Dartigues J F, Gagnon M, Michel P, Letenneur L, Commenges D, Barberger-Gateau P, Auriacombe S, Rigal B, Bedry R, Alpérovitch A
Unité INSERM 330, Université de Bordeaux II.
Rev Neurol (Paris). 1991;147(3):225-30.
Paquid is an epidemiological study designed to gather and follow up a cohort of 4,000 elderly subjects (65 years and older) living at home in order to study normal and pathological brain aging. These subjects were randomly chosen in the general population of 75 communities of South-Western France. We present the results of the data collected from 2,792 subjects on the prevalence and the correlates of clinically diagnosed dementia. The DSM III criteria for dementia were met by 101 subjects (3.62 p. 100). These cases were reviewed by a neurologist to confirm the diagnosis and to determine the cause of dementia using the NINCDS-ADRDA criteria. Forty-three subjects were classified as probable Alzheimer's disease; 8 as possible Alzheimer's disease; 5 as vascular dementia; 5 as Parkinson's disease with dementia; 2 as alcoholic dementia; 2 as "dementified psychosis"; and 1 unclassified. Fifteen patients refused to be examined by the neurologist, 18 were false-positives, and 2 died before the neurologists visit. Using the NINCDS-ADRDA criteria, the prevalence of dementia was as low as 1.6 p. 100. The prevalence of probable Alzheimer's disease decreased dramatically as educational level increased, lung 5.4 p. 100 for subjects with no education, 1.7 p. 100 for subjects with grade school level, 0.4 p. 100 for subjects with high school level and 0.4 p. 100 for subjects with university degrees. The relationship between dementia and educational level is still controversial in the literature. In this study the sample was large and randomly selected; all the demented cases fulfilled the NINCDS-ADRDA criteria. This suggests that educational level is indeed an important correlate of dementia in the French elderly community.
帕奎德研究是一项流行病学研究，旨在收集并跟踪4000名居家的老年受试者（65岁及以上），以研究正常和病理性脑老化。这些受试者是从法国西南部75个社区的普通人群中随机选取的。我们展示了从2792名受试者收集的数据中关于临床诊断痴呆症的患病率及其相关因素的结果。101名受试者（3.62%）符合《精神疾病诊断与统计手册》第三版（DSM III）的痴呆症标准。这些病例由一名神经科医生复查，以使用美国国立神经疾病与中风研究所 - 阿尔茨海默病及相关疾病协会（NINCDS - ADRDA）标准确认诊断并确定痴呆症病因。43名受试者被归类为可能的阿尔茨海默病；8名被归类为可能的阿尔茨海默病；5名被归类为血管性痴呆；5名被归类为帕金森病伴痴呆；2名被归类为酒精性痴呆；2名被归类为“痴呆性精神病”；1名未分类。15名患者拒绝接受神经科医生检查，18名是假阳性，2名在神经科医生就诊前死亡。根据NINCDS - ADRDA标准，痴呆症患病率低至1.6%。随着教育水平的提高，可能的阿尔茨海默病患病率急剧下降，文盲受试者中为5.4%，小学水平受试者中为1.7%，高中水平受试者中为0.4%，大学学历受试者中为0.4%。痴呆症与教育水平之间的关系在文献中仍存在争议。在本研究中，样本量大且为随机选取；所有痴呆病例均符合NINCDS - ADRDA标准。这表明教育水平确实是法国老年人群体中痴呆症的一个重要相关因素。
