流行病學現況
分享 : 首頁>疾病專區>健康知識館>失智症>流行病學現況

盛行率與發生率

失智症為中老年人普遍常見的疾病之一。其盛行率隨著年齡的增加而增加,每增加五歲盛行率約呈雙倍增加1。自1980年代以來,65歲以上的老年人罹患有失智症的比率在西方國家中約為3.6%~10.3%、中國約有1.8%~4.6%2, 3、日本約為3.7~6.7%4、南韓為9.5%~10.8%5,在台灣則約有1.7%~4.3%。6 7, 8 台灣的一社區研究調查65歲以上老年人失智症的發生率為千分之12.8,較歐洲(13.1)與美國(14.6)低。

危險因子

性別

失智症在女性的盛行率多於男性,除了因女性有較長的預期壽命外,相較於男性而言,女性罹患失智症的平均存活率較男性高。歐洲失智症研究組織(EURODEM)進行的統合分析(meta-analysis)發現女性有較高的風險罹患失智症(危險對比值odds ratio為1.2)。近期由英國的大規模追蹤研究也發現女性有較高的罹病風險(危險對比值為1.6) 9

家族病史

早發失智症較常見於具有家族病史的病患中。脂蛋白元E (apolipoprotein E, APOE) 基因為阿茲海默症的危險因子之一,帶有ε4基因者罹病風險較高,而帶有ε2基因者,罹病風險較低。此外APOE在不同年齡與種族其罹病風險也不同。帶有ε4的基因者在全球分布也不同,最低的地區在南歐、中東與北美。10

其他

中風、巴金森氏症與較差的健康自覺都被發現與失智症有關。9而心血管危險因子也是阿茲海默症的危險因子。11研究也發現酒精的攝取(特別是紅酒)是失智症的危險因子。中年或晚年罹患糖尿病也是阿茲海默症與失智症的危險因子。12 而頭部創傷與失智症的關係尚未得到證實13,歐洲失智症研究組織也未發現頭部外傷與增加失智症的風險有關。14

 

參考文獻

1

Jorm A, Korten A, Henderson A. The prevalence of dementia: a quantitative integration of the literature. Acta psychiatrica scandinavica 1987;76:465-479

2

Zhang M, Katzman R, Salmon D, et al. The prevalence of dementia and Alzheimer’s disease in Shanghai, China: impact of age, gender, and education. Annals of neurology 1990;27:428-437

3

Wang W, Wu S, Cheng X, et al. Prevalence of Alzheimer’s disease and other dementing disorders in an urban community of Beijing, China. Neuroepidemiology 2000;19:194-200

4

Meguro K, Ishii H, Yamaguchi S, et al. Prevalence of dementia and dementing diseases in Japan: the Tajiri project. Archives of neurology 2002;59:1109-1114

5

Lee DY, Lee JH, Ju YS, et al. The prevalence of dementia in older people in an urban population of Korea: the Seoul study. Journal of the American Geriatrics Society 2002;50:1233-1239

6

Rin H, Huang M, Tseng M. Prevalence of elderly dementias in Taipei area. Proc Ann Meeting Soc Neurol Psychiatry, ROC; 1987.

7

Liu H-C, Fuh J-L, Wang S-J, et al. Prevalence and subtypes of dementia in a rural Chinese population. Alzheimer Disease & Associated Disorders 1998;12:127-139.

8

Liu H-C, Lin K-N, Teng EL, et al. Prevalence and subtypes of dementia in Taiwan: A community survey of 5297 individuals. Journal of the American Geriatrics Society 1995.

9

Yip AG, Brayne C, Matthews FE. Risk factors for incident dementia in England and Wales: The Medical Research Council Cognitive Function and Ageing Study. A population-based nested case–control study. Age and ageing 2006;35:154-160.

10

Corbo R, Scacchi R. Apolipoprotein E (APOE) allele distribution in the world. Is APOE* 4 a ‘thrifty’allele? Annals of human genetics 1999;63:301-310.

11

Breteler M. Vascular risk factors for Alzheimer’s disease:: An epidemiologic perspective. Neurobiology of aging 2000;21:153-160.

12

Biessels GJ, Staekenborg S, Brunner E, Brayne C, Scheltens P. Risk of dementia in diabetes mellitus: a systematic review. The Lancet Neurology 2006;5:64-74.

13

Jellinger KA. Head injury and dementia. Current opinion in neurology 2004;17:719-723.

14

Launer LJ, Andersen K, Dewey ME, et al. Rates and risk factors for dementia and Alzheimer’s disease: results from EURODEM pooled analyses. EURODEM Incidence Research Group and Work Groups. European Studies of Dementia. Neurology 1999;52:78-84.

15

Larson EB, Kukull WA, Katzman RL. Cognitive impairment: dementia and Alzheimer’s disease. Annual review of public health 1992;13:431-449.

