Di Carlo Antonio, Baldereschi Marzia, Gandolfo Carlo, Candelise Livia, Ghetti Augusto, Maggi Stefania, Scafato Emanuele, Carbonin Pierugo, Amaducci Luigi, Inzitari Domenico
Institute of Neurosciences, Italian National Research Council, Florence, Italy.
Cerebrovasc Dis. 2003;16(2):141-50. doi: 10.1159/000070594.
Epidemiological data are essential to estimate the burden of stroke. We evaluated stroke incidence in older Italians and the effect of first-ever stroke on survival and activities of daily living (ADL).
The analysis was performed in the Italian Longitudinal Study on Aging (ILSA) sample, consisting of 5,632 individuals aged 65-84. The ILSA aims at major cardiovascular and neurological age-associated diseases. The baseline survey was performed in 1992 to detect prevalent diseases. The longitudinal examination started on September 1995 aiming at incidence, function and survival.
Complete follow-up data were achieved for 77% of the baseline stroke-free cohort (4,164 persons; 50.9% males; mean age 74.5 +/- 5.7 years). Incidence for first-ever stroke was 9.51 (95% CI: 7.75-11.27) per 1,000 person years and 12.99 (95% CI: 10.99-14.98) including recurrent stroke (total incidence). Crude mortality was 49.2% among first stroke patients and 15% among persons without stroke. The first-ever stroke mortality risk ratio, adjusted for demographics and comorbidity, was 2.40 (95% CI: 1.62-3.54). In survivors, impairment of at least one ADL was present in 67.6% of first-ever stroke patients vs. 31.6% of individuals without stroke. The comorbidity-adjusted OR was 2.63 (95% CI: 1.20-5.78) in the total cohort, and 4.00 (95% CI: 1.39-11.46) in individuals without disability at baseline.
The ILSA provides the first data on stroke incidence in Italy on a national basis. Overall, 153,000 new cases can be expected annually in the Italian elderly population. First-ever stroke still has a strong effect on survival and function of older persons.
流行病学数据对于评估中风负担至关重要。我们评估了意大利老年人群中的中风发病率以及首次中风对生存和日常生活活动（ADL）的影响。
分析在意大利纵向老龄化研究（ILSA）样本中进行，该样本由5632名年龄在65 - 84岁的个体组成。ILSA旨在研究主要的心血管和神经系统与年龄相关的疾病。1992年进行了基线调查以检测现患疾病。1995年9月开始进行纵向检查，旨在了解发病率、功能和生存情况。
在基线时无中风的队列中，77%（4164人；男性占50.9%；平均年龄74.5±5.7岁）获得了完整的随访数据。首次中风的发病率为每1000人年9.51例（95%置信区间：7.75 - 11.27），包括复发性中风的总发病率为12.99例（95%置信区间：10.99 - 14.98）。首次中风患者的粗死亡率为49.2%，无中风者为15%。经人口统计学和合并症调整后，首次中风的死亡风险比为2.40（95%置信区间：1.62 - 3.54）。在幸存者中，首次中风患者中有67.6%存在至少一项ADL功能受损，而无中风者中这一比例为31.6%。在整个队列中，经合并症调整后的比值比为2.63（95%置信区间：1.20 - 5.78），在基线时无残疾的个体中为4.00（95%置信区间：1.39 - 11.46）。
ILSA在全国范围内提供了意大利中风发病率的首批数据。总体而言，预计意大利老年人群每年有153000例新发病例。首次中风对老年人的生存和功能仍有很大影响。
