National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
Duke-NUS Medical School, Singapore, Singapore.
Alzheimers Res Ther. 2021 Nov 30;13(1):195. doi: 10.1186/s13195-021-00936-y.
Southeast Asia represents 10% of the global population, yet little is known about regional clinical characteristics of dementia and risk factors for dementia progression. This study aims to describe the clinico-demographic profiles of dementia in Southeast Asia and investigate the association of onset-type, education, and cerebrovascular disease (CVD) on dementia progression in a real-world clinic setting.
In this longitudinal study, participants were consecutive series of 1606 patients with dementia from 2010 to 2019 from a tertiary memory clinic from Singapore. The frequency of dementia subtypes stratified into young-onset (YOD; <65 years age-at-onset) and late-onset dementia (LOD; ≥65 years age-at-onset) was studied. Association of onset-type (YOD or LOD), years of lifespan education, and CVD on the trajectory of cognition was evaluated using linear mixed models. The time to significant cognitive decline was investigated using Kaplan-Meier analysis.
Dementia of the Alzheimer's type (DAT) was the most common diagnosis (59.8%), followed by vascular dementia (14.9%) and frontotemporal dementia (11.1%). YOD patients accounted for 28.5% of all dementia patients. Patients with higher lifespan education had a steeper decline in global cognition (p<0.001), with this finding being more pronounced in YOD (p=0.0006). Older patients with a moderate-to-severe burden of CVD demonstrated a trend for a faster decline in global cognition compared to those with a mild burden.
There is a high frequency of YOD with DAT being most common in our Southeast Asian memory clinic cohort. YOD patients with higher lifespan education and LOD patients with moderate-to-severe CVD experience a steep decline in cognition.
东南亚地区占全球人口的 10%，但人们对该地区痴呆症的临床特征和痴呆症进展的风险因素知之甚少。本研究旨在描述东南亚地区痴呆症的临床-人口学特征，并在真实临床环境中探讨发病类型、教育程度和脑血管疾病（CVD）与痴呆症进展的关系。
在这项纵向研究中，我们纳入了来自新加坡一家三级记忆诊所的 1606 名连续确诊的痴呆症患者（2010 年至 2019 年）。我们对青年起病型（YOD；发病年龄<65 岁）和老年起病型痴呆（LOD；发病年龄≥65 岁）进行了亚组分析。使用线性混合模型评估发病类型（YOD 或 LOD）、预期寿命教育年限和 CVD 对认知轨迹的影响。使用 Kaplan-Meier 分析来评估认知显著下降的时间。
阿尔茨海默病型痴呆（DAT）是最常见的诊断类型（59.8%），其次是血管性痴呆（14.9%）和额颞叶痴呆（11.1%）。YOD 患者占所有痴呆患者的 28.5%。教育程度越高的患者整体认知下降越明显（p<0.001），YOD 患者的下降更显著（p=0.0006）。与 CVD 负担较轻的患者相比，中重度 CVD 负担的老年患者整体认知下降速度更快。
在我们的东南亚记忆诊所队列中，YOD 患者比例较高，其中 DAT 最常见。教育程度较高的 YOD 患者和中重度 CVD 的 LOD 患者认知下降更为明显。
