De Deyn P P, Goeman J, Vervaet A, Dourcy-Belle-Rose B, Van Dam D, Geerts E
Department of Neurology and Memory Clinic, Middelheim General Hospital, ZNA, Antwerp, Belgium.
Clin Neurol Neurosurg. 2011 Nov;113(9):736-45. doi: 10.1016/j.clineuro.2011.07.030. Epub 2011 Aug 20.
To analyse the prevalence and incidence of dementia in a population of community-dwelling elderly (aged 75-80), living in socio-economically differing districts of Antwerp (Belgium), taking into account possible gender and educational differences.
A longitudinal cohort study (N=825) with a 3-year follow-up period (N=363). The Mini Mental State Examination (MMSE) was used as a primary screen of cognitive functioning. Scoring 21 or below led to a second phase examination by a neurologist, including the CAMDEX-R-N and a neurological examination, to provide a tentative aetiological diagnosis of dementia. These procedures were conducted annually during a 3-year follow-up period.
In accordance with international literature, the overall prevalence rate of dementia was 8.7%. The cumulative incidence rate (IR) of dementia was 36.60 per 1000Py with annual IRs ranging from 34.39 over 35.16 to 49.04 per 1000Py. Dementia of the Alzheimer type (DAT) was the most occurring prevalent and incident cause. Women appeared to be at higher risk and the occurrence of cognitive deterioration was more prominent in districts with lower socio-economic status, possibly related to a lower education level.
We demonstrate dementia is a considerable health problem in an urban Belgian population of community-dwelling elderly aged between 75 and 80 years old. In order to prepare health care and social security systems for the future management of dementia, proper epidemiological insight into the current and future magnitude of the burden of dementia, taking into account socio-economic differences, to which this study contributes, are required.
分析居住在比利时安特卫普社会经济状况不同地区的社区老年人群(75 - 80岁)中痴呆症的患病率和发病率,同时考虑可能存在的性别和教育差异。
一项纵向队列研究(N = 825),随访期为3年(N = 363)。简易精神状态检查表(MMSE)被用作认知功能的初步筛查工具。得分在21分及以下者需由神经科医生进行第二阶段检查,包括CAMDEX - R - N检查和神经学检查,以初步做出痴呆症的病因诊断。在3年的随访期内,这些检查每年进行一次。
与国际文献一致,痴呆症的总体患病率为8.7%。痴呆症的累积发病率为每1000人年36.60例,年发病率在每1000人年34.39例至49.04例之间。阿尔茨海默病型痴呆(DAT)是最常见的患病和发病原因。女性似乎风险更高,且在社会经济地位较低地区,认知功能恶化的情况更为突出,这可能与较低的教育水平有关。
我们证明,痴呆症在比利时城市中75至80岁的社区居住老年人群中是一个相当严重的健康问题。为了让医疗保健和社会保障系统为未来的痴呆症管理做好准备,需要对痴呆症负担的当前和未来规模有恰当的流行病学认识,同时考虑到社会经济差异,本研究对此有所贡献。