广州市城乡老年期痴呆死亡率的随访研究  

A follow-up study of mortality of dementia patients in Guangzhou

作　　者：黄若燕[1] 唐牟尼[1] 林康广[1] 郁俊昌[1] 陈映梅[1] 郭伟坚[1] 肖頔[1] 王怀坤[1] 佘生林 

机构地区：[1]广州市精神病医院精神科,510370

出　　处：《中华精神科杂志》2014年第2期99-102,共4页Chinese Journal of Psychiatry

摘　　要：目的 了解广州市城乡年龄≥55周岁人群中痴呆患者的死亡率.方法 2003年和2008年,采用老年期痴呆初筛调查表、老年期痴呆诊断问卷和死亡患者调查表等调查工具,分别对从广州市城乡5 276名年龄≥55周岁的老年人进行的痴呆患病率（基线）调查中发现的183例痴呆患者进行随访,通过一对一面谈,收集相关资料,包括痴呆死亡人数及总人年数,用两者之比计算出痴呆死亡率.采用DSM-Ⅳ诊断痴呆,采用临床痴呆程度评定量表（CDR）评定痴呆严重程度.结果 （1）基线调查时被评定为痴呆的老年人,7年后随访时的死亡率为18.55/100人年;其中阿尔茨海默病（AD）、血管性痴呆（VD）和其他类型痴呆（OD）患者死亡率分别为17.69/100、19.05/100和32.93/100人年,年龄60～69、70 ～ 79、≥80岁女性的痴呆患者死亡率分别为17.14/100、13.67/100、19.87/100人年.Logistic回归分析显示,年龄[OR=1.05,95％可信区间（CI）：1.03 ～ 1.08]和CDR（OR =2.56,95％CI：1.50 ～4.37）,对患者死亡存在统计学意义.结论 OD患者死亡率最高,VD患者次之,AD最低.增加痴呆患者死亡危险性的因素有年龄和痴呆程度.低龄痴呆患者的死亡率高于中龄痴呆患者.Objective To explore the mortality of dementia patients aged 55 years or over in Guangzhou. Methods From Sept 2001 to Feb 2002,5 276 persons aged 55 years or over living in urban and rural areas of Guangzhou were investigated by Senile Dementia Screening Questionnaire, Senile Dementia Diagnosis and Mortality Survey Questionnaire, in which 183 ones were diagnosed with dementia and followed up in 2003 and 2008. According to the information from interview, the dementia mortality was calculated by the ratio of the numbers of dementia deaths and total person-years. The clinical diagnosis of dementia and Alzheimer＇s disease （AD） were made according to the Diagnostic and Statistic Manual of Mental Disorder, fourth edition（ DSM -IV） criteria. The severity of dementia was assessed with the Clinical Scale for the Staging of Dementia Rate. Results （ 1 ） After 7 years the mortality of dementia was 18.55/100 person-years. The mortality rates of patients with Alzheimer＇s disease （AD） , vascular dementia （VD） and other types of dementia （OD） were 17.69/100, 19.05/100 and 32. 93/100 person-years respectively. The mortality rate of female dementia aged 60 - 69, 70 - 79, and 80 years or over were 17.14/100, 13.67/100 and 19. 87/100 person-years respectively. Logistic regression analysis showed that age （OR = 1.05, 95% confidence interval （CI） ： 1.03 - 1.08） and CDR （OR = 2.56, 95% CI： 1.50 - 4. 37） increased the risk of death. Conclusion The mortality of patients with OD is possibly highest among all the cases and the lowest in patients with AD. Age and the severity of dementia is likely to increase the mortality. The mortality on lower-age patients is higher than that in middle-age patients.

关 键 词：阿尔茨海默病 痴呆 血管性 死亡率 随访研究 

分 类 号：R749.16[医药卫生—神经病学与精神病学]