Wu Xiao-guang, Tang Zhe, Fang Xiang-hua, Guan Shao-chen, Liu Hong-jun, Diao Li-jun, Sun Fei
Department of Epidemical and Social Medicine, Xuan-wu Hospital of Capital Medical University, Beijing, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2011 Oct;32(10):973-7.
To study the mortality and risk of death on dementia among ageing population.
A random sample including 2788 elderly residents was studied. Dementia was diagnosed under the two-phase procedure in 1997. In phase 1, questionnaire was administered, including the Mini-Mental State Examination (MMSE) tested. In phase 2, all the elderly who showed low MMSE score and some with normal MMSE score, were examined by neurologists. The clinical diagnosis of dementia was set up by two neurologists according to the criteria of DSM-III-R and NINCDS-ADRDA. The same sample was followed up in 2000 and 2004 the same way and data on deaths and causes was gathered. The overall time for follow-up was 7.25 years.
171 cases with dementia were diagnosed from 2788 subjects in 1997, with a crude death rate (CDR) of dementia was 7.8 per 1000 person-years and age-standardized CDR as 5.5 per 1000 person-years. The death rate was increased exponentially with age. In the dementia group, the total number of deaths was 133, with the CDR as 236 per 1000 person-years and the age-standardized CDR as 206 per 1000 person-years, in the end of the survey. In the non-dementia group, the total number of deaths was 680, with CDR as 40 per 1000 person-years and the age-standardized CDR as 31 per 1000 person-years. The difference in the two groups was statistically significant. The hazard ratio (HR) of dementia death appeared to be the biggest in the 60 - 74 - year group than the other groups. Data was analyzed with the Cox proportional hazards model after making necessary adjustment on potential covariates with the HR of dementia as 2.181 (95%CI: 1.751 - 2.717). The HRs were 2.524 (95%CI: 1.964 - 3.243) in Alzheimer's disease and 1.859 (95%CI: 1.213 - 2.850) in vascular dementia.
The CDR and HR of dementia were higher than the non-dementia group in the aging population, showing that dementia was one of the most important risk factors on death in the aging population.
研究老年人群中痴呆症的死亡率和死亡风险。
对2788名老年居民进行随机抽样研究。1997年采用两阶段程序诊断痴呆症。在第一阶段，进行问卷调查，包括简易精神状态检查表（MMSE）测试。在第二阶段，所有MMSE得分低的老年人以及一些MMSE得分正常的老年人由神经科医生进行检查。两名神经科医生根据DSM-III-R和NINCDS-ADRDA标准对痴呆症进行临床诊断。2000年和2004年以同样的方式对同一样本进行随访，并收集死亡及死因数据。总的随访时间为7.25年。
1997年从2788名受试者中诊断出171例痴呆症患者，痴呆症的粗死亡率（CDR）为每1000人年7.8例，年龄标准化CDR为每1000人年5.5例。死亡率随年龄呈指数增长。在痴呆症组中，到调查结束时，死亡总数为133例，CDR为每1000人年236例，年龄标准化CDR为每1000人年206例。在非痴呆症组中，死亡总数为680例，CDR为每1000人年40例，年龄标准化CDR为每1000人年31例。两组差异具有统计学意义。痴呆症死亡的风险比（HR）在60 - 74岁组中似乎比其他组最大。在对潜在协变量进行必要调整后，采用Cox比例风险模型分析数据，痴呆症的HR为2.181（95%CI：1.751 - 2.717）。阿尔茨海默病的HR为2.524（95%CI：1.964 - 3.243），血管性痴呆的HR为1.859（95%CI：1.213 - 2.850）。
老年人群中痴呆症的CDR和HR高于非痴呆症组，表明痴呆症是老年人群死亡的最重要风险因素之一。
