Ott A, Breteler M M, van Harskamp F, Stijnen T, Hofman A
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Am J Epidemiol. 1998 Mar 15;147(6):574-80. doi: 10.1093/oxfordjournals.aje.a009489.
To assess age-, sex-, and subtype-specific incidence rates of dementia and to calculate the risk of dementia, the authors performed a large, community-based, prospective cohort study on dementia as part of the Rotterdam Study. Participants were recruited among residents of a suburb of Rotterdam, aged 55 years and older. Baseline examinations took place between 1990 and 1993. The average follow-up was 2.1 years. Screening for dementia followed a three-stage protocol. Medical records of subjects who had died or could not be examined in person were evaluated. Of 7,046 subjects who were nondemented at baseline, 162 developed dementia during 15,135 person-years of follow-up, resulting in an overall incidence rate of 10.7 per 1,000 person-years. From the youngest to the oldest 5-year age category, the incidence rate increased from 0.6 to 97.2 per 1,000 person-years. Only in men did the increase level off after age 85. Overall, the incidence rate per 1,000 person-years was 7.7 for Alzheimer's disease and 1.5 for vascular dementia. Dementia incidence rates and dementia-free Kaplan-Meier survival tables were used to calculate age- and sex-specific cumulative risks of dementia. Although the incidence rates of men and women up to age 85 were similar, the lifetime risk of dementia for 55-year-old women was twice as high as for men (0.33 vs. 0.16), reflecting both the higher life expectancy of women and the higher dementia risk at very old age.
为评估痴呆症的年龄、性别和亚型特异性发病率，并计算痴呆症风险，作者开展了一项大型的、基于社区的前瞻性队列研究，作为鹿特丹研究的一部分，研究对象为痴呆症。参与者从鹿特丹一个郊区年龄在55岁及以上的居民中招募。基线检查于1990年至1993年进行。平均随访时间为2.1年。痴呆症筛查遵循三阶段方案。对已死亡或无法亲自检查的受试者的病历进行了评估。在7046名基线时无痴呆症的受试者中，162人在15135人年的随访期间患上痴呆症，总体发病率为每1000人年10.7例。从最年轻到最年长的5岁年龄组，发病率从每1000人年0.6例增加到97.2例。只有男性在85岁以后发病率趋于平稳。总体而言，每1000人年的发病率，阿尔茨海默病为7.7例，血管性痴呆为1.5例。痴呆症发病率和无痴呆症的Kaplan-Meier生存表用于计算年龄和性别特异性痴呆症累积风险。尽管85岁以下男性和女性的发病率相似，但55岁女性患痴呆症的终生风险是男性的两倍（0.33对0.16），这既反映了女性预期寿命较长，也反映了极高龄时患痴呆症的风险较高。
