South Devon Healthcare NHS Foundation Trust, Torquay, UK.
Int J Geriatr Psychiatry. 2013 Jul;28(7):728-37. doi: 10.1002/gps.3880. Epub 2012 Sep 20.
Despite the growing burden of dementia in low-income countries, there are few previous data on the prevalence of dementia in sub-Saharan Africa. The aim of this study was to estimate the prevalence of dementia in those who are 70 years and older in the rural Hai District of Tanzania.
This was a two-phase cross-sectional survey. Using census data, we screened individuals aged 70 years and older from six rural villages using the Community Screening Instrument for Dementia in Phase I. In Phase II, a stratified sample of those identified in Phase I were clinically assessed using the DSM-IV criteria.
Of 1198 people who fulfilled the inclusion criteria, 184 screened positive for probable dementia, and 104 screened positive for possible dementia using the Community Screening Instrument for Dementia. During clinical assessment in Phase II, 78 cases of dementia were identified according to the DSM-IV criteria. The age-standardised prevalence of dementia was 6.4% (95% confidence interval: 4.9 to 7.9). Prevalence rates increased significantly with increasing age.
The prevalence of dementia in this rural Tanzanian population is similar to that reported in high-income countries. Dementia is likely to become a significant health burden in this population as demographic transition continues. Further research on risk factors for dementia in sub-Saharan Africa is needed to inform policy makers and plan local health services.
尽管在低收入国家痴呆症的负担不断增加,但此前关于撒哈拉以南非洲地区痴呆症患病率的数据很少。本研究旨在评估坦桑尼亚海地区 70 岁及以上人群中痴呆症的患病率。
这是一项两阶段横断面调查。在第一阶段,我们使用人口普查数据,使用社区痴呆症筛查工具从六个农村村庄中筛选出 70 岁及以上的个体。在第二阶段,根据 DSM-IV 标准,对第一阶段确定的分层样本进行临床评估。
在符合纳入标准的 1198 人中,184 人使用社区痴呆症筛查工具筛查出可能患有痴呆症,104 人筛查出可能患有痴呆症。在第二阶段的临床评估中,根据 DSM-IV 标准确定了 78 例痴呆病例。经年龄标准化后,痴呆症的患病率为 6.4%(95%置信区间:4.9%至 7.9%)。患病率随着年龄的增加而显著增加。
本研究中坦桑尼亚农村人群的痴呆症患病率与高收入国家相似。随着人口结构的转变,痴呆症很可能成为该人群的一个重大健康负担。需要进一步研究撒哈拉以南非洲地区痴呆症的危险因素,以为决策者提供信息并规划当地卫生服务。