Prevalence of cognitive impairment without dementia in the United States
Prevalence of cognitive impairment without dementia in the United States
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DOI：
10.7326/0003-4819-148-6-200803180-00005
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发表时间：
2008-03-18
影响因子：
39.2
通讯作者：
Wallace, Robert B.
中科院分区：
文献类型：
--
作者：
Plassman, Brenda L.;Langa, Kenneth M.;Wallace, Robert B.
背景资料：无痴呆症的认知障碍与残疾风险增加、医疗保健费用增加和进展为痴呆症相关。在美国没有基于人群的患病率估计。目的：估计美国无痴呆的认知障碍的患病率，并确定纵向认知和死亡率结果。设计：2001年7月至2005年3月的纵向研究。设置：认知障碍的家庭评估。参与者：亚当斯（老龄化、人口统计学和记忆研究）的参与者年龄在71岁或以上，来自全国代表性的HIRS（健康和退休研究）。在1770名选定的个体中，856名完成了初始评估，在241名选定的个体中，180名完成了16至18个月的随访评估。测量：评估，包括神经心理学测试，神经系统检查，临床和病史，用于分配正常认知，无痴呆的认知障碍或痴呆的诊断。全国患病率估计通过使用人口加权sample.Results：在2002年，估计有540万人（22.2%）在美国年龄71岁或以上的认知功能障碍无痴呆症。主要亚型包括前驱阿尔茨海默病（8.2%）和脑血管疾病（5.7%）。在完成随访评估的参与者中，每年有11.7%的无痴呆症的认知障碍患者进展为痴呆症，而那些患有前驱阿尔茨海默病和中风亚型的患者的年进展率为17%至20%。年死亡率为8%的认知功能障碍，没有痴呆症和近15%的认知功能障碍，由于医疗条件。局限性：只有56%的非死者的目标样本完成了初步评估。人口抽样的权重来调整至少一些潜在的偏见，由于nonresponse和attration.Conclusion：认知功能障碍，无痴呆症在美国比痴呆症更普遍，其亚型的患病率和结果各不相同。
Background: Cognitive impairment without dementia is associated with increased risk for disability, increased health care costs, and progression to dementia. There are no population-based prevalence estimates of this condition in the United States.Objective: To estimate the prevalence of cognitive impairment without dementia in the United States and determine longitudinal cognitive and mortality outcomes.Design: Longitudinal study from July 2001 to March 2005.Setting: In-home assessment for cognitive impairment.Participants: Participants in ADAMS (Aging, Demographics, and Memory Study) who were age 71 years or older drawn from the nationally representative HIRS (Health and Retirement Study). Of 1770 selected individuals, 856 completed initial assessment, and of 241 selected individuals, 180 completed 16- to 18-month follow-up assessment.Measurements: Assessments, including neuropsychological testing, neurologic examination, and clinical and medical history, were used to assign a diagnosis of normal cognition, cognitive impairment without dementia, or dementia. National prevalence rates were estimated by using a population-weighted sample.Results: In 2002, an estimated 5.4 million people (22.2%) in the United States age 71 years or older had cognitive impairment without dementia. Prominent subtypes included prodromal Alzheimer disease (8.2%) and cerebrovascular disease (5.7%). Among participants who completed follow-up assessments, 11.7% with cognitive impairment without dementia progressed to dementia annually, whereas those with subtypes of prodromal Alzheimer disease and stroke progressed at annual rates of 17% to 20%. The annual death rate was 8% among those with cognitive impairment without dementia and almost 15% among those with cognitive impairment due to medical conditions.Limitations: Only 56% of the nondeceased target sample completed the initial assessment. Population sampling weights were derived to adjust for at least some of the potential bias due to nonresponse and attrition.Conclusion: Cognitive impairment without dementia is more prevalent in the United States than dementia, and its subtypes vary in prevalence and outcomes.