Background: Information on the incidence of nondegenerative and nonvascular dementia is limited. Design: We used the records-linkage system of the Rochester Epidemiology Project to ascertain incident cases of dementia...Background: Information on the incidence of nondegenerative and nonvascular dementia is limited. Design: We used the records-linkage system of the Rochester Epidemiology Project to ascertain incident cases of dementia in Rochester, Minn, from January 1, 1990, through December 31, 1994. To define causes of dementia, we reviewed all diagnoses, imaging study results, laboratory test results, and clinical courses, as recorded historically in the patient dossier. Results: We found 560 incident cases of dementia, and 60 of them (10.7%) had onset before the age of 70 years (younger-onset group). Forty-three cases (7.7%) were due to nondegenerative nonvascular causes and represented 30.0%of the total in the you nger-onset group, but only 5.0%of the total in the older-onset group (aged 70 -99 years). The most common nondegenerative nonvascular causes were cancer with or without brain metastases (n=13), chronic alcoholism (n=7), and chronic menta l illness (n=11). There were no cases of dementia due to normal-pressure hydroc ephalus, subdural hematoma, hypothyroidism, vitamin B12 deficiency, or neurosyph ilis. There were 2 individuals with acute confusion due to subdural hematoma and 1 with hypothyroidism whose cognition normalized with therapy. Conclusions: Non degenerative nonvascular causes were more common than expected in patients with a younger onset of dementia. None of the patients with dementia reverted to norm al with treatment of the putative reversible cause.展开更多
文摘Background: Information on the incidence of nondegenerative and nonvascular dementia is limited. Design: We used the records-linkage system of the Rochester Epidemiology Project to ascertain incident cases of dementia in Rochester, Minn, from January 1, 1990, through December 31, 1994. To define causes of dementia, we reviewed all diagnoses, imaging study results, laboratory test results, and clinical courses, as recorded historically in the patient dossier. Results: We found 560 incident cases of dementia, and 60 of them (10.7%) had onset before the age of 70 years (younger-onset group). Forty-three cases (7.7%) were due to nondegenerative nonvascular causes and represented 30.0%of the total in the you nger-onset group, but only 5.0%of the total in the older-onset group (aged 70 -99 years). The most common nondegenerative nonvascular causes were cancer with or without brain metastases (n=13), chronic alcoholism (n=7), and chronic menta l illness (n=11). There were no cases of dementia due to normal-pressure hydroc ephalus, subdural hematoma, hypothyroidism, vitamin B12 deficiency, or neurosyph ilis. There were 2 individuals with acute confusion due to subdural hematoma and 1 with hypothyroidism whose cognition normalized with therapy. Conclusions: Non degenerative nonvascular causes were more common than expected in patients with a younger onset of dementia. None of the patients with dementia reverted to norm al with treatment of the putative reversible cause.
