Trends in dementia incidence: Evolution over a 10-year period in France
Trends in dementia incidence: Evolution over a 10-year period in France
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DOI：
10.1016/j.jalz.2015.11.001
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发表时间：
2016-03-01
影响因子：
14
通讯作者：
Helmer, Catherine
中科院分区：
文献类型：
--
作者：
Grasset, Leslie;Brayne, Carol;Helmer, Catherine
引言：最近很少有研究表明痴呆症发生率呈下降趋势。法国队列长期随访，使我们能够探讨发病率的演变trends.Methods：两个不同的人群年龄>= 65岁的受试者，包括在1988-1989年（n = 1469）和1999-2000年（n = 2104）进行了随访超过10年，与认知和痴呆的系统评估。多状态疾病-死亡模型被用来比较痴呆症的发病率使用临床和算法diagnosis.Results：使用算法诊断，发病率显着下降，整体和女性（年龄调整后的风险比[HR] = 0.62;置信区间（CI）= 0.48-0.80的两个人群之间的妇女）。教育、血管因素和抑郁的差异仅在一定程度上解释了这种降低（女性完全调整HR = 0.73; CI = 0.57-0.95）。没有显着的下降趋势，发现男性或使用临床诊断为任何sex.Discussion：我们的研究提供了进一步的支持，减少痴呆症的发病率在妇女使用算法诊断。诊断边界的变化掩盖了这种减少。(C)2016年阿尔茨海默氏症协会。爱思唯尔公司出版All rights reserved.
Introduction: Few recent studies have suggested declining trends in dementia frequency. French cohorts with long follow-up allowed us to explore incidence evolution trends.Methods: Two different populations of subjects aged >= 65 years included in 1988-1989 (n = 1469) and 1999-2000 (n = 2104) were followed up over 10 years, with systematic assessment for cognition and dementia. Multistates illness-death models were used to compare dementia incidence using both clinical and algorithmic diagnoses.Results: Using the algorithmic diagnosis, incidence declined significantly overall and for women (age-adjusted hazard ratio [HR] = 0.62; confidence interval (CI) = 0.48-0.80 for women between the two populations). Differences in education, vascular factors, and depression accounted only to some extent for this reduction (women full-adjusted HR = 0.73; CI = 0.57-0.95). No significant decreasing trends were found for men or when using the clinical diagnosis for either sex.Discussion: Our study provides further support for a decrease in dementia incidence in women using algorithmic diagnosis. Changes in diagnostic boundaries mask this reduction. (C) 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.