Epidemiology of Alzheimer's disease. Issues of etiology and validity.
Epidemiology of Alzheimer's disease. Issues of etiology and validity.
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发表时间：
1993
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通讯作者：
L. Fratiglioni
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作者：
L. Fratiglioni
本论文涉及阿尔茨海默病（AD）的流行病学以及此类研究有效性的某些方面。 AD 是老年人中常见的慢性痴呆症。由于缺乏治疗和致残性质，在老年人口比例不断增加的所有社会中，这种疾病的社会影响都很大。已经进行了三项关于 AD 病因学的研究。第一个是针对早发性 AD 和各种假定危险因素的病例对照研究。这些病例来自于意大利进行的一项 AD 临床研究。从 116 个病例的近亲处获得的暴露信息与从 116 家医院和 97 个人口对照的近亲处类似收集的信息进行了比较。另外两项病因学研究涉及迟发性 AD，分别是关于社会人口统计学变量的患病率研究和针对选定的假定危险因素的病例对照研究。这两项研究是在瑞典斯德哥尔摩正在进行的一项基于人口的老龄化和痴呆症研究中进行的。这项社会人口变量研究包括 1810 人中的 116 例 AD 病例。病例对照研究比较了 98 例 AD 病例和 266 例对照的线人获得的信息。这三项调查的主要结果是：（1）AD的患病率随着年龄的增长而增加，甚至在高龄时也是如此。 (2)AD的患病率不因性别和教育程度而异。 (3) 早发性和迟发性 AD 的主要危险因素是痴呆症的家族聚集性（相对风险分别为 2.6 和 3.2）。 (4)早发性AD的第二个危险因素可能是母亲分娩时的高龄，但这一结果有待证实。我们的研究中没有出现其他人报告的其他危险因素。 (5) 饮酒和体力劳动对迟发性 AD 的相对风险较高。体力劳动可以作为职业暴露以及生活条件或生活习惯的指标。尽管这两个结果可能会受到偏见的影响，但这些结果对未来的研究具有启发性。在诊断、病例确定和暴露评估三个不同方面进行了三项验证研究。第一项研究根据 DSM-III-R 诊断标准调查了 AD 诊断的可重复性。将检查医生做出的诊断与另一位临床医生根据受试者的临床记录独立做出的诊断进行比较。（摘要截断为 400 字）
This thesis concerns the epidemiology of Alzheimer's disease (AD) and some aspects of the validity of such studies. AD is a common and chronic dementing disorder among elderly people. Due to the lack of treatment and to the invalidating nature, the social impact of this disease is high in all the societies in which the proportion of elderly is increasing. Three studies on AD etiology have been performed. The first is a case-control study on early-onset AD and a wide range of putative risk factors. The cases were gathered from a clinical study on AD carried out in Italy. The information on the exposure obtained from a next-of-kin of 116 cases was compared with the information similarly collected from the next-of-kin of 116 hospital and 97 population controls. The other two etiological studies deal with late-onset AD and are a prevalence study on sociodemographic variables and a case-control study on selected putative risk factors. These two studies were performed within a population-based study on ageing and dementia that is ongoing in Stockholm, Sweden. The study on sociodemographic variables included 116 AD cases among 1810 people. The case-control study compared the information obtained by the informants of 98 AD cases and 266 controls. The main results of these three investigations are: (1) The prevalence of AD increases with age, even in advanced ages. (2) The prevalence of AD does not vary by gender and education. (3) The main risk factor for both early- and late-onset AD is the familial aggregation of dementia (relative risk of 2.6 and 3.2, respectively). (4) A second risk factor for early-onset AD may be the advanced age of the mother at index delivery, but this result needs confirmation. No other risk factors reported by others emerged in our study. (5) High relative risks were found for alcohol consumption and manual work in late-onset AD. Manual work could be an indicator of occupational exposures as well as life conditions or life habits. Although both these results may be affected by bias, the results are provocative for future research. Three validation studies were carried out on three different aspects: diagnosis, case ascertainment, and exposure assessment. The first study investigated the reproducibility of AD diagnosis according to the DSM-III-R diagnostic criteria. The diagnoses made by the examining physicians were compared with the diagnosis made independently by another clinician on the subjects' clinical records.(ABSTRACT TRUNCATED AT 400 WORDS)