지역 사회 노인의 치매와 경도인지장애 유병률과 위험 인자
Prevalence and Risk Factors of Dementia and MCI in Community-dwelling Elderly Koreans
0
조회
0
다운로드
9
인용
0
참고문헌
키워드
초록
Background: We investigated the prevalence of dementia and mild cognitive impairment (MCI) and their risk factors in an urban community-dwelling elderly people over 65 years old. Methods: A two-phase investigation was performed from January 2010 to December 2011. In Phase I, all subjects (n=9,485) responded to the Korean version of the Mini-Mental State Examination (K-MMSE). Based on the K-MMSE score the subjects were classified into two groups (‘Normal’ and ‘Cognitive decline’). In Phase II, cognitive decline subjects were diagnosed as dementia or MCI according to the neuropsychological tests and doctor’s interview. We also surveyed the socioeconomic and medical factors in Normal, Dementia and MCI groups. And we compared and analyzed the socioeconomic and medical risk factors by multiple logistic regressions in Dementia and MCI group. Results: The prevalence of dementia and MCI was obtained 5.4% and 4.3%, respectively. Old age, alcohol intake, living together, low economic status, jobless in the past, diabetes mellitus, previous stroke, lower BMI and family history of dementia were associated with the increased dementia risk. Higher education, hypertension and physical activity were associated with the decreased dementia risk. And old age, alcohol intake, higher education, previous stroke, lower BMI and physical activity were common risk factors in MCI group. Conclusions: The prevalence of dementia and MCI was obtained much lower than previous reports. Dementia and MCI patients had common socioeconomic and medical risk factors. It is also important to control the risk factors earlier to prevent the increase of patients in dementia. And in order to prove the hypothesis that early control of the risk factors can decrease the occurrence of dementia, the further prospective studies are needed.
Abstract
Background: We investigated the prevalence of dementia and mild cognitive impairment (MCI) and their risk factors in an urban community-dwelling elderly people over 65 years old. Methods: A two-phase investigation was performed from January 2010 to December 2011. In Phase I, all subjects (n=9,485) responded to the Korean version of the Mini-Mental State Examination (K-MMSE). Based on the K-MMSE score the subjects were classified into two groups (‘Normal’ and ‘Cognitive decline’). In Phase II, cognitive decline subjects were diagnosed as dementia or MCI according to the neuropsychological tests and doctor’s interview. We also surveyed the socioeconomic and medical factors in Normal, Dementia and MCI groups. And we compared and analyzed the socioeconomic and medical risk factors by multiple logistic regressions in Dementia and MCI group. Results: The prevalence of dementia and MCI was obtained 5.4% and 4.3%, respectively. Old age, alcohol intake, living together, low economic status, jobless in the past, diabetes mellitus, previous stroke, lower BMI and family history of dementia were associated with the increased dementia risk. Higher education, hypertension and physical activity were associated with the decreased dementia risk. And old age, alcohol intake, higher education, previous stroke, lower BMI and physical activity were common risk factors in MCI group. Conclusions: The prevalence of dementia and MCI was obtained much lower than previous reports. Dementia and MCI patients had common socioeconomic and medical risk factors. It is also important to control the risk factors earlier to prevent the increase of patients in dementia. And in order to prove the hypothesis that early control of the risk factors can decrease the occurrence of dementia, the further prospective studies are needed.
