Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
J Alzheimers Dis. 2021;84(4):1515-1522. doi: 10.3233/JAD-210544.
The burden of dementia is changing due to population aging and changes in incidence and risk factor profiles. Reliable projections of future disease burden require accurate estimates of disease duration across different stages of dementia severity.
To provide an overview of current evidence on severity stage and disease duration in patients with dementia.
We reviewed the literature on duration of mild cognitive impairment (MCI), dementia, and various dementia severity stages. Data on study setting, country, sample size, severity stages, dementia type, and definition of disease duration was collected. Weighted averages and Q-statistics were calculated within severity stages and duration definitions.
Of 732 screened articles, 15 reported the duration of one or more severity stages and only half of those reported severity stage onset to conversion to the following stage. In those studies, MCI, very mild dementia, and mild dementia stages lasted 3-4 years and moderate and severe dementia stages lasted 1-2 years. Information on the disease duration was reported in 93 (13%) of screened articles and varied from 1 to 17 years. Reporting of dementia severity stage and disease duration in the literature was highly heterogeneous, which was accounted for only in part by dementia type, study setting, or continent of data collection.
The duration of dementia disease stages shortens with advancing stage. However, reliable modelling of future dementia burden and informing of intervention strategies will require more consistently reported duration estimates from studies that follow individuals longitudinally throughout their entire disease course.
由于人口老龄化以及发病和风险因素谱的变化，痴呆症的负担正在发生变化。可靠的未来疾病负担预测需要对不同严重程度痴呆阶段的疾病持续时间进行准确估计。
概述痴呆症患者严重程度阶段和疾病持续时间的现有证据。
我们回顾了关于轻度认知障碍（MCI）、痴呆症以及各种痴呆严重程度阶段持续时间的文献。收集了关于研究地点、国家、样本量、严重程度阶段、痴呆症类型和疾病持续时间定义的数据。在严重程度阶段和持续时间定义内计算了加权平均值和 Q 统计量。
在筛选出的 732 篇文章中，有 15 篇报告了一个或多个严重程度阶段的持续时间，只有一半的文章报告了严重程度阶段的发病到向后续阶段的转变。在这些研究中，MCI、极轻度痴呆和轻度痴呆阶段持续 3-4 年，中度和重度痴呆阶段持续 1-2 年。有 93 篇（13%）筛选出的文章报告了疾病持续时间，范围从 1 年到 17 年不等。文献中痴呆严重程度阶段和疾病持续时间的报告高度异质，这部分归因于痴呆症类型、研究地点或数据收集的大陆。
随着疾病严重程度的增加，痴呆症的持续时间会缩短。然而，要可靠地预测未来的痴呆症负担并为干预策略提供信息，需要有更多研究从个体的整个疾病过程中进行纵向随访，报告更一致的持续时间估计值。
