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智障人士痴呆的患病率和可改变的风险因素。

Prevalence and modifiable risk factors for dementia in persons with intellectual disabilities.

机构信息

Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan.

Department of Neuropsychiatry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

出版信息

Alzheimers Res Ther. 2023 Jul 18;15(1):125. doi: 10.1186/s13195-023-01270-1.

Abstract

BACKGROUND

People with intellectual disability (ID) without Down syndrome (DS) are presumed to be at higher risk of developing dementia due to their lower baseline cognitive reserve. We aimed to determine the prevalence of dementia in people with ID without DS and to identify risk factors of dementia.

METHODS

This was a cross-sectional survey and multicenter study in Japan. Adults with ID without DS residing in the facilities were included. Caregivers of all participants were interviewed by medical specialists, and participants suspected of having cognitive decline were examined directly. ICD-10 criteria for dementia, DC-LD criteria for dementia, and DSM-5 criteria for neurocognitive disorders were used to diagnose dementia. The severity of ID, educational history, and comorbidities were compared by dividing the groups into those with and without dementia.

RESULTS

A total of 1831 participants were included; 118/1831 (6.44%) were diagnosed with dementia. The prevalence of dementia for each age group was 8.8%, 60-64 years; 9.0%, 65-69 years; 19.6%, 70-74 years; and 19.4%, 75-79 years. Age, severity of ID, duration of education, hypertension, depression, stroke, and traumatic brain injury were significantly associated with the presence of dementia.

CONCLUSIONS

Although the prevalence of dementia in people with ID without DS was found to be higher at a younger age than in the general population, the results of this study suggested that adequate education, prevention of head trauma and stroke, and treatments of hypertension and depression may reduce the risk of dementia. These may be potentially important modifiable risk factors for the prevention of dementia in these people.

摘要

背景

由于认知储备较低,非唐氏综合征(Down syndrome,DS)的智力障碍(intellectual disability,ID)患者被认为痴呆的风险更高。本研究旨在确定非 DS ID 患者痴呆的患病率,并确定痴呆的危险因素。

方法

这是一项在日本进行的横断面调查和多中心研究。研究纳入居住在设施中的非 DS ID 成人。所有参与者的照护者均由医学专家进行访谈,疑似认知能力下降的参与者则直接接受检查。采用国际疾病分类第 10 版(ICD-10)痴呆标准、痴呆临床诊断标准-长谷川量表(Diagnostic Criteria for Dementia-Longitudinal follow-up study version,DC-LD)和精神障碍诊断与统计手册第 5 版(Diagnostic and Statistical Manual of Mental Disorders,DSM-5)神经认知障碍标准诊断痴呆。根据是否患有痴呆将参与者分为两组,比较两组的 ID 严重程度、教育史和合并症。

结果

共纳入 1831 名参与者,其中 118/1831(6.44%)被诊断为痴呆。各年龄组痴呆的患病率分别为:8.8%,60-64 岁;9.0%,65-69 岁;19.6%,70-74 岁;19.4%,75-79 岁。年龄、ID 严重程度、受教育年限、高血压、抑郁、卒中和创伤性脑损伤与痴呆的发生显著相关。

结论

虽然非 DS ID 患者的痴呆患病率在较年轻时高于一般人群,但本研究结果表明,充分的教育、预防头部外伤和卒中和治疗高血压及抑郁,可能降低痴呆的风险。这些可能是预防此类人群痴呆的潜在重要可改变危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bee/10354971/119285daa093/13195_2023_1270_Fig1_HTML.jpg

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