Ding Mozhu, Ek Stina, Aho Emil, Jönsson Linus, Schmidt-Mende Katharina, Modig Karin
Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
Lancet Reg Health Eur. 2024 Aug 16;45:101029. doi: 10.1016/j.lanepe.2024.101029. eCollection 2024 Oct.
Although dementia incidence has decreased in high-income countries, it is important to monitor the prevalence of dementia and identify potential underdiagnosis in population subgroups. This study provides the most up-to-date prevalence of dementia diagnosis in Sweden, by geographical regions and sociodemographic groups.
We identified all individuals aged ≥62 years, registered and alive in Sweden at the end of 2022 (n = 2.48 million). Dementia diagnoses were identified using ICD-9/10 codes in the National Patient Register since 1987, as well as anti-dementia drug use from the Prescribed Drug Register since 2005.
At the end of 2022, 3.7% (92,293/2,483,798) of people aged ≥62 years in Sweden had a dementia diagnosis from specialist care or drug prescriptions and varied from 0.6% in ages 62-69 to 14.8% in ages ≥90. The prevalence of cognitive impairment diagnosis was 2.5%. There was some geographical variation in the prevalence of dementia diagnosis, with a larger proportion of diagnoses coming from drug prescriptions than from specialist care in northern Sweden. While people born abroad and people without a close relative had a slightly higher prevalence of dementia diagnosis than Swedish born and those with close relatives, the prevalence was substantially lower for people living alone than for cohabiting individuals.
Comparing case estimates from previous screening cohorts, our results suggest underdiagnosis of dementia in the general older population, particularly among people who live alone. In more rural areas with lower availability of memory clinics, primary care may play an important role in diagnosing older adults with dementia.
Swedish Research Council for Health, Working Life and Welfare; Swedish Research Council; Region Stockholm.
尽管高收入国家的痴呆症发病率有所下降，但监测痴呆症的患病率并识别特定人群亚组中可能存在的诊断不足情况十分重要。本研究提供了瑞典按地理区域和社会人口群体划分的最新痴呆症诊断患病率。
我们确定了所有年龄≥62岁、于2022年底在瑞典登记且在世的个体（n = 248万）。自1987年起，使用国家患者登记处的ICD - 9/10编码来识别痴呆症诊断，自2005年起，还利用处方药登记处的抗痴呆药物使用情况来识别。
2022年底，瑞典年龄≥62岁的人群中，有3.7%（92,293/2,483,798）的人被诊断患有痴呆症，诊断来源为专科护理或药物处方，患病率在62 - 69岁年龄段为0.6%，在≥90岁年龄段为14.8%。认知障碍诊断的患病率为2.5%。痴呆症诊断患病率存在一定的地理差异，瑞典北部地区通过药物处方诊断出的病例比例高于专科护理。虽然国外出生的人和没有近亲的人痴呆症诊断患病率略高于瑞典出生的人和有近亲的人，但独居者的患病率显著低于同居者。
与之前筛查队列的病例估计数相比，我们的结果表明，一般老年人群体中存在痴呆症诊断不足的情况，尤其是独居者。在记忆诊所资源较少的农村地区，初级保健在诊断老年痴呆症患者方面可能发挥重要作用。
瑞典健康、工作生活与福利研究委员会；瑞典研究委员会；斯德哥尔摩地区。
