北京市丰台区阿尔茨海默病患病现状分析

doi:10.12183/j.scjpm.2020.0502

摘要/Abstract

摘要： 目的了解北京市丰台区阿尔茨海默病（AD）患病现状,分析其影响因素,为制定健康管理政策提供科学依据。方法采用方便抽样方法抽取北京市丰台区≥60岁常住居民进行AD患病及相关因素调查,采用简易智能精神状态检查量表（MMSE）对调查对象进行初筛,阳性者由精神科医师按诊断标准确诊。采用描述流行病学方法进行分析,并采用单、多因素分析方法对AD患病影响因素进行分析。结果本研究调查丰台区≥60岁人群5 901人,年龄60~92岁,以70~79岁为主,占39.3%,男女性别比为0.96∶1。检出AD 者319 例,患病率为 5.41%。二分类Logistic回归分析结果显示,年龄增大（OR=2.284）、未婚/丧偶/离异（OR=2.487）、内向性格（OR=2.298）、过量饮酒（OR=12.820）、社会支持水平低（OR=1.514）、血脂异常（OR=2.512）均为老年AD的危险因素;有兴趣爱好（OR=0.299）、经常参加体育锻炼（OR=0.045）均为老年AD的保护因素。结论北京市丰台区老年人AD患病率较高,且随着年龄增大患病率升高,危险因素较多,应引起相关部门重视。

关键词: 阿尔茨海默病, 认知障碍, 患病率, 影响因素

Abstract: Objective To understand the prevalence of Alzheimer's disease （AD） in Fengtai District of Beijing and analyze its influencing factors, so as to provide scientific basis for formulating health management policies. Methods Convenience sampling method was used to select permanent residents ≥ 60 years old in Fengtai District of Beijing for AD prevalence and related factors investigation, and the Simple Mental State Examination Scale （MMSE） was used to screen the elderly for AD. The positive cases were diagnosed by psychiatrists according to the diagnostic criteria. Descriptive epidemiological method was used for analysis, and univariate and multivariate logistic regressions were used to analyze the influencing factors of AD. Results A total of 5 901 people aged 60 - 92 years old in Fengtai District were investigated, mainly 70 - 79 years old, accounting for 39.3%. The ratio of male to female was 0.96∶1. Three hundred and nineteen cases of AD were diagnosed, the prevalence rate was 5.41%. Binary logistic regression analysis showed that age increased （OR=2.284）, unmarried/widowed/divorced （OR=2.487）, introversion （OR=2.298）, excessive drinking （OR=12.820）, low level of social support （OR =1.514）, dyslipidemia （OR=2.512） were the risk factors of AD in the elderly; interest （OR=0.299） and regular physical exercise （OR=0.045） were the protective factors. Conclusion The prevalence of AD in the elderly in Fengtai District of Beijing is relatively high, and with the increase of age, the prevalence increases. There are many risk factors of AD, and relevant departments should pay attention to it.

Key words: Alzheimer's disease, Cognitive impairment, Prevalence rate, Influencing factor

中图分类号:

R195.4

徐玉芝, 柳欣, 尹志科, 邓永梅. 北京市丰台区阿尔茨海默病患病现状分析[J]. 华南预防医学, 2020, 46(5): 502-505.

XU Yu-zhi, LIU Xin, YIN Zhi-ke, DENG Yong-mei. Prevalence of Alzheimer's disease in Fengtai District,Beijing[J]. South China Journal of Preventive Medicine, 2020, 46(5): 502-505.

参考文献

[1] Gaebel W, Jürgen Z, Reed GM .Mental and behavioural disorders in the ICD-11: Concepts, methodologies, and current status[J]. Psychiatria Polska, 2017, 51(2):169-195.
[2] Pyenson B, Sawhney TG, Steffens C, et al.The real-world medicare costs of Alzheimer disease: Considerations for policy and Care[J]. J Manag Care Spec Pharm,2019,25(7):800-809.
[3] GBD 2015 mortality and causes of death collaborators. global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: A systematic analysis for the global burden of disease study 2015BD 2015 mortality and causes of death collaborators. global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: A systematic analysis for the global burden of disease study 2015[J]. Lancet, 2016, 388(10053):1459-1544.
[4] 王英全, 梁景宏, 贾瑞霞,等. 2020—2050年中国阿尔茨海默病患病情况预测研究[J]. 阿尔茨海默病及相关病杂志, 2019,2(1): 289-298.
[5] 黄悦勤. 医学科研中随机误差控制和样本量确定[J]. 中国心理卫生杂志, 2015, 29(11): 874-880.
[6] 钱铭怡,武国城,朱荣春,等.艾森克人格问卷简式量表中国版(EPQ-RSC)的修订[J].心理学报,2000(3):317-323.
[7] Almeida OP, Garrido GJ, Alfonso H, et al.24-month effect of smoking cessation on cognitive function and brain structure in later life[J]. Neuroimage, 2011, 55(4): 1480-1489.
[8] 胡彩红,张梅, 李纯. 我国成年居民饮酒行为与血脂异常关系研究[J]. 疾病监测, 2020,35(8): 378-389.
[9] 杨雪莹, 高凤, 安昕,等. 山东省老年人获得社会支持状况及影响因素分析[J]. 卫生职业教育, 2020,38(4): 143-145.
[10] 肖水源,杨德森.社会支持对身心健康的影响[J].中国心理卫生杂志,1987(4):183-187.
[11] 彭丹涛,许贤豪,刘江红,等.简易智能精神状态检查量表检测老年期痴呆患者的应用探讨[J].中国神经免疫学和神经病学杂志,2005(4):187-190,211.
[12] 中华医学会精神科分会. CCMD-3中国精神障碍分类与诊断标准[J].济南:山东科学技术出版社,2001:1.
[13] Ferri CP, Prince M, Brayne C, et al.Global prevalence of dementia:A Delphi consensus study[J]. Lancet, 2005,366(9503): 2112-2117.
[14] 高瑗,原新. 中国老年人口健康转移与医疗支出[J]. 人口研究, 2020, 44(2): 60-72.
[15] Puranen A, Taipale H, Koponen M, et al.Incidence of antidepressant use in community-dwelling persons with and without Alzheimer's disease: 13-year follow-up[J]. Int J Geriatr Psychiatry, 2017,32(1): 94-101.
[16] 李卓然,魏新华,江新青.影像技术和分子检测技术在阿尔茨海默病诊断中的应用研究进展[J].分子诊断与治疗杂志,2019,11(2):146-151.
[17] Jeong W,Hyein L,Sukhee C,et al.ApoE4-induced cholesterol dysregulation and its brain cell type-specific implications in the pathogenesis of Alzheimer's disease[J]. Mol Cells,2019,42(11):739-746.
[18] 鄢波, 邓汉宇,任莹,等. 阿尔茨海默病患者照顾者生活质量的调查研究[J]. 华西医学, 2015,30(4): 604-608.
[19] 谭小林, 赵科,赵晋,等. 阿尔茨海默病患者的主要照料者心理健康与生活质量的相关性研究[J]. 中华临床医师杂志(电子版), 2015,9(12): 19-24.
[20] 叶佳欣,江丽丽,高银燕,等.中国家庭护理对阿尔茨海默病患者健康状况影响的meta分析[J].华南预防医学,2019,45(3):227-232.