Very old women at highest risk of dementia and Alzheimer's disease: Incidence data from the Kungsholmen project, Stockholm
Very old women at highest risk of dementia and Alzheimer's disease: Incidence data from the Kungsholmen project, Stockholm
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DOI：
10.1212/wnl.48.1.132
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发表时间：
1997-01-01
期刊：
影响因子：
9.9
通讯作者：
Winblad, B
中科院分区：
文献类型：
--
作者：
Fratiglioni, L;Viitanen, M;Winblad, B
目的：了解老年人不同类型痴呆的发病率，并探讨其与年龄、性别的关系。设计：在瑞典斯德哥尔摩对无痴呆症队列进行了平均三年的随访。随访结束时，受试者接受护士的访谈、医生的临床检查以及心理学家的认知评估。使用死亡证明、医院临床记录和出院诊断对已故队列成员进行研究。痴呆症诊断由两名医生根据 DSM-III-R 标准独立做出。参与者：队列由 1,473 名受试者（75 岁以上）组成，其中 987 名在随访时接受临床检查，314 名在检查前死亡，172 名拒绝参加。结果：在随访期间，148 名受试者出现痴呆。在75至79岁年龄组中，痴呆症发病率为每1000人年女性19.6例和男性12.4例，而90岁以上受试者的相应数字为每1000人年86.7例和15.0例。阿尔茨海默氏病也存在类似的按年龄和性别分布的模式。在各年龄层中，女性痴呆症和阿尔茨海默病的发病率均高于男性。女性患痴呆症的年龄调整优势比为 1.9，患阿尔茨海默病的优势比为 3.1。结论：（1）痴呆症的发病率随着年龄的增长而增加，即使在年龄最大的年龄组中也是如此； (2) 女性比男性患痴呆症的风险更高，尤其是在高龄时； (3)这种模式主要是由于阿尔茨海默病的年龄和性别分布，而不是血管性痴呆。
Objective: To determine the incidence of different types of dementia in the very old, and to explore the relation with age and gender. Design: A dementia-free cohort was followed for an average of three years in Stockholm, Sweden. At the end of the follow-up, the subjects were interviewed by nurses, clinically examined by physicians, and cognitively assessed by psychologists. Deceased cohort members were studied using death certificates, hospital clinical records, and discharge diagnoses. Dementia diagnoses were made according to the DSM-III-R criteria independently by two physicians. Participants: The cohort consisted of 1,473 subjects (75+ years old), of which 987 were clinically examined at follow-up, 314 died before the examination, and 172 refused to participate. Results: During the follow-up, 148 subjects developed dementia. In the age-group 75 to 79, the incidence rates for dementia were 19.6 for women and 12.4 for men per 1,000 person-years, whereas for 90+ year-old subjects the corresponding figures were 86.7 and 15.0 per 1,000 person-years. A similar pattern of distribution by age and gender was seen for Alzheimer's disease. In each age stratum, the incidence rates of dementia and Alzheimer's disease were higher for women than for men. The age-adjusted odds ratio for women was 1.9 for dementia and 3.1 for Alzheimer's disease. Conclusions: (1) The incidence of dementia increases with age, even in the oldest age groups; (2) women have a higher risk of developing dementia than men, especially at very old ages; (3) this pattern is mainly due to the age and gender distribution of Alzheimer's disease, rather than vascular dementia.