Diagnostic Correlates of Alzheimer Dementia in a U.S. Nationwide Inpatient Sample
Diagnostic Correlates of Alzheimer Dementia in a U.S. Nationwide Inpatient Sample
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DOI：
10.1097/jgp.0b013e3181ca3a13
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发表时间：
2010-09-01
影响因子：
7.2
通讯作者：
Choi, Jae H.
中科院分区：
文献类型：
--
作者：
Preuss, Ulrich W.;Watzke, Stefan;Choi, Jae H.
前言：阿尔茨海默病（Alzheimer dementia，ALZ-D）是老年人最常见的疾病之一。一些躯体和精神疾病已被认为是与此诊断。本文旨在分析一个具有代表性的大型美国公司。S.全国住院患者样本（NIS）的目的是确定60岁及以上受试者中ALZ-D的诊断相关性。方法：在800，457例住院患者的总样本中（与2004年所有住院患者的2%相似），315，244例患者年龄≥ 60岁。其中，9，572例（3.03%）被诊断为ALZ-D，而33，367例（10.59%）被诊断为骨关节炎（OA），并作为对照组。进行了潜在的躯体和精神诊断相关性的比较。结果如下：通过单因素比较和多因素logistic回归分析确定，在控制年龄和性别后，（与OA相比）血管系统疾病的诊断率总体较高（中风：比值比1.69; 95%置信区间：1.25-2.30）和精神病性和情感性精神障碍（双相：2.78 [1.26-6.12];双情感：3.06 [2.10-4.47]）。年龄增长和男性与ALZ-D的诊断呈正相关。讨论：NIS的这些分析证实了许多与ALZ-D相关的躯体诊断。然而，精神病和情感障碍被确定为与ALZ-D同样显著的相关性，即使存在所有其他障碍。需要前瞻性和纵向数据来研究ALZ-D与躯体和精神疾病之间的潜在因果关系和时间关系。(Am J Geriatr Psychiatry 2010; 18：821-829）
Introduction: Alzheimer dementia (ALZ-D) is among the most frequent diseases in the elderly. Several somatic and psychiatric disorders have been suggested to be related to this diagnosis. The aim of this analysis of a large and representative U. S. nationwide inpatient sample (NIS) was to identify diagnostic correlates of ALZ-D in subjects aged 60 years and older. Methods: Of the total sample of 800,457 inpatient subjects (similar to 2% of all inpatients in 2004), 315,244 individuals were 60 years or older. Of these, 9,572 (3.03%) received a diagnosis of ALZ-D, whereas 33,367 (10.59%) were diagnosed with osteoarthritis (OA) and served as a comparison group. Comparisons of potential somatic and psychiatric diagnostic correlates were conducted. Results: As determined by both univariate comparison and multivariate logistic regression analysis, after controlling for age and gender, subjects with ALZ-D (versus OA) had an overall higher rate of diagnoses of diseases of the vascular system (stroke: odds ratio 1.69; 95% confidence interval: 1.25-2.30) and psychotic and affective disorders (bipolar: 2.78 [1.26-6.12]; schizoaffective: 3.06 [2.10-4.47]). Increasing age and male gender were positively associated with the diagnosis of ALZ-D. Discussion: Many somatic diagnoses related to ALZ-D were confirmed by these analyses of the NIS. However, psychotic and affective disorders were identified to be equally significant correlates of ALZ-D, even in the presence of all other disorders. Prospective and longitudinal data are needed to investigate potential causal and temporal relationships between ALZ-D with somatic and psychiatric disorders. (Am J Geriatr Psychiatry 2010; 18:821-829)