Ritchie K, Robine J M, Letenneur L, Dartigues J F
French National Institute of Health and Medical Research (INSERM), Montpellier.
Am J Public Health. 1994 Feb;84(2):232-6. doi: 10.2105/ajph.84.2.232.
Increasing concern with the quality of gains in life years has led to the development of a new synthetic indicator of population health:health expectancy. Until now, calculations have been made for physical disabilities only. A first estimate of mental health expectancy is presented: dementia-free life expectancy.
Sullivan's method was used to calculate dementia-free life expectancy for a random representative sample of 4134 persons over 65 years of age in the Bordeaux region of France. The diagnosis of senile dementia was made in two stages, based on Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria.
At 65 years of age, a person's dementia-free life expectancy is 16.9 years within a total life-expectancy of 17.7 years; it decreases with age in parallel with the decrease in total life expectancy so that life expectancy with dementia stays constant at 0.8 years. Although dementia prevalence increases with age, if the prevalence is adjusted for mortality, the largest number of persons with dementia are in their early eighties. At each age women have a higher dementia-free life expectancy.
Trends in dementia-free life expectancy are similar to those found in disability-free life expectancy. Because the dementia prevalence rates used in this estimate resemble a general model derived from meta-analysis, it can be assumed that similar results will be found in other Western countries with similar mortality rates.
人们对生命年增长质量的关注度不断提高，促使一种新的人口健康综合指标——健康期望寿命得以发展。到目前为止，仅针对身体残疾进行了计算。本文给出了心理健康期望寿命的首次估计值：无痴呆症预期寿命。
采用沙利文方法，对法国波尔多地区4134名65岁以上随机代表性样本的无痴呆症预期寿命进行计算。老年痴呆症的诊断分两个阶段进行，依据《精神疾病诊断与统计手册》（DSM - III - R）标准。
65岁时，一个人的无痴呆症预期寿命为16.9年，总预期寿命为17.7年；随着年龄增长，无痴呆症预期寿命与总预期寿命同步下降，使得患痴呆症后的预期寿命保持在0.8年不变。尽管痴呆症患病率随年龄增加，但如果对患病率进行死亡率调整，患痴呆症人数最多的是80岁出头的人群。在每个年龄段，女性的无痴呆症预期寿命更高。
无痴呆症预期寿命的趋势与无残疾预期寿命的趋势相似。由于本估计中使用的痴呆症患病率类似于从荟萃分析得出的一般模型，因此可以假定在死亡率相似的其他西方国家会得到类似结果。
