EPIDEMIOLOGY OF DEMENTIA IN OLDER JAPANESE AMERICANS

来自日本的文献表明，血管疾病的患病率 在那个国家，痴呆症远远超过阿尔茨海默病。在 在美国，则出现了相反的趋势。然而，直接比较 由于缺乏标准化的诊断，患病率令人困惑 标准。日裔美国人痴呆症的人群研究 建议65岁以上的老年人居住在华盛顿州的金县。该项目已 五个主要目标：(1)确定特定年龄和性别的流行率 这一人群中痴呆亚型的比率，(2)收集信息 痴呆症的潜在危险因素，特别是阿尔茨海默氏症 疾病，(3)纵向跟踪流行病例以描述疾病 痴呆症亚型的进展和生存，并进行尸检 对在研究过程中死亡的病例进行诊断，(4)制定 认知完好的固定队列，以及(5)比较我们对 日裔美国老年人对正在进行的平行研究 檀香山、夏威夷和日本。将对基本人口进行普查，以 识别65岁以上的日裔美国人。放映 文书(CAST)将适用于所有已确定身份的人员。一个 验证研究将确定演员的截止分数，而这一分数 将确定一个人是否继续诊断过程 或者成为认知完好无损群体的一员。人员筛选 积极的将提交给算法评估，这将 确定认知障碍是否是后天的和进行性的，以及 如果有，无论是否合并脑血管疾病。人 被确定患有这种痴呆症的人将进一步转诊到临床 对常规诊断的评价。前两个阶段是设计的 与夏威夷火奴鲁鲁使用的方法平行，火奴鲁鲁在那里 正在评估心脏观察队列的患病率和发病率 痴呆症。日本的方法也将与日本的方法标准化 火奴鲁鲁。痴呆症患病率的国际比较 与脑血管疾病和原发性退行性痴呆相关 将使用算法评估中的诊断分类。 拟议研究中的临床评估将基于CERAD BATCH(建立阿尔茨海默氏症登记协会)一个 将进行病例对照研究，以检查危险因素 流行和突发事件。将跟踪流行病例进行研究 痴呆症亚型之间的疾病进展和生存，并获得 死亡病例的神经病理诊断 学习。在研究期间，认知完好的固定队列 人员将每两年组成一次，并进行监测。续签申请 将提交继续跟踪队列，以进行研究 本地区与痴呆亚型相关的发病率和危险因素 少数民族人口。

Literature from Japan suggests that the prevalence rate of vascular dementia far exceeds that of Alzheimer's disease in that country. In the U.S., the opposite trend is observed. However, direct comparison of prevalence rates is confounded by the lack of standardized diagnostic criteria. A population-based study of dementia in Japanese-Americans over age 65 residing in King County, WA is proposed. The project has five main aims: (1) to establish age- and gender-specific prevalence rates for dementia subtypes in this population, (2) to gather information on potential risk factors for dementia, specifically for Alzheimer's disease, (3) to follow prevalent cases longitudinally to describe disease progression and survival in dementia subtypes, and to obtain autopsy diagnosis on cases dying during the course of the study, (4) to develop a cognitively intact fixed cohort, and (5) to compare our assessments of Japanese-American elderly to parallel studies being conducted in Honolulu, Hawaii and Japan. The base population will be censused to identify persons of Japanese-American origin over age 65. A screening instrument (CAST) will be administered to all identified persons. A validation study will determine the CAST cut-off score, and this score will determine whether or not a person continues the diagnostic process or becomes a member of the cognitively intact cohort. Persons screening positive will be referred to an algorithmic evaluation, which will determine whether cognitive impairment was acquired and progressive, and if so, whether associated with cerebrovascular disease or not. Persons determined to have such a dementia will be further referred to a clinical evaluation for conventional diagnosis. The first two phases are designed in parallel with methods used in Honolulu, Hawaii, where the Honolulu Heart Watch cohort is being evaluated for prevalence and incidence of dementia. Methods in Japan will also be standardized with those in Honolulu. Cross-national comparison of prevalence rates of dementia associated with cerebrovascular disease and primary degenerative dementia will use diagnostic classifications from the algorithmic evaluation. Clinical evaluations in the proposed study will be based on the CERAD battery (Consortium to Establish a. Registry for Alzheimer's Disease). A case-control study will be conducted to examine risk factors using both prevalent and incident cases. Prevalent cases will be followed to study disease progression and survival among dementia subtypes, and to obtain neuropathologic diagnoses for cases who die during the course of the study. During the study period, a fixed cohort of cognitively intact persons will bc formed and monitored bi-annually. A renewal application will be submitted for continued followup of the cohort, to study incidence and risk factors associated with dementia subtypes in this ethnic population.