摘要
目的 调查广州城区 75岁以上老年人的痴呆患病情况。 方法 采用 2阶段整群抽样方法。初级抽样单元为街道 ,次级抽样单元为居民小组。第 1阶段采用系统抽样 ,第 2阶段采用简单随机抽样方法。分人群筛选和病例诊断 2个阶段进行调查。筛选阶段采用简易精神状态检查量表(MMSE)及日常活动功能量表 (ADL)等。诊断阶段根据病史、精神科医师访问、神经心理测试、神经系统及一般体检结果作出评定 ,诊断采用DSM Ⅲ R和NINCDS ADRDA的标准。 结果 筛选阶段中MMSE作为筛选工具 ,其敏感度为 74 5 1%、特异度为 74 96 %。 75岁以上老年人痴呆患病率为8 90 % ,男、女患病率分别为 2 91%和 13 11%。Alzheimer病 (AD)患病率为 7 49% ,其中男性和女性分别为 2 0 1%和 11 36 % ,血管性痴呆 (VD)患病率为 1 16 %。 75岁以上老年人中AD占所有痴呆患者的84 2 4% ,VD仅为 13 0 0 %。 75～ 79岁、80～ 84岁到 85岁及以上组 ,随年龄的增加AD的比例明显增加。 结论 广州城区 75岁以上老年人的痴呆患病率低于上海的调查结果 ,但较国内其他研究的结果高。 75岁以上老年人中 ,女性、低教育程度者AD患病率较高 ,AD在痴呆患者中所占的比例明显高于国内外的报道。MMSE作为筛选工具尚有不足之处 ,应结合其他量表如ADL、POD等一?
Objective To obtain an accurate prevalence of dementia and Alzheimer's disease (AD) in large sample of ≥75 year old elderly living in Guangzhou city. Methods From August 1994 to December 1995, the study was conducted in Liwan District of Guangzhou, China. A two stage cluster sampling design was used to obtain a large sample. ‘Jiedao’ (resident unit in China) was the primary sampling units (PSU),‘Jumin Xiaozu’ (resident group) was the secondary sampling units (SSU). Systematic sampling and simple random sampling procedures were used for the first and second stages, respectively. The study was divided into two phases: a door to door survey of the entire sample aged ≥75 years (4 735 persons), followed by a clinical examination of suspected cases for positive and differential diagnosis. In the first phase, mini mental status examination (MMSE) was used as screening method for dementia. In the second phase, dementia and AD were clinically diagnosed according to the criteria of Diagnostic and Statistical Manual for Mental Disorders (DSM III R) , National Institute of Neurological and Communicative Disorders (NINCDS) and Stroke Alzheimer's Disease and Related Disorders Association (ADRDA). Results The sensitivity and specificity of MMSE were 0 7451 and 0 7496 respectively while the positive predictive value was 0 2251. The prevalence of dementia in individuals aged 75 years and over was 8 90%, in which male and female were found to be 2 91% and 13 11%, and that of AD was 7 49%, male and female found to be 2 01% and 11 36% respectively. The prevalence of vascular dementia (VD) was 1 16%. Of the subjects with dementia, 84 24% was diagnosed Alzheimer's disease, 13% VD, and 2 76% dementia with other causes. The proportion of AD increased obviously by every 5 years. Conclusions The prevalence of dementia in ≥ 75 year persons was lower in Guangzhou than that in Shanghai, but was higher than that in other regional studies within China. In ≥75 year male and/
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2000年第6期450-455,共6页
Chinese Journal of Geriatrics
基金
广东省科学技术委员会科学基金!资助项目(930914)
广东省卫生系统"五个一科教兴医"重点科研项目(粤卫科〔1996〕20号文)
