Livingston G, Hawkins A, Graham N, Blizard B, Mann A
Academic Department of Psychiatry, Royal Free Hospital, London.
Psychol Med. 1990 Feb;20(1):137-46. doi: 10.1017/s0033291700013313.
The steps to setting up a population register of elderly residents are described. Based upon this, 87.2% of the elderly residents of an inner-city electoral area were screened for memory disorder, depression and activity limitation using the Short CARE. Contact with medical and social agencies was also recorded; 4.7% were classed as cases by the dementia diagnostic scale, sufferers being older and not living alone. Of the residents 15.9% were classed as depressed, this state being more prevalent in those not currently married. The depressed were, in contrast to the demented residents, likely to be in recent contact with hospital and general practitioner. Thirty-two per cent of the population showed impairment in daily activity, these individuals were usually older, not married and receiving hospital care. Sleep disorder and complaint of many somatic symptoms were associated with a diagnosis of depression. In contrast, most respondents with a subjective complaint of memory disorder, which was common in this population, were neither suffering from depression nor dementia. With this accurate sampling frame and a good response rate, the prevalence rate of clinical depression must be seen as disturbingly high. The prevalence rate of dementia approximated to that of other surveys. This study also indicated that general practitioners' lists may be inaccurate and that non-responders to first approaches for interview, although similar in demographic features to those responding, may contain among them many suffering from dementia.
本文描述了建立老年居民人口登记册的步骤。基于此，使用简短CARE量表对市中心一个选区87.2%的老年居民进行了记忆障碍、抑郁和活动受限筛查。还记录了与医疗和社会机构的接触情况；根据痴呆诊断量表，4.7%的居民被归类为病例，患者年龄较大且非独居。15.9%的居民被归类为抑郁，这种状态在目前未婚者中更为普遍。与痴呆居民相比，抑郁者近期更有可能与医院和全科医生有接触。32%的人口存在日常活动障碍，这些人通常年龄较大、未婚且正在接受医院护理。睡眠障碍和许多躯体症状的主诉与抑郁症诊断相关。相比之下，在该人群中常见的大多数主诉记忆障碍的受访者既没有患抑郁症也没有患痴呆症。有了这个准确的抽样框架和良好的应答率，临床抑郁症的患病率必须被视为高得令人不安。痴呆症的患病率与其他调查相近。这项研究还表明，全科医生的名单可能不准确，而且首次接受访谈邀请未应答者，尽管其人口统计学特征与应答者相似，但其中可能有许多人患有痴呆症。
