Kushwaha Suman, Talwar Puneet, Anthony Aldrin, Gupta Meena, Bala Kiran, Agarwal Rachna, Sharma Vibha, Kukreti Ritushree
Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, India.
Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Delhi, India.
Dement Geriatr Cogn Dis Extra. 2017 Jul 26;7(2):257-273. doi: 10.1159/000478978. eCollection 2017 May-Aug.
As variability in the clinical profile of dementia subtypes had been reported with regional differences across the world, we conducted a retrospective hospital-based study in a North Indian population.
We retrieved patient records from 2007 to 2014 for details of clinical evaluation, diagnosis, neuroimaging, biochemical investigations, and follow-up of 1,876 patients with dementia (PwD), and the data were analyzed using descriptive statistics.
Of the total PwD, Alzheimer disease (AD) accounted for 30% followed by vascular dementia (VaD) 26%, mixed dementia (MD) 21%, Parkinson-related dementia 11%, frontotemporal dementia (FTD) 7%, and infective dementia 5%. Of all PwD excluding the infective group ( = 1,777), 63% were men, 39% were from rural areas, 87% had behavioral abnormalities along with cognitive deficits, and 73% had impaired ADLs. Among dementia subtypes, a positive family history, cardiovascular and metabolic risk factors, and behavioral abnormalities were found to be distributed. However, there existed a predominance of specific behavioral pattern in each subtype. The mean duration of follow-up varied from 2.9 ± 2.3 (VaD) to 3.6 ± 2.1 (AD) and greater than 30% were found to be stable on treatment (except in dementia with Lewy body).
This large hospital-based study provides a distribution pattern and clinical spectrum of dementia subtypes in a North Indian population.
由于世界各地不同地区报道的痴呆亚型临床特征存在差异,我们在北印度人群中开展了一项基于医院的回顾性研究。
我们检索了2007年至2014年的患者记录,以获取1876例痴呆患者的临床评估、诊断、神经影像学、生化检查及随访的详细信息,并使用描述性统计方法对数据进行分析。
在所有痴呆患者中,阿尔茨海默病(AD)占30%,其次是血管性痴呆(VaD)占26%,混合性痴呆(MD)占21%,帕金森病相关痴呆占11%,额颞叶痴呆(FTD)占7%,感染性痴呆占5%。在排除感染性痴呆组(n = 1777)的所有痴呆患者中,63%为男性,39%来自农村地区,87%存在行为异常及认知缺陷,73%日常生活活动能力受损。在痴呆亚型中,发现阳性家族史、心血管和代谢危险因素及行为异常呈分布状态。然而,每种亚型中存在特定行为模式的优势。随访的平均时长从2.9±2.3(VaD)到3.6±2.1(AD)不等,且发现超过30%的患者在治疗后病情稳定(路易体痴呆除外)。
这项基于医院的大型研究提供了北印度人群中痴呆亚型的分布模式和临床谱。