Finlay-Albarrán Medical School, Havana, Cuba.
MEDICC Rev. 2009 Apr;11(2):29-35. doi: 10.37757/MR2009V11.N2.8.
Introduction Approximately 24.2 million persons throughout the world suffer dementia with 4.6 million new cases reported annually. Only 10% of dementia and Alzheimer's disease studies are conducted in developing countries where 66% of sufferers live. Cuba, a developing country, exhibits health indicators similar to those of developed nations. Its population of 11.6 million is aging rapidly: by the year 2020 it is estimated that persons aged ≥65 years will comprise 25% of the population, making Cuban society the "oldest" in Latin America. Objectives Ascertain and characterize behavior of dementia, its etiologies and risk factors in persons aged ≥65 years in the Havana City municipality of Playa. Methods A two-phase, cross-sectional, door-to-door study was conducted in the municipality targeting all persons aged ≥65 years, achieving a 96.4% response rate (n=18,351). Folstein Mini Mental State Examination (MMSE), Hughes Clinical Dementia Rating (CDR) and a structured interview on risk factors were applied. DSM-IV, NINCDS-ADRDA and NINDS-AIREN criteria were used to determine dementia diagnosis, as well as other criteria for diagnosing Alzheimer's and other specific forms of dementia. Results Dementia prevalence was 8.2% of adults aged ≥65 years, with a slight predominance in males. The most frequent cause of dementia was Alzheimer's disease, followed by mixed dementias. Dementia-associated risk factors were: history of stroke, hypertension, depression, skull-brain trauma, family history of dementia, low educational level and advanced age. Conclusions This study corroborates that dementia and Alzheimer's disease constitute an important and growing health problem for our country due to the accelerated aging of the Cuban population. It also underlines the importance of early diagnosis and proper treatment of hypertension and other vascular risk factors, as well as the need for a national public health program for the prevention and early diagnosis of dementia and Alzheimer's disease, targeting elderly and at-risk populations.
简介
全球约有 2420 万人患有痴呆症，每年新增病例约 460 万。只有 10%的痴呆症和阿尔茨海默病研究在发展中国家进行，而这些国家的患者却占了 66%。古巴是一个发展中国家，其健康指标与发达国家相似。古巴 1160 万的人口正在迅速老龄化：到 2020 年，预计 65 岁以上的人口将占总人口的 25%，使古巴社会成为拉丁美洲最“古老”的社会。
目的
确定并描述哈瓦那市普拉亚行政区≥65 岁人群中痴呆症的行为、病因和危险因素。
方法
在该市进行了两阶段、横断面、逐户研究，目标人群为所有≥65 岁的人，应答率达到 96.4%（n=18351）。采用 Folstein 简易精神状态检查（MMSE）、Hughes 临床痴呆评定量表（CDR）和结构化访谈进行危险因素评估。采用 DSM-IV、NINCDS-ADRDA 和 NINDS-AIREN 标准确定痴呆诊断，以及其他诊断阿尔茨海默病和其他特定类型痴呆的标准。
结果
≥65 岁成年人的痴呆患病率为 8.2%，男性略占优势。最常见的痴呆病因是阿尔茨海默病，其次是混合性痴呆。与痴呆相关的危险因素包括：中风史、高血压、抑郁、颅脑创伤、痴呆家族史、低教育程度和高龄。
结论
这项研究证实，由于古巴人口老龄化加速，痴呆症和阿尔茨海默病已成为我国一个重要且日益严重的健康问题。它还强调了早期诊断和适当治疗高血压和其他血管危险因素的重要性，以及制定国家公共卫生计划预防和早期诊断痴呆症和阿尔茨海默病的必要性，针对老年人和高危人群。
