Zhang Ying, Shi Zhihong, Liu Mengyuan, Liu Shuai, Yue Wei, Liu Shuling, Xiang Lei, Lu Hui, Liu Ping, Wisniewski Thomas, Wang Jinhuan, Ji Yong
Department of Neurology, Tianjin Huanhu Hospital, Tianjin, PR China.
Neuroepidemiology. 2014;42(4):197-203. doi: 10.1159/000360138. Epub 2014 Apr 15.
Few data are available on the prevalence of cognitive impairment no dementia (CIND) in rural China. The aim of this study was to estimate the prevalence of CIND in individuals aged 60 years and older in a large rural community, and to analyze the associated risk factors.
A two-phase, door-to-door epidemiological study was used for residents aged 60 years and older in Ji County, a rural county near Tianjin in Northern China. In phase 1 of the study, the Mini-Mental State Examination and Clinical Dementia Rating were administered for screening purposes. In phase 2, the subjects who screened positive were further examined by neurologists. A total of 5,744 individuals underwent the home visit interview, where demographic variables and comorbidities were recorded; 5,550 individuals completed the two phases. CIND was diagnosed by the Aging, Demographics and Memory Study on CIND criteria. The odds ratio (OR) for each risk factor was calculated by logistic regression analysis.
The prevalence of CIND among those aged 60 years and older was 23.3%. The prevalence of CIND was lower among those with a higher level of education or social involvement. CIND was more prevalent in females, older individuals, those with a past history of stroke, and those living without a partner. Significant risk factors were found by multivariate analyses: past history of stroke (OR = 1.889; 95% CI: 1.437-2.483); being female (OR = 1.546; 95% CI: 1.305-1.832); and having no partner (divorced, widowed or single; OR = 1.250; 95% CI: 1.042-1.499). In turn, level of education (OR = 0.560; 95% CI: 0.460-0.681) and engagement in social activities (OR = 0.339; 95% CI: 0.258-0.404) were protective factors.
This is the first large-scale community-based epidemiological study assessing the prevalence of cognitive loss in the rural Chinese population. The total prevalence of CIND observed was 23.3%, which was higher than in other studies in Western and Asian countries. Living without a partner, female gender and previous stroke increased the risk of CIND, whereas a higher level of education and engagement in social activities reduced the risk of CIND.
关于中国农村地区非痴呆性认知障碍(CIND)患病率的数据较少。本研究旨在估计一个大型农村社区中60岁及以上人群的CIND患病率,并分析相关危险因素。
对中国北方靠近天津的一个农村县——蓟县60岁及以上居民进行了一项两阶段的上门流行病学研究。在研究的第一阶段,采用简易精神状态检查表和临床痴呆评定量表进行筛查。在第二阶段,对筛查呈阳性的受试者由神经科医生进行进一步检查。共有5744人接受了家访面谈,记录了人口统计学变量和合并症;5550人完成了两个阶段的检查。根据衰老、人口统计学和记忆研究的CIND标准诊断CIND。通过逻辑回归分析计算每个危险因素的比值比(OR)。
60岁及以上人群中CIND的患病率为23.3%。在教育水平较高或社会参与度较高的人群中,CIND的患病率较低。CIND在女性、老年人、有中风病史的人和没有伴侣的人中更为普遍。多变量分析发现了显著的危险因素:中风病史(OR = 1.889;95%CI:1.437 - 2.483);女性(OR = 1.546;95%CI:1.305 - 1.832);没有伴侣(离婚、丧偶或单身;OR = 1.250;95%CI:1.042 - 1.499)。相反,教育水平(OR = 0.560;95%CI:0.460 - 0.681)和参与社会活动(OR = 0.339;95%CI:0.258 - 0.404)是保护因素。
这是第一项评估中国农村人口认知功能丧失患病率的大规模社区流行病学研究。观察到的CIND总患病率为23.3%,高于西方国家和亚洲国家的其他研究。没有伴侣、女性性别和既往中风会增加CIND的风险,而较高的教育水平和参与社会活动会降低CIND的风险。