16

Breteler MM, Claus JJ, van Duijn CM, Launer LJ, Hofman A. Epidemiology of Alzheimer’s disease. Epidemiologic Reviews 1992;14:59-82.

17

Heyman A, Fillenbaum G, Prosnitz B, Raiford K, Burchett B, Clark C. Estimated prevalence of dementia among elderly black and white community residents. Archives of neurology 1991;48:594-598.

18

Skoog I, Nilsson L, Palmertz B, Andreasson L-A, Svanborg A. A population-based study of dementia in 85-year-olds. New England Journal of Medicine 1993;328:153-158.

19

Aronson MK, Ooi WL, Geva DL, Masur D, Blau A, Frishman W. Dementia: age-dependent incidence, prevalence, and mortality in the old old. Archives of Internal Medicine 1991;151:989-992.

20

Beck JC, Benson DF, Scheibel AB, Spar JE, Rubenstein LZ. Dementia in the elderly: the silent epidemic. Annals of Internal Medicine 1982;97:231-241.

21

McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’ s disease: Recommendations from the National Institute on Aging-Alzheimer’ s Association workgroups on diagnostic guidelines for Alzheimer’ s disease. Alzheimer’ s & Dementia 2011;7:263-269.

22

Albert MS, DeKosky ST, Dickson D, et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia 2011;7:270-279.

23

Luchsinger JA, Noble JM, Scarmeas N. Diet and Alzheimer’s disease. Current neurology and neuroscience reports 2007;7:366-372.

24

Callahan CM, Hendrie HC, Tierney WM. Documentation and evaluation of cognitive impairment in elderly primary care patients. Annals of Internal Medicine 1995;122:422-429.

25

Ross GW, Abbott RD, Petrovitch H, et al. Frequency and Characteristics of Silent Dementia Among Elderly Japanese-American MenThe Honolulu-Asia Aging Study. Jama 1997;277:800-805.

26

Costa P, Williams T, Albert M, et al. Early identification of Alzheimer’s disease and related dementias. AMERICAN FAMILY PHYSICIAN 1997;55:1303-1314.

27

Hasselblad V, Hedges LV. Meta-analysis of screening and diagnostic tests. Psychological bulletin 1995;117:167.

28

McDowell I, Kristjansson B, Hill G, Hebert R. Community screening for dementia: the Mini Mental State Exam (MMSE) and modified Mini-mental State Exam (3MS) compared. Journal of clinical epidemiology 1997;50:377-383.

29

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research 1975;12:189-198.

30

Galvin J, Roe C, Powlishta K, et al. The AD8 A brief informant interview to detect dementia. Neurology 2005;65:559-564.

31

Yang Y-H, Galvin JE, Morris JC, Lai C-L, Chou M-C, Liu C-K. Application of AD8 questionnaire to screen very mild dementia in Taiwanese. American journal of Alzheimer’s disease and other dementias 2011;26:134-138.

32

Galvin J RC, Powlishta K, . The AD8 A brief informant interview to detect dementia. Neurology 2005;65:559-564.

33

Ryu HJ1 KH, Han SH. Validity and reliability of the Korean version of the AD8 informant interview (K-AD8) in dementia. Alzheimer disease and associated disorders 2009;23:371-376.

34

Wilder D, Cross P, Chen J, et al. Operating characteristics of brief screens for dementia in a multicultural population. The American Journal of Geriatric Psychiatry 1995;3:96-107.

35

Boustani M, Peterson B, Hanson L, Harris R, Lohr KN. Screening for dementia in primary care: a summary of the evidence for the US Preventive Services Task Force. Annals of Internal Medicine 2003;138:927-937.

36

Law S, Wolfson C. Validation of a French version of an informant-based questionnaire as a screening test for Alzheimer’s disease. The British Journal of Psychiatry 1995;167:541-544.

37

Lawrence JM, Davidoff DA, Katt?Lloyd D, Connell A, Berlow YA, Savoie JA. Is Large?Scale Community Memory Screening Feasible? Experience from a Regional Memory?Screening Day. Journal of the American Geriatrics Society 2003;51:1072-1078.

38

Lawrence J, Davidoff D, Katt-Lloyd D, Auerbach M, Hennen J. A pilot program of improved methods for community-based screening for dementia. The American Journal of Geriatric Psychiatry 2001;9:205-211.

39

Lantz M. Telling the Patient the Diagnosis of Alzheimer’s Disease: Is Truth-Telling Always Best? Clinical Geriatrics 2004;12:22-25.

40

Turnbull Q, Wolf AM, Holroyd S. Attitudes of elderly subjects toward “truth telling” for the diagnosis of Alzheimer’s disease. Journal of geriatric psychiatry and neurology 2003;16:90-93.

41

Sano M. Current concepts in the prevention of Alzheimer’s disease. CNS Spectr 2003;8:846-853.

 

回上頁 回頂端 友善列印