Brunnström Hans, Gustafson Lars, Passant Ulla, Englund Elisabet
Department of Pathology, University Hospital, S-221 85 Lund, Sweden.
Arch Gerontol Geriatr. 2009 Jul-Aug;49(1):146-9. doi: 10.1016/j.archger.2008.06.005. Epub 2008 Aug 9.
We investigated the distribution of neuropathologically defined dementia subtypes among individuals with dementia disorder. The neuropathological reports were studied on all patients (n=524; 55.3% females; median age 80, range 39-102 years) with clinically diagnosed dementia disorder who underwent complete autopsy including neuropathological examination within the Department of Pathology at the University Hospital in Lund, Sweden, during the years 1974-2004. The neuropathological diagnosis was Alzheimer's disease (AD) in 42.0% of the cases, vascular dementia (VaD) in 23.7%, dementia of combined Alzheimer and vascular pathology in 21.6%, and frontotemporal dementia in 4.0% of the patients. The remaining 8.8% of the patients had other dementia disorders, including combinations other than combined Alzheimer and vascular pathology. The registered prevalence of dementia subtypes depends on many variables, including referral habits, clinical and neuropathological judgments and diagnostic traditions, all of these variables potentially changing over time. This, however, does not seem to obscure the delineation of the major dementia subgroups. In this material of 30 years from Lund in the south of Sweden, AD by far dominated among dementia subtypes, while cerebrovascular pathology corresponded with the dementia disorder, either entirely or partly, in almost half of the demented patients.
我们研究了痴呆症患者中神经病理学定义的痴呆亚型分布情况。对1974年至2004年间在瑞典隆德大学医院病理科接受包括神经病理学检查在内的完整尸检的所有临床诊断为痴呆症的患者（n = 524；女性占55.3%；年龄中位数80岁，范围39 - 102岁）的神经病理学报告进行了研究。神经病理学诊断结果显示，42.0%的病例为阿尔茨海默病（AD），23.7%为血管性痴呆（VaD），21.6%为阿尔茨海默病与血管病变合并的痴呆，4.0%的患者为额颞叶痴呆。其余8.8%的患者患有其他痴呆症，包括阿尔茨海默病与血管病变合并以外的其他组合。痴呆亚型的登记患病率取决于许多变量，包括转诊习惯、临床和神经病理学判断以及诊断传统，所有这些变量都可能随时间变化。然而，这似乎并未模糊主要痴呆亚组的划分。在瑞典南部隆德的这份长达30年的资料中，AD在痴呆亚型中占主导地位，而脑血管病变在几乎一半的痴呆患者中与痴呆症完全或部分相关。
