Seno H, Ishino H, Inagaki T, Iijima M, Kaku K, Inata T
Department of Psychiatry, Shimane Medical University, Izumo, Japan.
Gerontology. 1999 Jan-Feb;45(1):44-8. doi: 10.1159/000022054.
In Japan, vascular dementia (VD) has been responsible for the majority of all dementia cases in both epidemiological and neuropathological studies. Recently, however, several epidemiological investigations have shown that the rate of VD has decreased and senile dementia of the Alzheimer type (SDAT) is now the major cause of dementia, though few neuropathological investigations show that the majority of dementia is SDAT.
The purpose of the study was to clarify the rates of dementia types in Japanese nursing home residents and to compare the ratio of SDAT to VD in the first and second halves of the study.
One hundred and twenty-two demented nursing home residents (48 men and 74 women) were evaluated neuropathologically over a period of 17 years in Shimane prefecture, Japan. All subjects died between 1976 and 1992. The average age at death was 81.4 +/- 9.4 years for men, 85.0 +/- 7.2 for women and 83.6 +/- 8.3 for total samples.
In classifying dementia type, SDAT accounted for 34% (41 cases); VD 35% (42); mixed dementia 11% (14); and 'other' dementia 20% (25) of all samples. Comparison of the first 9-year period with the second 8-year period revealed the ratio of SDAT to VD tended to increase (from 0.83 to 1.15). This increasing tendency was found both in men (from 0.53 to 0.7) and in women (from 1.13 to 1.44). These tendencies, however, were not statistically significant.
There was no change statistically in the ratio of SDAT to VD between the first half of the study and the second half. However, there was an increasing tendency of the ratio in our study.
在日本，无论是流行病学研究还是神经病理学研究，血管性痴呆（VD）在所有痴呆病例中都占大多数。然而，最近几项流行病学调查显示，VD的发病率有所下降，阿尔茨海默型老年性痴呆（SDAT）现已成为痴呆的主要病因，尽管很少有神经病理学研究表明大多数痴呆是SDAT。
本研究旨在明确日本养老院居民中痴呆类型的发生率，并比较研究前半期和后半期SDAT与VD的比例。
在日本岛根县，对122名患有痴呆的养老院居民（48名男性和74名女性）进行了为期17年的神经病理学评估。所有受试者于1976年至1992年间死亡。男性死亡时的平均年龄为81.4±9.4岁，女性为85.0±7.2岁，所有样本的平均年龄为83.6±8.3岁。
在痴呆类型分类中，SDAT占所有样本的34%（41例）；VD占35%（42例）；混合性痴呆占11%（14例）；“其他”痴呆占20%（25例）。将前9年与后8年进行比较，发现SDAT与VD的比例有增加趋势（从0.83增至1.15）。男性（从0.53增至0.7）和女性（从1.13增至1.44）均呈现这种增加趋势。然而，这些趋势在统计学上并不显著。
在研究的前半期和后半期，SDAT与VD的比例在统计学上没有变化。然而，在我们的研究中该比例有增加趋势。
