EPIDEMIOLOGY OF ALZHEIMER DISEASE IN A TOTAL POPULATION

阿尔茨海默病(AD)的流行病学研究 人口[魁北克Saquay-Lac-Saint-Jean地区人口] 具有几个独特而重要的特征，包括计算机化的 人口数据库和世界上最大的铝精炼厂之一，是 建议。本研究的第一阶段有5个目标：(1)验证密钥 通过以下方式确定AD病例的告密者确定方法 SLSJ两个地理区域的患病率调查；(2)估计年龄- 和不同性别的痴呆症和阿尔茨海默病的患病率； 流行病例，以便在临床上和通过 尸检；(4)确定约1900名非痴呆者的固定队列 将在发病率、风险因素和生存方面发挥作用的个人 研究；及(5)进行以人群为基础的AD病例对照研究 关注痴呆症家族史、教育和铝作为危险因素 各种因素。将利用3个阶段的程序来确定病例。第一阶段 将提供痴呆症嫌疑人的初步识别(通过网络 第一年的主要告密者；第二年和第三年的人口筛查)。在… 第二阶段，疑犯将由受过专门训练的老年医生和 全科医生确定他们是否符合DSM-IIIR标准 痴呆症。在州3，被认为患有痴呆症的个人将得到 一项全面的检查，以确定导致痴呆症的疾病。 主要的告密者将包括健康专业人员和非专业人员。这个 流行率调查将使用2,000个分层随机样本 以上的个人从社会化医疗登记中识别 魁北克。这个样本将被筛查，那些不合格的人 筛查将在第二阶段和第三阶段进行痴呆症评估。非痴呆症 约占样本95%的受试者将被重新调查 评估和跟踪痴呆症的发展。案件举报人 对于可能和可能的AD，以及2个来自非 痴呆症人群将参与病例对照研究。其他非- 痴呆症受试者将接受危险因素和家族史的调查 问卷调查研究与糖尿病后期发展有关的危险因素 广告。

An epidemiologic study of Alzheimer's disease (AD) based on a large population [that of the Saquenay-Lac-Saint-Jean (SLSJ) region of Quebec] with several unique and important features, including a computerized population database and one of the world's largest aluminum refineries, is proposed. The first phase of this study has 5 aims: (1) to validate a key informant ascertainment methodology for identifying cases of AD by means of a prevalence survey of 2 geographic regions in SLSJ; (2) to estimate age- and sex-specific prevalence rates of dementia and AD; (3) to follow prevalent cases in order to confirm diagnoses clinically and through autopsy; (4) to identify a fixed cohort of approximately 1,900 non-demented individuals that will be utilized in incidence, risk factor and survival studies; and (5) to perform a population-based case control study of AD focusing on family history od dementia, education and aluminum as risk factors. A 3-stage procedure will be utilized to identify cases. Stage 1 will provide initial identification of dementia suspects (by a network of key informants in year 1; by population screening in years 2 and 3). At stage 2, suspects will be assessed by specially-trained geriatricians and general practitioners to determine whether they meet DSM-IIIR criteria for dementia. At state 3, individuals considered to have dementia will receive a complete workup to determine the disease responsible for the dementia. Key informants will include both health professionals and lay persons. The prevalence survey will utilize a stratified random sample of 2,000 individuals over 64 identified from the socialized health care registry of Quebec. This sample will be screened, and those individuals who fail the screen will be evaluated in stages 2 and 3 for dementia. Non-demented subjects, who will comprise approximately 95% of the sample, will be re- evaluated and followed for development of dementia. Informants for cases of possible and probable AD and for 2 matched controls drawn from the non- demented population will participate in the case-control study. Other non- demented subjects will be administered the risk factor and family history questionnaires to study risk factors in relation to later development of AD.