The incidence of dementia in England and Wales: Findings from the five identical sites of the MRC CFA study
The incidence of dementia in England and Wales: Findings from the five identical sites of the MRC CFA study
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DOI：
10.1371/journal.pmed.0020193
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发表时间：
2005-08-01
期刊：
影响因子：
15.8
通讯作者：
Brayne, C
中科院分区：
文献类型：
--
作者：
Matthews, F;Brayne, C
背景：虽然痴呆症的发病率在不同的国家之间存在差异，但由于大多数发病率研究都是单一地点的，或者没有足够的数字来比较地点，所以国家内的差异还没有被探索。很少有国家进行多点发病率研究，以便于各国进行比较。这项研究旨在提供英格兰和威尔士不同地点痴呆症发病率差异的可靠衡量标准，并根据年龄和性别得出总体估计。方法和结果医学研究理事会认知功能和老龄化研究在英国五个不同地点使用相同的方法，每个地点都有不同的风险模式和死亡率。在前两波采访之间，使用基于可能性的方法估计了发病率。发病率随年龄增长而上升，特别是75岁以上，从65-69岁的每千人年7.4%(95%可信区间，3.616.1)上升到85岁及以上的每千人年84.9%(95%可信区间，63.0%-107.8)。男女两性的增长速度都很明显，并持续到最年长的年龄组。因此，据估计，英格兰和威尔士每年约有18万新的痴呆症病例。没有令人信服的证据表明不同地点的痴呆症发病率存在差异，发病率也不能反映这些地点可能存在的危险因素患病率的差异。结论在英格兰和威尔士，没有证据表明痴呆发病率在不同地点之间存在差异。痴呆症的发病率在年龄最大的时候不会下降。
Background Although incidence of dementia is known to vary between nations, variation within country has not been explored because most incidence studies are single site or have insufficient numbers to compare sites. Few countries have conducted multisite incidence studies in order to facilitate national comparisons. This study aims to provide robust measures of the variation of the incidence of dementia across sites within England and Wales and produce overall estimates by age and sex.Methods and Findings The Medical Research Council Cognitive Function and Ageing Study used identical methodology in five diverse sites across the United Kingdom, each with different risk patterns and mortality rates. Incidence has been estimated using likelihood-based methods between the first two waves of interviews. Incidence rates rise with age, particularly above the age of 75 y, from 7.4 (95% confidence interval, 3.6-16.1) per 1,000 person years at age 65-69 y to 84.9 (95% confidence interval, 63.0-107.8) per 1,000 person years at age 85 y and above. The rate of increase for both sexes is marked, and continues into the oldest age groups. Hence, it is estimated that approximately 180,000 new cases of dementia occur in England and Wales each year. There is no convincing evidence of variation across sites, and incidence rates do not reflect the variations in the prevalence of possible risk factors in these sites.Conclusion There is no evidence, within England and Wales, of variation in dementia incidence across sites. Dementia incidence rates do not tail off at the oldest ages.