Chaves Márcia Lorena, Camozzato Ana Luiza, Godinho Cláudia, Piazenski Isabel, Kaye Jeffrey
Dementia Clinic, Neurology Service, Hospital de Clínicas de Porto Alegre, Brazil.
J Geriatr Psychiatry Neurol. 2009 Sep;22(3):181-7. doi: 10.1177/0891988709332942. Epub 2009 Mar 23.
The objective of the study was to evaluate incident cases of Alzheimer disease (AD) and mild cognitive impairment (MCI) in an elderly community cohort in a major city of southern Brazil and to determine the variables associated with the development of cognitive dysfunction. Data were drawn from a cohort to investigate healthy aging among community elderly (N = 345) and were derived from the follow-up for a maximum of 8 years. Sociodemographic, psychiatric and medical information, the Mini-Mental State Examination (MMSE), and the Clinical Dementia Rating scale were obtained in each assessment. The Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition; DSM-IV), NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and related Disorders Association), and the Mayo Clinic criteria were applied to ascertain diagnoses of AD and MCI. The incidence rate per 1000 persons-year for MCI was 13.2 (95% confidence interval [CI] 7.79-20.91) and for AD was 14.8 (95% CI 9.04-22.94). Cognitive dysfunction was associated with education (odds ratio [OR] = 0.86; confidence limit [CL] 0.76-0.97 95%) and baseline MMSE (OR = 0.81; CL 0.70-0.94 95%). The AD incidence in this sample was higher than those reported in a previous Brazilian study. The study filled the epidemiological gap in the evaluation of MCI in Brazil.
本研究的目的是评估巴西南部一个大城市老年社区队列中阿尔茨海默病（AD）和轻度认知障碍（MCI）的发病情况，并确定与认知功能障碍发展相关的变量。数据来自一个调查社区老年人健康老龄化的队列（N = 345），随访时间最长为8年。每次评估时均获取社会人口统计学、精神病学和医学信息、简易精神状态检查表（MMSE）以及临床痴呆评定量表。采用《精神疾病诊断与统计手册》（第四版；DSM-IV）、美国国立神经疾病和中风研究所及阿尔茨海默病及相关疾病协会（NINCDS-ADRDA）以及梅奥诊所的标准来确定AD和MCI的诊断。MCI的每1000人年发病率为13.2（95%置信区间[CI] 7.79 - 20.91），AD的每1000人年发病率为14.8（95% CI 9.04 - 22.94）。认知功能障碍与教育程度（优势比[OR] = 0.86；置信限[CL] 0.76 - 0.97 95%）和基线MMSE（OR = 0.81；CL 0.70 - 0.94 95%）相关。该样本中的AD发病率高于巴西此前一项研究报告的发病率。本研究填补了巴西MCI评估方面的流行病学空白。
