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2015 年至 2019 年期间德国综合和专科诊所中痴呆和轻度认知障碍的患病率和发病率趋势。

Trends in Dementia and Mild Cognitive Impairment Prevalence and Incidence in German General and Specialist Practices Between 2015 and 2019.

机构信息

Institute for Social Medicine, Occupational Medicine, and Public Health (ISAP) of the Medical Faculty at the University of Leipzig, Leipzig, Germany.

Professional Association of German Neurologists, Germany.

出版信息

J Alzheimers Dis. 2021;79(4):1683-1690. doi: 10.3233/JAD-201385.

Abstract

BACKGROUND

The number of patients with dementia is forecast to grow continuously. However, there are indications that the incidence and prevalence is falling in high-income countries.

OBJECTIVE

To examine whether any effects of declining incidence and prevalence rates of dementia and mild cognitive impairment (MCI) were evident in Germany between 2015 and 2019.

METHODS

The analysis was based on 797 general and 132 specialists (neurological/psychiatric) practices and included 10.1 million patients aged 18 years and older who visited between January 2014 and December 2019 one of the practitioners. The prevalence and incidence of dementia and MCI were demonstrated descriptively.

RESULTS

Between 2015 and 2019, the prevalence (incidence) of dementia decreased from 2.18%(0.44%) in 2015 to 2.07%(0.35%) in 2019. A relatively large decrease in the prevalence (incidence) of dementia was observed in patients aged 80 and older, at -1.47%(-0.62%), compared to younger patients, at -0.40%(-0.18%). By contrast, the prevalence and incidence of MCI have remained constant over the years (0.19%to 0.22%and 0.06%, respectively). Overall, the number of patients diagnosed with dementia decreased slightly by 1%while the number of patients diagnosed with MCI increased by 17%.

CONCLUSION

Our results confirmed the reduction in the prevalence and incidence of dementia and revealed a decrease in the number of patients with dementia despite continued demographic changes. Future studies are warranted to determine whether the results are caused by changing risk and lifestyle factors or changes in medical diagnosis and treatment behavior of the practitioners.

摘要

背景

预计痴呆症患者人数将持续增长。然而,有迹象表明,在高收入国家,痴呆症和轻度认知障碍(MCI)的发病率和患病率正在下降。

目的

研究 2015 年至 2019 年期间德国痴呆症和轻度认知障碍(MCI)发病率和患病率下降是否存在任何影响。

方法

该分析基于 797 家普通和 132 家专科(神经科/精神科)诊所的数据,共纳入了 2014 年 1 月至 2019 年 12 月期间在其中一家诊所就诊的 1010 万名 18 岁及以上的患者。描述性地展示了痴呆症和 MCI 的患病率和发病率。

结果

2015 年至 2019 年期间,痴呆症的患病率(发病率)从 2015 年的 2.18%(0.44%)下降到 2019 年的 2.07%(0.35%)。在 80 岁及以上的患者中,痴呆症的患病率(发病率)下降幅度较大,为-1.47%(-0.62%),而在较年轻的患者中,为-0.40%(-0.18%)。相比之下,MCI 的患病率和发病率多年来一直保持不变(分别为 0.19%至 0.22%和 0.06%)。总体而言,被诊断为痴呆症的患者数量略有减少 1%,而被诊断为 MCI 的患者数量增加了 17%。

结论

我们的研究结果证实了痴呆症患病率和发病率的降低,并揭示了尽管人口结构发生了变化,但痴呆症患者的数量仍有所减少。未来的研究需要确定这些结果是由于风险和生活方式因素的变化,还是由于医生的诊断和治疗行为的变化。

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