Liu C K, Lin R T, Chen Y F, Tai C T, Yen Y Y, Howng S L
Department of Neurology, Kaohsiung Medical College, Kaohsiung, Taiwan, ROC.
J Formos Med Assoc. 1996 Oct;95(10):762-8.
This two-stage epidemiologic study was to investigate the prevalence and types of dementia among elderly people in the Saa-Min district of Kaohsiung City in Taiwan. In stage one, the Chinese Mini-Mental Status Examination (CMMSE) and Blessed Dementia Rating Scale were employed. In stage two, a comprehensive neurobehavioral examination and neuropsychologic tests were administered by neurologists and neuropsychologists. Dementia was defined by DSM-III-R criteria. The National Institute of Neurological and Communication Disorders and Stroke-Alzheimer's Disease and Related Disorders Association guidelines for Alzheimer's disease (AD) and the National Institute of Neurological Disorder and Stroke-Association international pour la Recherche et l'Enseignement en Neurosciences criteria for vascular dementia (VaD) were applied. A total of 1,016 randomly selected elderly people participated in phase one: 131 people with CMMSE below cutoff values participated in phase two, of whom 45 were confirmed to have a form of dementia. The prevalence of dementia in this sample was 4.4% (3.2% in men and 5.8% in women): 2.0% for those 65 to 74 years old, 8.3% for those 75 to 84 and 24.4% for those > or = 85 years old; 6.0% for those who were illiterate, 3.3% for those who attended grade-school; and 2.8% for those who finished junior-high-school. AD (22 cases, 48.9%) was the most common cause of dementia, followed by VaD (11 cases, 24.4%) and mixed dementia (MIX: 5 cases, 11.1%). Old age and being female were significant high risk factors for AD. Medical history indicated that stroke and hypertension were significant risk factors for VaD. A relatively high prevalence of dementia was observed in this study, probably because we assessed neurobehavior in great detail. Although AD was the leading cause of dementia in the present population sample. VaD and MIX also comprised an important proportion, reflecting the high prevalence of stroke in Taiwan. Older women had high risk for AD, not for VaD; and those with a history of stroke and hypertension had high risk for VaD, not for AD.
这项两阶段的流行病学研究旨在调查台湾高雄市三民区老年人痴呆症的患病率及类型。在第一阶段，采用了中文版简易精神状态检查表（CMMSE）和Blessed痴呆评定量表。在第二阶段，由神经科医生和神经心理学家进行全面的神经行为检查和神经心理测试。痴呆症根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）标准进行定义。应用了美国国立神经疾病和中风研究所-阿尔茨海默病及相关疾病协会关于阿尔茨海默病（AD）的指南以及美国国立神经疾病和中风研究所-国际神经科学研究与教学协会关于血管性痴呆（VaD）的标准。共有1016名随机选取的老年人参与了第一阶段：131名CMMSE低于临界值的人参与了第二阶段，其中45人被确诊患有某种形式的痴呆症。该样本中痴呆症的患病率为4.4%（男性为3.2%，女性为5.8%）：65至74岁的人群中患病率为2.0%，75至84岁的人群中患病率为8.3%，85岁及以上的人群中患病率为24.4%；文盲人群中患病率为6.0%，小学学历人群中患病率为3.3%，初中学历人群中患病率为2.8%。AD（22例，48.9%）是痴呆症最常见的病因，其次是VaD（11例，24.4%）和混合性痴呆（MIX：5例，11.1%）。高龄和女性是AD的显著高危因素。病史表明，中风和高血压是VaD的显著危险因素。本研究中观察到痴呆症患病率相对较高，可能是因为我们对神经行为进行了详细评估。尽管AD是当前人群样本中痴呆症的主要病因，但VaD和MIX也占了相当比例，反映出台湾中风的高患病率。老年女性患AD的风险高，而非VaD；有中风和高血压病史的人患VaD的风险高，而非AD。
