Chandra V, Ganguli M, Pandav R, Johnston J, Belle S, DeKosky S T
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA, USA.
Neurology. 1998 Oct;51(4):1000-8. doi: 10.1212/wnl.51.4.1000.
To determine the prevalence of AD and other dementias in a rural elderly Hindi-speaking population in Ballabgarh in northern India.
The authors performed a community survey of a cohort of 5,126 individuals aged 55 years and older, 73.3% of whom were illiterate. Hindi cognitive and functional screening instruments, developed for and validated in this population, were used to screen the cohort. A total of 536 subjects (10.5%) who met operational criteria for cognitive and functional impairment and a random sample of 270 unimpaired control subjects (5.3%) underwent standardized clinical assessment for dementia using the Diagnostic and Statistical Manual of Mental Disorders-fourth edition diagnostic criteria, the Clinical Dementia Rating Scale (CDR), and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable and possible AD.
We found an overall prevalence rate of 0.84% (95% CI, 0.61 to 1.13) for all dementias with a CDR score of at least 0.5 in the population aged 55 years and older, and an overall prevalence rate of 1.36% (95% CI, 0.96 to 1.88) in the population aged 65 years and older. The overall prevalence rate for AD was 0.62% (95% CI, 0.43 to 0.88) in the population aged 55+ and 1.07% (95% CI, 0.72 to 1.53) in the population aged 65+. Greater age was associated significantly with higher prevalence of both AD and all dementias, but neither gender nor literacy was associated with prevalence.
In this population, the prevalence of AD and other dementias was low, increased with age, and was not associated with gender or literacy. Possible explanations include low overall life expectancy, short survival with the disease, and low age-specific incidence potentially due to differences in the underlying distribution of risk and protective factors compared with populations with higher prevalence.
确定印度北部巴拉加尔说印地语的农村老年人群中阿尔茨海默病（AD）及其他痴呆症的患病率。
作者对5126名55岁及以上的个体进行了一项社区调查，其中73.3%为文盲。使用针对该人群开发并验证的印地语认知和功能筛查工具对该队列进行筛查。共有536名符合认知和功能障碍操作标准的受试者（10.5%）以及270名未受损对照受试者的随机样本（5.3%）使用《精神疾病诊断与统计手册》第四版诊断标准、临床痴呆评定量表（CDR）以及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）的可能和疑似AD标准接受了痴呆症的标准化临床评估。
我们发现，在55岁及以上人群中，所有CDR评分至少为0.5的痴呆症总体患病率为0.84%（95%置信区间，0.61至1.13），在65岁及以上人群中总体患病率为1.36%（95%置信区间，0.96至1.88）。55岁及以上人群中AD的总体患病率为0.62%（95%置信区间，0.43至0.88），65岁及以上人群中为1.07%（95%置信区间，0.72至1.53）。年龄越大，AD和所有痴呆症的患病率越高，但性别和文盲程度均与患病率无关。
在该人群中，AD和其他痴呆症的患病率较低，随年龄增长而增加，且与性别或文盲程度无关。可能的解释包括总体预期寿命较低、患病后的生存期较短以及年龄特异性发病率较低，这可能是由于与患病率较高的人群相比，风险和保护因素的潜在分布存在差异。
