21 世纪超高龄人群的时间性痴呆和认知障碍趋势。

Temporal Dementia and Cognitive Impairment Trends in the Very Old in the 21st Century.

机构信息

Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, Uppsala, Sweden.

Department of Community Medicine and Rehabilitation, Division of Geriatic Medicine, Umeå University, Umeå, Sweden.

出版信息

J Alzheimers Dis. 2023;93(1):61-74. doi: 10.3233/JAD-220915.

DOI:10.3233/JAD-220915

PMID:36938733

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10200221/

Abstract

BACKGROUND

Long-increasing dementia incidence and prevalence trends may be shifting. Whether such shifts have reached the very old is unknown.

OBJECTIVE

To investigate temporal trends in the incidence of dementia and cognitive impairment and prevalence of dementia, cognitive impairment, Alzheimer's disease, vascular dementia, and unclassified dementia among 85-, 90-, and ≥ 95-year-olds in Sweden during 2000-2017.

METHODS

This study was conducted with Umeå 85 + /Gerontological Regional Database data from 2182 85-, 90-, and ≥ 95-year-olds in Sweden collected in 2000-2017. Using logistic regression, trends in the cumulative 5-year incidences of dementia and cognitive impairment; prevalences of dementia, cognitive impairment, Alzheimer's disease, and vascular dementia; and Mini-Mental State Examination thresholds for dementia diagnosis were estimated.

RESULTS

Dementia and cognitive impairment incidences decreased in younger groups, which generally showed more-positive temporal trends. The prevalences of overall dementia, cognitive impairment, and Alzheimer's disease were stable or increasing; longer disease durations and increasing dementia subtype classification success may mask positive changes in incidences. Vascular dementia increased while unclassified dementia generally decreased.

CONCLUSION

The cognitive health of the very old may be changing in the 21st century, possibly indicating a trend break.

摘要

背景

痴呆症的发病率和患病率呈长期增长趋势，这种趋势可能正在发生变化。目前尚不清楚这种变化是否已经出现在非常高龄的人群中。

目的

调查 2000 年至 2017 年间瑞典 85 岁、90 岁和≥95 岁人群中痴呆症和认知障碍的发病率以及痴呆症、认知障碍、阿尔茨海默病、血管性痴呆和未分类痴呆的患病率的时间趋势。

方法

本研究使用了来自瑞典于 2000 年至 2017 年收集的 2182 名 85 岁、90 岁和≥95 岁的乌默奥 85+ /老年区域数据库的数据。使用逻辑回归估计了痴呆症和认知障碍的 5 年累积发病率、痴呆症、认知障碍、阿尔茨海默病和血管性痴呆的患病率以及痴呆症诊断的 Mini-Mental State Examination 阈值的趋势。