DEVELOPMENT OF DEMENTING ILLNESSES IN AN 80-YEAR-OLD VOLUNTEER COHORT
DEVELOPMENT OF DEMENTING ILLNESSES IN AN 80-YEAR-OLD VOLUNTEER COHORT
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DOI：
10.1002/ana.410250402
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发表时间：
1989-04-01
影响因子：
11.2
通讯作者：
OOI, WL
中科院分区：
文献类型：
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作者：
KATZMAN, R;ARONSON, M;OOI, WL
我们对434名志愿者进行了为期5年的前瞻性随访，这些志愿者在入院时可以走动，功能正常，可能无痴呆，年龄在75至85岁之间。五十六人（发病率为3.53/100人-年）发展为进行性痴呆：32人符合阿尔茨海默病（AD）的诊断标准（发病率为2.0/100人-年），15人患有血管性或混合性痴呆，9人患有其他疾病或未确诊。痴呆症的新发病例与心肌梗死一样常见，是中风的两倍。痴呆和AD的危险因素均为年龄（80岁以上）和性别（女性）;其他报告的危险因素，如家族史、既往脑损伤、甲状腺疾病、母亲年龄和吸烟，在该老年队列中不是AD的危险因素。既往卒中是血管性或混合性痴呆的主要危险因素;糖尿病和左心室肥大也是血管性痴呆的危险因素，但无高血压病史。AD发展的主要预测因素是入组时的核心心理状态。在33项精神状态测试中出现0到2个错误的队列中，58.5%的人每年患AD的几率不到0.6%，而在该测试中出现5到8个错误的队列中，16%的人每年患AD的几率超过12%。因此，有可能确定一个80岁老年人的大队列，他们的AD风险较低，而一个较小的队列风险很高。
We have prospectively followed over a 5-year period 434 volunteers who were at intake ambulatory, functional, presumably nondemented, and between 75 and 85 years of age. Fifty-six (an incidence of 3.53 per 100 person-years at risk) developed a progressive dementia: 32 met diagnostic criteria for Alzheimer''s disease (AD) (an incidence of 2.0 per 100 person-years at risk), 15 had vascular or mixed dementia, and 9 had other disorders or remain undiagnosed. New cases of dementia were as common as myocardial infarction and twice as common as stroke. Risk factors for both dementia and AD were age (over 80) and gender (female); other reported risk factors such as family history, prior head injury, thyroid disease, maternal age, and smoking were not risk factors for AD in this elderly cohort. Prior stroke was the major risk factor for vascular or mixed dementia; diabetes and left ventricular hypertrophy but not a history of hypertension per se were also risk factors for vascular dementia. The major predictor of the development of AD was the mental status core on entry. The 58.5% of the cohort who made zero to two errors on a 33-item mental status test had a less than 0.6% per year chance of developing AD, whereas the 16% of the cohort with five to eight errors on this test developed AD at a rate of over 12% per year. Thus, it is possible to identify a large cohort of 80-year-olds who are at low risk for AD and a smaller cohort at very high risk.