Liu C K, Lai C L, Tai C T, Lin R T, Yen Y Y, Howng S L
Department of Neurology, Graduate Institute of Behavioral Sciences, Kaohsiung Medical College, Taiwan.
Neurology. 1998 Jun;50(6):1572-9. doi: 10.1212/wnl.50.6.1572.
To determine the incidence rate (IR) and subtypes of dementia in southern Taiwan.
From a cohort of 2,915 community inhabitants aged 65 years and over, 2,507 and 2,175 subjects participated in the first- and second-year follow-up surveys, respectively. A two-phase study used the Mini-Mental State Examination in phase I and the Consortium to Establish a Registry of Alzheimer's Disease (CERAD) neuropsychological battery and the neurobehavioral examination in phase II. We applied International Classification of Diseases (ICD)-10NA criteria for dementia, National Institute of Neurological and Communication Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) guidelines for Alzheimer's disease (AD), and National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria for vascular dementia (VaD).
The annual IR for total dementia was 1.28%, which increased with age from 0.77% for 65- to 74-year-olds to 6.19% for persons aged 85 years or older. AD (25 cases, 41.7%, IR=0.54%) was the most common cause of dementia, followed by VaD (19 cases, 31.7%, IR=0.41%) and mixed dementia (9 cases, 15.0%). After adjusting for sex, increasing age was significantly associated with total dementia and AD (p < 0.01). Illiteracy was associated with a marginally increased risk for total dementia (aRR=1.59, p < 0.1) as was being female for AD (aRR = 1.92, p < 0.1). The 2-year mortality rate was high among the demented (48% in total dementia, 38% in AD, and 60% in VaD).
The age-specific incidence of dementia in Taiwan is approaching that of developed countries and the low prevalence of dementia (especially VaD) may be mainly due to the high mortality. Age was the major risk factor for total dementia and AD. Being female was probably a risk factor for AD, as was illiteracy for total dementia.
确定台湾南部痴呆症的发病率（IR）及亚型。
在2915名65岁及以上的社区居民队列中，分别有2507名和2175名受试者参与了第一年和第二年的随访调查。一项两阶段研究在第一阶段使用简易精神状态检查表，在第二阶段使用阿尔茨海默病注册协会（CERAD）神经心理成套测验和神经行为检查。我们应用国际疾病分类（ICD）-10NA痴呆症标准、美国国立神经疾病与中风研究所-阿尔茨海默病及相关疾病协会（NINCDS-ADRDA）阿尔茨海默病（AD）指南以及美国国立神经疾病与中风研究所-国际神经科学研究与教学协会（NINDS-AIREN）血管性痴呆（VaD）标准。
总痴呆症的年发病率为1.28%，随年龄增长而增加，从65至74岁人群的0.77%增至85岁及以上人群的6.19%。AD（25例，41.7%，发病率=0.54%）是痴呆症最常见的病因，其次是VaD（19例，31.7%，发病率=0.41%）和混合性痴呆（9例，15.0%）。在调整性别因素后，年龄增长与总痴呆症和AD显著相关（p<0.01）。文盲与总痴呆症风险略有增加相关（风险比=1.59，p<0.1），女性患AD也是如此（风险比=1.92，p<0.1）。痴呆患者的两年死亡率较高（总痴呆症患者中为48%，AD患者中为38%，VaD患者中为60%）。
台湾痴呆症的年龄别发病率接近发达国家，痴呆症（尤其是VaD）的低患病率可能主要归因于高死亡率。年龄是总痴呆症和AD的主要危险因素。女性可能是AD的危险因素，文盲是总痴呆症的危险因素。
