EPIDEMIOLOGY OF A D IN WOMEN--RISK AND IMPACT

这是一个应用程序（1 R29 AG11862，“流行病学的 妇女阿尔茨海默病：风险和影响”），该项目没有得到资助。 阿尔茨海默氏病是一个巨大的和日益增长的公共卫生问题， 美国和其他发达国家。因为疾病的发生 与年龄有很大关系，因为女性 受影响的妇女比男子多得多。性别 这种疾病的风险及其后果的差异 在流行病学研究中得到的正式关注相对较少， 然而.这项拟议中的研究将比较发生率和疾病 对妇女和男子的影响，并预测 美国人口中受影响的女性和男性人数。现有数据 调查人员可以完全访问的数据集将用于这些 分析。 假设年龄别的发病率和患病率 数据将测试女性患阿尔茨海默病的比例高于男性 从一个特定的社区人口。可能存在的性别差异 将检查疾病的几个重要后果：假设 身体功能下降的速度在女性中更大， 老年痴呆症的死亡率高于男性，但女性的死亡率较低， 将在三个不同的环境（社区， 机构长期护理、非机构长期护理）。的 假设攻击性行为的发生率在女性中较低， 老年痴呆症比男性将在这两个检查 环境（社区、机构长期护理）。使用医疗 阿尔茨海默病患者的服务将在数据中进行检查， 一个明确的社区，假设患有阿尔茨海默氏症的女性 比男性更有可能使用急症护理医院服务 控制疾病水平和其他风险因素， 有可能进入机构长期护理。最后，增长 老年痴呆症在美国妇女中的人口在未来将 使用一系列人口项目进行检查。妇女占 占所有65岁以上人口和最年长老人的最大比例，而 这些群体的规模正在迅速扩大。准确描述 风险和疾病后果的差异是重要的第一步， 确定资源需求和潜在的干预途径。

This is a revision of an application (1 R29 AG11862, "Epidemiology of Alzheimer's Disease in Women: Risk and Impact") which was not funded. Alzheimer's disease poses a large and growing public health problem for the U.S. and other developed countries. Because occurrence of the disease is very strongly related to age and because women live substantially longer than men, many more women are affected than are men. Gender differences both in risk of this disease and its consequences have received relatively little formal attention in epidemiologic studies, however. The proposed research will compare occurrence rates and disease consequences in women and men and provide projections of the growth in the numbers of affected women and men in the U.S. population. Existing data sets to which the investigators have full access will be used for these analyses. The hypothesis that the age-specific incidence and prevalence of Alzheimer's disease are higher among women than men will be tested in data from a defined community population. Possible gender differences in several important consequences of the disease will be examined: Hypotheses that the rate of decline in physical function is larger among women with Alzheimer's disease than men but that mortality is lower among women with the disease will each be tested in three different settings (community, institutional long-term care, non-institutional long-term care). The hypothesis that rates of aggressive behaviors are lower among women with Alzheimer's disease than among men will be examined in two of these settings (community, institutional long-term care). Use of medical services by persons with Alzheimer's disease will be examined in data from a defined community with the hypotheses that women with Alzheimer's disease are more likely to use acute care hospital services than men controlling for level of disease and other risk factors and also more likely to enter institutional long-term care. Finally, the growth of Alzheimer's disease among women in the U.S. population in the future will be examined, using a range of demographic projects. Women comprise the largest segment of all persons over age 65 and of the oldest old, and the size of these groups is growing rapidly. Accurate description of differences in risk and disease consequences is an essential first step in identifying both resource needs and potential avenues for intervention.