Dharmasaroja Pornpatr A, Lolekha Praween, Kulkantrakorn Kongkiat, Charernboon Thammanard, Watcharakorn Arvemas, Piyabhan Pritsana
Stroke and Neurodegenerative Diseases Research Unit, Faculty of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120, Thailand.
Stroke and Neurodegenerative Diseases Research Unit, Faculty of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120, Thailand.
J Clin Neurosci. 2017 Dec;46:37-40. doi: 10.1016/j.jocn.2017.08.040. Epub 2017 Sep 8.
More than half of patients with dementia lived in countries with low and middle incomes. However, there have been few studies on the natural course of disease in these countries. The purpose of this study was to study the natural course and the predictive factors of advanced stage and death in Thai patients with dementia. Patients with dementia who were treated in neurologic and psychiatric clinic from September 2004 to February 2016, were included. Data about natural course of diseases, behavioral and psychological symptoms in dementia (BPSD) and complications were studied. 207 patients were included. Mean age was 77years old. Mean Thai Mental State Examination (TMSE) was 17.5. Alzheimer's disease was the most common cause of dementia (55%). With the mean follow-up of 39months (range from 2 to 126months), 64% of the patients had BPSD. Sixty-two patients (30%) had complications required admission. Seven patients died. Fifty-four patients (29%) ended in the advanced stage of dementia. Mean duration from diagnosis to the advanced stage was 49months. Complications that required admission usually occurred in moderate to severe dementia and were strongly associated with the advanced stage or death (OR 6.1, 95%CI 2.57-14.49, p-value<0.0001). Alzheimer's disease was the most common cause of dementia in the study. Most demented patients presented in moderate severity of dementia. Mean duration from diagnosis to the advanced stage of dementia was approximate 4-5years. Complications required admissions related to the progression to advanced stage or death.
超过半数的痴呆症患者生活在低收入和中等收入国家。然而，关于这些国家疾病自然病程的研究却很少。本研究的目的是探讨泰国痴呆症患者的自然病程以及晚期和死亡的预测因素。纳入了2004年9月至2016年2月在神经科和精神科诊所接受治疗的痴呆症患者。研究了疾病自然病程、痴呆的行为和心理症状（BPSD）以及并发症的数据。共纳入207例患者。平均年龄为77岁。泰国精神状态检查（TMSE）平均为17.5。阿尔茨海默病是痴呆症最常见的病因（55%）。平均随访39个月（范围为2至126个月），64%的患者有BPSD。62例患者（30%）有需要住院治疗的并发症。7例患者死亡。54例患者（29%）进入痴呆晚期。从诊断到晚期的平均病程为49个月。需要住院治疗的并发症通常发生在中度至重度痴呆患者中，并且与晚期或死亡密切相关（比值比6.1，95%置信区间2.57 - 14.49，p值<0.0001）。阿尔茨海默病是本研究中痴呆症最常见的病因。大多数痴呆患者表现为中度痴呆。从诊断到痴呆晚期的平均病程约为4至5年。需要住院治疗的并发症与进展到晚期或死亡有关。
