Peng Dantao, Shi Zhihong, Xu Jun, Shen Lu, Xiao Shifu, Zhang Nan, Li Yi, Jiao Jinsong, Wang Yan-Jiang, Liu Shuai, Zhang Meilin, Wang Meng, Liu Shuling, Zhou Yuying, Zhang Xiao, Gu Xiao-Hua, Yang Ce-Ce, Wang Yu, Jiao Bin, Tang Beisha, Wang Jinhuan, Yu Tao, Ji Yong
aDepartment of Neurology, China-Japanese Friendship Hospital, Beijing bTianjin Key Laboratory of Cerebrovascular and of neurodegenerative diseases, Tianjin Dementia Institute cDepartment of Neurology, Tianjin Huanhu Hospital, Tianjin dDepartment of Neurology, Northern Jiangsu Province Hospital, Affiliated to Yangzhou University, Yangzhou, Jiangsu Province eDepartment of Neurology, Xiangya Hospital, Central South University, Changsha fDepartment of Geriatrics, Shanghai Mental Health Center of Shanghai Jiaotong University School of Medicine, Shanghai gDepartment of neurology, General Hospital of Tianjin Medical University, Tianjin hDepartment of Neurology, Qilu Hospital, Shandong university, Shandong iDepartment of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing jDepartment of Nutrition and Food Science, School of Public Health, Tianjin Medical University kFirst Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin lDepartment of Neurology, Beijing Hospital, Ministry of Health, Beijing mThe Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu Province nDepartment of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China.
Medicine (Baltimore). 2016 Jun;95(26):e3727. doi: 10.1097/MD.0000000000003727.
Alzheimer disease (AD) is the most frequent cause of dementia. AD diagnosis, progression, and treatment have not been analyzed nationwide in China. The primary aim of this study was to analyze demographic and clinical characteristics related to cognitive decline in AD patients treated at outpatient clinics in China.We performed a retrospective study of 1993 AD patients at 10 cognitive centers across 8 cities in China from March 2011 to October 2014. Of these, 891 patients were followed for more than 1 year.The mean age at diagnosis was 72.0 ± 10.0 years (range 38-96 years), and the mean age at onset of AD was 69.8 ± 9.5 years. Most patients (65.1%) had moderate to severe symptoms at the time of diagnosis, and mean Mini-Mental State Examination at diagnosis was 15.7 ± 7.7. AD patients showed significant cognitive decline at 12 months after diagnosis. Having more than 9 years of formal education was an independent risk factor related to rapid cognitive decline [odds ratio (OR) = 1.80; 95% confidence interval (95% CI): 1.11-2.91]. Early-onset AD patients experienced more rapid cognitive decline than late-onset patients (OR = 1.83; 95% CI: 1.09-3.06).Most AD patients in China had moderate to severe symptoms at the time of diagnosis and experienced significant cognitive decline within 1 year. Rapid cognitive decline in AD was related to having a higher educational level and younger age of onset.
阿尔茨海默病（AD）是痴呆最常见的病因。在中国尚未对AD的诊断、病情进展及治疗进行全国范围的分析。本研究的主要目的是分析在中国门诊接受治疗的AD患者认知功能下降相关的人口统计学和临床特征。
我们对2011年3月至2014年10月期间中国8个城市10个认知中心的1993例AD患者进行了一项回顾性研究。其中，891例患者随访时间超过1年。诊断时的平均年龄为72.0±10.0岁（范围38 - 96岁），AD发病的平均年龄为69.8±9.5岁。大多数患者（65.1%）在诊断时具有中度至重度症状，诊断时简易精神状态检查表平均得分为15.7±7.7。AD患者在诊断后12个月出现显著的认知功能下降。接受正规教育超过9年是与认知功能快速下降相关的独立危险因素[比值比（OR）= 1.80；95%置信区间（95%CI）：1.11 - 2.91]。早发型AD患者比晚发型患者经历更快的认知功能下降（OR = 1.83；95%CI：1.09 - 3.06）。
中国大多数AD患者在诊断时具有中度至重度症状，并在1年内出现显著的认知功能下降。AD患者认知功能的快速下降与较高的教育水平和发病年龄较轻有关。
