Klich-Rączka Alicja, Piotrowicz Karolina, Mossakowska Małgorzata, Skalska Anna, Wizner Barbara, Broczek Katarzyna, Wieczorowska-Tobis Katarzyna, Grodzicki Tomasz
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.
Exp Gerontol. 2014 Sep;57:233-42. doi: 10.1016/j.exger.2014.06.003. Epub 2014 Jun 14.
The growing incidence of dementia in ageing societies is a major concern of health care organizations. Because of its detrimental influence on the mental and functional statuses of elderly people, it leads to increased economic burdens caused by the social and financial needs of patients with dementia and their caregivers. There has been no data concerning the prevalence of dementia in the elderly in the general Polish community so far. The main aim of the study was to assess the prevalence of cognitive impairment suspected of dementia among the Polish elderly and the relationships between cognitive performance and age, gender, place of residence and educational status. The presented data was the result of nationwide, multicentre PolSenior Study conducted from 2007 to 2011 in the Polish elderly population. Cognitive functions were evaluated using Mini-Mental State Examination (MMSE) performed by pre-trained nurses. The result of MMSE lower than 24 points was classified as cognitive impairment suspected of dementia and divided according to its severity into three stages: mild, moderate and severe dementia. The results were analysed in two ways: raw MMSE and MMSE scores after Mungas adjustment (MMSEadj), that is, corrected for age and educational level, and these were compared. To verify the suspicion of dementia an assessment was complemented by an interview of carers for the occurrence and course of memory disorders, treatment of dementia and by functional status assessment. In order to assess the prevalence of suspicion of dementia in the general Polish population, statistical analyses based on weighting were done. The suspicion of dementia on the basis of raw MMSE was made in 20.4% of respondents aged 65years and more, and after Mungas adjustment in 12.1% of older subjects. The prevalence of cognitive impairment grew with increasing age, as well as depending on the educational status of elderly respondents in both types of analyses; raw MMSE and MMSEadj. There was no significant difference in the prevalence of cognitive impairment according to gender in the general population (raw MMSE); however in analyses including MMSEadj results, the suspicion of dementia was made more often among men. Suspicion of dementia based on raw MMSE and MMSEadj results was made significantly more often among men than women at the age of 65-69years, and significantly more often among the oldest women, aged 90years and more. Suspicion of dementia was diagnosed more often in respondents living in rural communities (based on raw MMSE, but not on MMSEadj), which might be related to the differences in their educational status.
在老龄化社会中,痴呆症发病率不断上升是医疗保健机构主要关注的问题。由于其对老年人心理和功能状态产生不利影响,导致痴呆症患者及其照料者的社会和经济需求造成经济负担增加。到目前为止,波兰普通社区中尚无关于老年人痴呆症患病率的数据。该研究的主要目的是评估波兰老年人中疑似痴呆症的认知障碍患病率,以及认知表现与年龄、性别、居住地点和教育程度之间的关系。所呈现的数据是2007年至2011年在波兰老年人群中进行的全国性多中心PolSenior研究的结果。认知功能通过由经过预培训的护士进行的简易精神状态检查表(MMSE)进行评估。MMSE结果低于24分被归类为疑似痴呆症的认知障碍,并根据其严重程度分为三个阶段:轻度、中度和重度症和重度痴呆症。结果通过两种方式进行分析:原始MMSE和Mungas调整后的MMSE分数(MMSEadj),即根据年龄和教育水平进行校正,并对两者进行比较。为了验证痴呆症的疑似情况,通过对照料者进行关于记忆障碍的发生和病程、痴呆症治疗以及功能状态评估的访谈来补充评估。为了评估波兰普通人群中疑似痴呆症的患病率,进行了基于加权的统计分析。基于原始MMSE,65岁及以上受访者中有20.4%被怀疑患有痴呆症,在Mungas调整后,老年受试者中有12.1%被怀疑患有痴呆症。在两种分析类型(原始MMSE和MMSEadj)中,认知障碍的患病率均随着年龄增长以及取决于老年受访者的教育程度而增加。在普通人群中(原始MMSE),根据性别,认知障碍患病率没有显著差异;然而,在包括MMSEadj结果的分析中,男性中疑似痴呆症的情况更为常见。基于原始MMSE和MMSEadj结果,65 - 69岁男性中疑似痴呆症的情况明显比女性更常见,在90岁及以上的老年女性中也明显更常见。居住在农村社区的受访者中疑似痴呆症的诊断更为频繁(基于原始MMSE,但不基于MMSEadj),这可能与他们的教育程度差异有关。