstrate the relationship of vascular factors to AD, the previously reported studies suggest that either hypertension per se or blood pressure changes appear to partially participate in the pathogenesis of AD.
在日本，血管性痴呆（VaD）比阿尔茨海默病（AD）更为常见，而在西方国家，AD则更为频发。久山研究是一项针对65岁及以上日本老年人群痴呆症的流行病学研究，该研究表明，在7年的随访期（1985 - 1992年）内，男性VaD患病率下降，而AD在两性中均保持不变。VaD患病率的下降似乎是由于近年来高血压管理使中风发病率降低所致。无论男女，年龄调整后的总痴呆发病率约为每1000人年20例；男性中VaD更为常见，女性中AD更为常见。VaD的风险因素包括年龄、高血压、既往中风和饮酒，而年龄仅是AD的一个重要风险因素。尽管久山研究未能证明血管因素与AD的关系，但先前报道的研究表明，高血压本身或血压变化似乎部分参与了AD的发病机制。
