Gao S, Hendrie H C, Hall K S, Hui S
Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.
Arch Gen Psychiatry. 1998 Sep;55(9):809-15. doi: 10.1001/archpsyc.55.9.809.
Prevalence studies on dementia and Alzheimer disease (AD) have reported a positive association with age. However, the trend of the association in the oldest-old categories has been the subject of discussion. The relationship between sex and AD has been inconsistent with these studies. Prevalence rates are influenced by the survival and disease incidence. Incidence rates provide a better measure of disease risk.
English-language articles identified through a MEDLINE search on "incidence dementia" and "incidence Alzheimer's disease" were examined and references from identified articles were reviewed. Population-based studies using personal interviews, standard clinical diagnosis criteria (DSM-III for dementia, National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorder Association for AD) and reporting age-specific incidence rates were included in the meta-analysis. Data from the selected studies were extracted and verified. Mixed-effect models were used in the meta-analysis to accommodate the heterogeneity of the studies.
Incident dementia and AD are associated with a significant quadratic age effect indicating that the increase in incidence rates slows down with the increase in age, although there is no sign of a decline in the incidence rates themselves. The odds ratios for women to develop incidence of dementia and AD relative to men are 1.18 (95% confidence interval, 0.95-1.46) and 1.56 (95% confidence interval, 1.16-2.10), respectively.
The acceleration of incidence rates for AD and dementia slows down with the increase in age, although we find no evidence of a rate decline. Women are at higher risk of developing AD than men.
关于痴呆症和阿尔茨海默病（AD）的患病率研究报告称其与年龄呈正相关。然而，最年长者类别中这种关联的趋势一直是讨论的主题。性别与AD之间的关系在这些研究中并不一致。患病率受生存率和疾病发病率的影响。发病率能更好地衡量疾病风险。
通过对“痴呆症发病率”和“阿尔茨海默病发病率”进行MEDLINE检索确定的英文文章进行了审查，并对已识别文章的参考文献进行了回顾。纳入荟萃分析的是基于人群的研究，这些研究采用个人访谈、标准临床诊断标准（痴呆症采用DSM - III，AD采用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标准）并报告特定年龄的发病率。从所选研究中提取并核实数据。荟萃分析中使用混合效应模型来处理研究的异质性。
新发痴呆症和AD与显著的二次年龄效应相关，这表明发病率的增加随着年龄增长而减缓，尽管发病率本身没有下降的迹象。女性相对于男性发生痴呆症和AD的发病率的优势比分别为1.18（95%置信区间，0.95 - 1.46）和1.56（95%置信区间，1.16 - 2.10）。
AD和痴呆症发病率的加速增长随着年龄增长而减缓，尽管我们没有发现发病率下降的证据。女性患AD的风险高于男性。
