Incidence and causes of nondegenerative nonvascular dementia - A population-based study
Incidence and causes of nondegenerative nonvascular dementia - A population-based study
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DOI：
10.1001/archneur.63.2.218
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发表时间：
2006-02-01
影响因子：
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通讯作者：
Rocca, WA
中科院分区：
文献类型：
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作者：
Knopman, DS;Petersen, RC;Rocca, WA
背景：关于非退行性和非血管性痴呆发病率的信息有限。设计：我们使用罗切斯特流行病学项目的记录链接系统来确定明尼苏达州罗切斯特市从 1990 年 1 月 1 日到 1994 年 12 月 31 日发生的痴呆病例。为了确定痴呆的原因，我们回顾了患者历史记录的所有诊断、影像学研究结果、实验室检查结果和临床过程。结果：我们发现了 560 例痴呆病例，其中 60 例（10.7%）在 70 岁之前发病（年轻发病组）。 43 例（7.7%）是由于非退行性非血管原因所致，占年轻发病组总数的 30.0%，但仅占老年发病组（70-99 岁）总数的 5.0%。最常见的非退行性非血管原因是伴或不伴脑转移的癌症 (n = 13)、慢性酗酒 (n = 7) 和慢性精神疾病 (n = 11)。没有因常压脑积水、硬膜下血肿、甲状腺功能减退、维生素 B-12 缺乏或神经梅毒引起的痴呆病例。有 2 名患者因硬膜下血肿而出现急性精神错乱，而 1 名患者则患有甲状腺功能减退症，其认知功能通过治疗而恢复正常。结论：在起病较早的痴呆患者中，非退行性非血管原因比预期更常见。通过治疗假定的可逆病因，没有一位痴呆患者恢复正常。
Background: Information on the incidence of nondegenerative and nonvascular dementia is limited.Design: We used the records-linkage system of the Rochester Epidemiology Project to ascertain incident cases of dementia in Rochester, Minn, from January 1, 1990, through December 31, 1994. To define causes of dementia, we reviewed all diagnoses, imaging study results, laboratory test results, and clinical courses, as recorded historically in the patient dossier.Results: We found 560 incident cases of dementia, and 60 of them (10.7%) had onset before the age of 70 years (younger-onset group). Forty-three cases (7.7%) were due to nondegenerative nonvascular causes and represented 30.0% of the total in the younger-onset group, but only 5.0% of the total in the older-onset group (aged 70-99 years). The most common nondegenerative nonvascular causes were cancer with or without brain metastases (n = 13), chronic alcoholism (n = 7), and chronic mental illness (n = 11). There were no cases of dementia due to normal-pressure hydrocephalus, subdural hematoma, hypothyroidism, vitamin B-12 deficiency, or neurosyphilis. There were 2 individuals with acute confusion due to subdural hematoma and I with hypothyroidism whose cognition normalized with therapy.Conclusions: Nondegenerative nonvascular causes were more common than expected in patients with a younger onset of dementia. None of the patients with dementia reverted to normal with treatment of the putative reversible cause.