Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Asahigawaso Research Institute, Asahigawa Medical Welfare Center, Okayama, Japan.
Int J Geriatr Psychiatry. 2020 Apr;35(4):414-422. doi: 10.1002/gps.5258. Epub 2020 Jan 15.
There are only a few studies of the prevalence of dementia in people with intellectual disability (ID) without Down syndrome (DS), and there is a large difference in the prevalences between reported studies. Moreover, the prevalence of mild cognitive impairment (MCI) in ID has not been reported. We aimed to evaluate the prevalence of dementia in adults of all ages and the prevalence of MCI in people with ID. Furthermore, we tried to clarify the differences depending on the various diagnostic criteria.
The survey included 493 adults with ID at 28 facilities in Japan. The caregivers answered a questionnaire, and physicians directly examined the participants who were suspected of cognitive decline. Dementia and MCI were diagnosed according to ICD-10, DC-LD, and DSM-5 criteria.
The prevalence of dementia was 0.8% for the 45 to 54 years old group, 3.5% for the 55 to 64 years old group, and 13.9% for the 65 to 74 years old group in people with ID without DS. The prevalence of MCI was 3.1% for patients 45 to 54, 3.5% for patients 55 to 64, and 2.8% for patients 65 to 74 with ID without DS. DSM-5 was the most inclusive in diagnosing dementia and MCI in people with ID.
People with ID without DS may develop dementia and MCI at an earlier age and higher rate than the general population. Among the diagnostic criteria, DSM-5 was the most useful for diagnosing their cognitive impairment.
仅有少数研究调查了非唐氏综合征（DS）智力障碍（ID）人群中痴呆的患病率，且报道的研究之间患病率差异较大。此外，ID 患者轻度认知障碍（MCI）的患病率尚未报道。我们旨在评估各年龄段 ID 成人的痴呆患病率和 ID 患者的 MCI 患病率。此外，我们试图根据各种诊断标准阐明差异。
该调查纳入了日本 28 家机构的 493 名 ID 成人。护理人员回答了一份问卷，疑似认知能力下降的参与者由医生直接检查。根据 ICD-10、DC-LD 和 DSM-5 标准诊断痴呆和 MCI。
在非 DS ID 人群中，45-54 岁组的痴呆患病率为 0.8%，55-64 岁组为 3.5%，65-74 岁组为 13.9%。非 DS ID 患者中，45-54 岁者 MCI 的患病率为 3.1%，55-64 岁者为 3.5%，65-74 岁者为 2.8%。DSM-5 最适合 ID 患者痴呆和 MCI 的诊断。
非 DS ID 人群可能比一般人群更早、更高的比例出现痴呆和 MCI。在诊断标准中，DSM-5 最适合诊断 ID 患者的认知障碍。
