The Sagol Neuroscience Center, Department of Neurology, Sheba Medical Center, Tel Hashomer, Israel.
J Alzheimers Dis. 2012;29(2):431-9. doi: 10.3233/JAD-2011-111667.
The prevalence of mild cognitive impairment (MCI) and Alzheimer's disease (AD) have not been well been studied in Arab populations. In a door-to-door study of all residents aged ≥ 65 years in Wadi-Ara, an Arab community in northern Israel, we estimated the prevalence of AD, MCI, and the risk of conversion to AD. Subjects were classified as cognitively normal, MCI, AD, or other based on neurological and cognitive examination (in Arabic). MCI subjects were re-examined (interval ≥ 1 year) to determine conversion to AD and contributions of age, gender, and education to the probability of conversion. Of the 944 participants (96.6% of those approached; 49.4% men), 92 (9.8%) had AD. An unusually high prevalence of MCI (n = 303, 32.1%) was observed. Since the majority of women (77.2%) had no schooling, we estimated the effect of gender on the risk of AD and MCI among subjects without schooling and of school years among men. Among subjects with no schooling (n = 452), age (p = 0.02) and female gender (p < 0.0001) were significant predictors of AD, whereas risk of MCI increased only with age (p = 0.0001). Among men (n = 318), age increased the risk (p < 0.0001), school years reduced the risk of AD (p = 0.039) and similarly for MCI [age (p = 0.0001); school years (p = 0.0007)]. Age (p = 0.013), but not gender or school years, was a significant predictor of conversion from MCI to AD (annual rate 5.7%). The prevalence of MCI and AD are unusually high in Wadi Ara, while the rate of conversion from MCI to AD is low. Yet unidentified genetic factors might underlie this observation.
在阿拉伯人群中，轻度认知障碍（MCI）和阿尔茨海默病（AD）的患病率尚未得到很好的研究。在以色列北部阿拉伯社区瓦迪-阿拉的一项针对所有 65 岁及以上居民的逐户研究中，我们估计了 AD、MCI 的患病率以及向 AD 转化的风险。根据神经学和认知检查（阿拉伯语），将受试者分为认知正常、MCI、AD 或其他类别。对 MCI 受试者进行重新检查（间隔≥1 年），以确定向 AD 的转化以及年龄、性别和教育对转化概率的贡献。在 944 名参与者中（96.6%的受访者；49.4%为男性），92 名（9.8%）患有 AD。观察到异常高的 MCI 患病率（n=303，32.1%）。由于大多数女性（77.2%）没有受过教育，我们估计了性别对无教育受试者 AD 和 MCI 风险以及男性受教育年限的影响。在没有受过教育的受试者中（n=452），年龄（p=0.02）和女性性别（p<0.0001）是 AD 的显著预测因素，而 MCI 的风险仅随年龄增加（p=0.0001）。在男性中（n=318），年龄增加了风险（p<0.0001），受教育年限降低了 AD 的风险（p=0.039），MCI 也同样如此[年龄（p=0.0001）；受教育年限（p=0.0007）]。年龄（p=0.013），而不是性别或受教育年限，是从 MCI 向 AD 转化的显著预测因素（年转化率为 5.7%）。在瓦迪阿拉，MCI 和 AD 的患病率异常高，而从 MCI 向 AD 的转化率较低。尚未确定的遗传因素可能是导致这一观察结果的原因。
