Forbes Raeburn B, Colville Shuna, Swingler Robert J
Department of Neurology, Royal Victoria Hospital, Belfast BT12 6BA, UK.
Age Ageing. 2004 Mar;33(2):131-4. doi: 10.1093/ageing/afh013.
To describe the clinical features, incidence, survival and process of care of people with Amyotrophic Lateral Sclerosis/Motor Neurone Disease aged 80 years or more at diagnosis.
Prospective, population-based descriptive epidemiological study.
Scotland (population 5.1 million), The Scottish Motor Neurone Disease Register 1989-1998.
135 people aged 80 years or over at diagnosis.
Descriptive Epidemiology of Amyotrophic Lateral Sclerosis/Motor Neurone Disease in the over 80s. Survival described using Kaplan-Meier curves.
135 of 1226 cases (11%) were aged 80 years or more. Sixty-seven (50%) had bulbar onset, and 58 (43%) were men. The standardised incidence was 10.2/100000 (95% CI 7.4-13.1) in men and 6.1/100000 (95% CI = 4.3-7.6) in women. Median survival from first symptoms was 1.7 years (IQR 1.0-2.8), less than younger patients (P = 0.0003; log Rank test). We found evidence of differences in the process of care, as older people were less likely to be prescribed Riluzole (OR 0.12, 95% CI = 0.02-0.89) or be assessed by a neurologist (OR 0.76, 95% CI = 0.67-0.86).
This is the first comprehensive report of the epidemiology of Amyotrophic Lateral Sclerosis/Motor Neurone Disease in older people. Clinical presentation and survival differ from the population as a whole. There is evidence of a different process of care. While this may be to the detriment of their survival, this finding would need to be confirmed by further prospective studies.
描述确诊时年龄在80岁及以上的肌萎缩侧索硬化症/运动神经元病患者的临床特征、发病率、生存率及护理过程。
基于人群的前瞻性描述性流行病学研究。
苏格兰（人口510万），1989 - 1998年苏格兰运动神经元病登记处。
确诊时年龄在80岁及以上的135人。
80岁以上肌萎缩侧索硬化症/运动神经元病的描述性流行病学研究。采用Kaplan - Meier曲线描述生存率。
1226例病例中有135例（11%）年龄在80岁及以上。67例（50%）为延髓起病，58例（43%）为男性。男性标准化发病率为10.2/10万（95%可信区间7.4 - 13.1），女性为6.1/10万（95%可信区间4.3 - 7.6）。从首发症状开始计算的中位生存期为1.7年（四分位间距1.0 - 2.8），短于年轻患者（P = 0.0003；对数秩检验）。我们发现护理过程存在差异，老年人服用利鲁唑的可能性较小（比值比0.12，95%可信区间0.02 - 0.89），接受神经科医生评估的可能性也较小（比值比0.76，95%可信区间0.67 - 0.86）。
这是关于老年人肌萎缩侧索硬化症/运动神经元病流行病学的首份综合报告。临床表现和生存率与总体人群不同。有证据表明护理过程存在差异。虽然这可能对他们的生存不利，但这一发现需要进一步的前瞻性研究来证实。
