Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet-Stockholm University, Stockholm, Sweden.
Neurology. 2013 May 14;80(20):1888-94. doi: 10.1212/WNL.0b013e318292a2f9. Epub 2013 Apr 17.
To explore whether prevalence, survival, and incidence of dementia have changed from 1987-1994 to 2001-2008 in Stockholm, Sweden.
This study is based on 2 cross-sectional surveys of people aged 75 years or over conducted in central Stockholm: the Kungsholmen Project (KP) (1987-1989, n = 1,700) and the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) (2001-2004, n = 1,575). In both surveys we diagnosed dementia according to DSM-III-R criteria, following the identical diagnostic procedure. Death certificates were used to determine survival status of KP participants as of December 1994 and SNAC-K participants as of June 2008. We used logistic and Cox models to compare prevalence and survival, controlling for major confounders. We inferred incidence of dementia according to its relationship with prevalence and survival.
At baseline, 225 subjects in KP and 298 in SNAC-K were diagnosed with dementia. The age- and sex-standardized prevalence of dementia was 17.5% (12.8% in men; 19.2% in women) in KP and 17.9% (10.8% in men; 20.5% in women) in SNAC-K. The adjusted odds ratio of dementia in SNAC-K vs KP was 1.17 (95% confidence interval 0.95-1.46). The multiadjusted hazard ratio of death in SNAC-K vs KP was 0.71 (0.57-0.88) in subjects with dementia, 0.68 (0.59-0.79) in those without dementia, and 0.66 (0.59-0.74) in all participants.
Prevalence of dementia was stable from the late 1980s to the early 2000s in central Stockholm, Sweden, whereas survival of patients with dementia increased. These results suggest that incidence of dementia may have decreased during this period.
探讨 1987-1994 年至 2001-2008 年期间瑞典斯德哥尔摩痴呆症的患病率、生存率和发病率是否发生了变化。
本研究基于在斯德哥尔摩市中心进行的两次 75 岁及以上人群的横断面调查：Kungsholmen 项目（KP）（1987-1989 年，n=1700）和瑞典 Kungsholmen 老龄化和护理全国研究（SNAC-K）（2001-2004 年，n=1575）。在这两项研究中，我们根据 DSM-III-R 标准诊断痴呆症，并采用相同的诊断程序。死亡证明用于确定 KP 参与者截至 1994 年 12 月和 SNAC-K 参与者截至 2008 年 6 月的生存状态。我们使用逻辑和 Cox 模型来比较患病率和生存率，同时控制主要混杂因素。根据患病率和生存率之间的关系，我们推断出痴呆症的发病率。
在基线时，KP 中有 225 名受试者和 SNAC-K 中有 298 名受试者被诊断为痴呆症。KP 中年龄和性别标准化的痴呆症患病率为 17.5%（男性为 12.8%；女性为 19.2%），SNAC-K 中为 17.9%（男性为 10.8%；女性为 20.5%）。SNAC-K 与 KP 相比，痴呆症的调整后优势比为 1.17（95%置信区间为 0.95-1.46）。SNAC-K 与 KP 相比，痴呆症患者的多调整后死亡风险比为 0.71（0.57-0.88），无痴呆症患者为 0.68（0.59-0.79），所有参与者为 0.66（0.59-0.74）。
瑞典斯德哥尔摩市中心的痴呆症患病率从 20 世纪 80 年代末到 21 世纪初保持稳定，而痴呆症患者的生存率有所提高。这些结果表明，在此期间，痴呆症的发病率可能有所下降。
