EPIDEMIOLOGY OF DEMENTIA

来自日本的文献表明， 在那个国家，痴呆症的发病率远远超过阿尔茨海默氏症。 在 美国，观察到相反的趋势。然而，直接比较 缺乏标准化的诊断方法， 的搜索. 日裔美国人痴呆的人群研究 年龄超过65岁，居住在华盛顿州国王县。 该项目 五个主要目标：（1）确定按年龄和性别分列的流行率 在这个人群中痴呆亚型的发病率，（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 痴呆亚型的进展和存活率，并获得尸检 研究期间死亡病例的诊断，（4）制定一个 认知完整的固定队列，（5）比较我们对 日裔美国老年人进行的平行研究， 檀香山，夏威夷和日本。 将对基础人口进行普查， 识别65岁以上日裔美国人。 筛选 将对所有已识别的人员执行CAST工具。 一 验证研究将确定CAST截止评分，该评分 将决定一个人是否继续诊断过程 或成为认知完整群体的一员。 人员筛查 积极的将被称为算法评估，这将 确定认知障碍是否是获得性和进行性的，以及 如果是，是否与脑血管疾病有关。 人 确定患有这种痴呆症的患者将进一步被转诊到临床 常规诊断评价。 前两个阶段的设计 与夏威夷檀香山使用的方法并行，其中檀香山 正在评估心脏观察队列的患病率和发生率， 痴呆 日本的方法也将与 檀香山。痴呆症患病率的跨国比较 与脑血管疾病和原发性退行性痴呆相关 将使用来自算法评估的诊断分类。 拟定研究中的临床评价将基于CERAD 电池（Consortium to Establish a.阿尔茨海默病登记处）。 一 将进行病例对照研究，以检查风险因素， 常见和偶发病例。 将对流行病例进行随访研究 痴呆亚型之间的疾病进展和存活率，并获得 神经病理学诊断的情况下，谁死在过程中， study. 在研究期间，一个固定的认知完整的队列， 将每两年组建和监测一次人员。 更新申请 将提交给队列继续随访，以研究 与痴呆亚型相关的发病率和危险因素 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.