Incidence and survival of dementia in a general population of Japanese elderly: the Hisayama study
Incidence and survival of dementia in a general population of Japanese elderly: the Hisayama study
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DOI：
10.1136/jnnp.2008.155481
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发表时间：
2009-04-01
影响因子：
11
通讯作者：
Kiyohara, Y.
中科院分区：
文献类型：
--
作者：
Matsui, Y.;Tanizaki, Y.;Kiyohara, Y.
目的：估计发病率和生存率的总和原因特定的痴呆症在一般Japanese population.Methods：共828例无痴呆症，年龄在65岁或以上，前瞻性随访17年。痴呆被细分为病因特异性亚型：即阿尔茨海默病（AD）、血管性痴呆（VD）、路易体痴呆（DLB）、组合型痴呆和其他类型的痴呆。在随访期间，275名受试者患上了痴呆症，其中251名其中164例进行了脑尸检，87例进行了神经影像学检查。总痴呆、AD、VD、DLB、混合型痴呆和其他类型痴呆的发生率分别为32.3（n=275）、14.6（n = 124）、9.5（n = 81）、1.4（n = 12）、3.8（33）和3.1（16）每1000人年。AD、混合型痴呆和其他类型痴呆的发病率随年龄的增长而增加，尤其是85岁以后，但VD和DLB没有观察到这种趋势。65-89岁痴呆患者的生存曲线明显低于年龄和性别匹配的对照组（10年生存率为13.6%vs29.3%，hazardratio为1.67，95%可信区间为1.31 ~ 2.13）。10年的生存率没有显着不同的痴呆subtypes.Conclusions：我们的研究结果表明，日本老年人口有很高的风险，痴呆症的发展，特别是AD和VD，一旦痴呆症是成立的，死亡的风险是相当大的。
Objective: To estimate the incidence and survival rates of total and cause specific dementia in a general Japanese population.Methods: A total of 828 subjects without dementia, aged 65 years or over, were followed-up prospectively for 17 years. Dementia was subdivided into cause specific subtypes: namely, Alzheimer's disease (AD), vascular dementia (VD), dementia with Lewy bodies (DLB), combined dementia and other types of dementia. During the follow-up, 275 subjects developed dementia; of these, 251 (91.2%) were evaluated morphologically, with 164 subjected to brain autopsy examination and the remaining 87 to neuroimaging.Results: The incidences of total dementia, AD, VD, DLB, combined dementia and other types of dementia were 32.3 (n=275), 14.6 (124), 9.5 (81), 1.4 (12), 3.8 (33), and 3.1 (16) per 1000 person years, respectively. The incidences of AD, combined dementia and other types of dementia rose with increasing age, particularly after the age of 85 years, but this tendency was not observed for VD or DLB. The survival curve of dementia cases aged 65-89 years was significantly lower than that of age and sex matched controls (10 year survival rate, 13.6% vs 29.3%; hazard ratio 1.67; 95% confidence interval 1.31 to 2.13). The 10 year survival rates were not significantly different among dementia subtypes.Conclusions: Our findings suggest that the Japanese elderly population has a high risk for the development of dementia, specifically AD and VD, and once dementia is established, the risk of death is considerable.