참고문헌 (50)
- 통계청, "고령자 통계", ~ (2014)
- 서울시, "서울시 치매관리사업안내서", ~ (2011)
- Woo JI, "Prevalence estimation of dementia in a rural area of Korea", J Am Geriatr Soc, 46, pp.983~987 (1998)
- Kim DH, "Prevalence of dementia in the elderly of an urban community in Korea", Korean J Prev Med, 32, pp.306~316 (1999)
- Kwak DI, "Epidemiological study of dementiain a Korea urban area", J Korean Geriatr Psychiatry, 3, pp.44~52 (1999)
- Lee DY, "The prevalence of dementia in older people in an urban population of Korea : the Seoul study", J Am Geriatr Soc, 50, pp.1233~1239 (2002)
- 신일선, "광주광역시에서 치매의 유병률과 위험인자의 도시-농촌 지역 비교", 신경정신의학, 41(6), pp.1165~1173 (2002), 대한신경정신의학회
- Kim J, "The prevalence of dementia in a metropolitan city of South Korea", Int J Geriatr Psychiatry, 18, pp.617~622 (2003)
- Suh GH, "Community study of dementia in the older Korean rural population", Aust N Z J Psychiatry, 37, pp.606~612 (2003)
- 신희영, "새로운 치매 선별검사를 이용한 도시지역 노인의 치매 유병률과 관련요인", 예방의학회지, 38(3), pp.351~358 (2005), 대한예방의학회
- Jhoo JH, "Prevalence of dementia and its subtypes in an elderly urban Korean population: results from the Korean Longitudinal Study on Health And Aging (KLoSHA)", Dement Geriatr Cogn Disord, 26, pp.270~276 (2008)
- Kim KW, "A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea", J Alzheimers Dis, 23, pp.281~291 (2011)
- 2012년 치매 유병률 조사, "보건복지부", ~ (2012)
- Seok-Ju Choi, "Prevalence of Alzheimer’s Dementia and Its Risk Factors in Community-Dwelling Elderly Koreans", PSYCHIATRY INVESTIGATION, 5(2), pp.78~85 (2008), 대한신경정신의학회
- 국내 치매 노인 유병률 현황과 위험요인, "조맹제", 한국보건사회연구원, ~ (2010)
- 강연욱, "K-MMSE(Korean-Mini Mental State Examination)의 노인 규준 연구", 한국심리학회지:일반, 25(2), pp.1~12 (2006), 한국심리학회
- Kang YW, "Seoul neuropsychological screening battery" (2003), Human Brain Research & Consulting Co
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental disorders" (1994), American Psychiatric Association
- Anstey, KJ, "Alcohol consumption as a risk factor for dementia and cognitive decline : meta-Analysis of prospective studies", Am J Geriatr Psychiatry, 17, pp.542~555 (2009)
- 2010 치매관리사업 보고서, "서울시", ~ (2010)
- 최호진, "지역사회 60세 이상 기초수급자 인지 기능 전수조사 결과 분석", Dementia and Neurocognitive Disorders(대한치매학회지), 10(4), pp.112~116 (2011), 대한치매학회
- Luchsinger JA, "Alcohol intake and risk of dementia", J Am Geriatr Soc, 52, pp.540~546 (2004)
- Peters R, "Alcohol, dementia and cognitive decline in the elderly: a systematic review", Age Ageing, 37, pp.505~512 (2008)
- Mukamal KJ, "Prospective study of alcohol consumption and risk of dementia in older adults", JAMA, 289, pp.1405~1413 (2003)
- Sinforiani E, "The effects of alcohol on cognition in the elderly : from protection to neurodegeneration", Funct Neurol, 26, pp.103~106 (2011)
- Katzman R, "Education and the prevalence of dementia and Alzheimer’s disease", Neurology, 43, pp.13~20 (1993)
- Stern Y, "Influence of education and occupation on the incidence of Alzheimer’s disease", JAMA, 271, pp.1004~1010 (1994)
- Valenzuela MJ, "Brain reserve and dementia : a systematic review", Psychol Med, 36, pp.441~454 (2006)
- Karp A, "Relation of education and occupation-based socioeconomic status to incident Alzheimer’s disease", Am J Epidemiol, 159, pp.175~183 (2004)
- Lehmann SW, "Living alone with dementia : lack of awareness adds to functional and cognitive vulnerabilities", Int Psychogeriatr, 22, pp.778~784 (2010)
- Jeon GS, "Gender differences in correlates of mental health among elderly Koreans", J Gerontol B Psychol Sci Soc Sci, 62, pp.S323~S329 (2007)
- Chen JH, "Risk factors for dementia", Formos Med Assoc, 108, pp.754~764 (2009)
- Savva GM, "Alzheimer’s Society Vascular Dementia Systematic Review Group. Epidemiological studies of the effect of stroke on incident dementia: a systematic review", Stroke, 41, pp.e41~e46 (2010)
- Beydoun MA, "Obesity and central obesity as risk factors for incident dementia and its sub-types : a systematic review and meta-analysis", Obes Rev, 9, pp.204~218 (2008)
- Fitzpatrick AL, "Midlife and late-life obesity and the risk of dementia : cardiovascular health study", Arch Neurol, 66, pp.336~342 (2009)
- Buchman AS, "Change in body mass index and risk of incident Alzheimer disease", Neurology, 65, pp.892~897 (2005)
- Larson EB, "Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older", Ann Intern Med, 144, pp.73~81 (2006)
- Laurin D, "Physical activity and risk of cognitive impairment and dementia in elderly persons", Arch Neurol, 58, pp.498~504 (2001)
- Heyn P, "The effects of exercise training on elderly persons with cognitive impairment and dementia : a meta-analysis", Arch Phys Med Rehabil, 85, pp.1694~1704 (2004)
- Reuben DB, "The associations between physical activity and inflammatory markers in high-functioning older persons : MacArthur Studies of Successful Aging", J Am Geriatr Soc, 51, pp.1125~1130 (2003)
- Barnes DE, "Physical activity and dementia : the need for prevention trials", Exerc Sport Sci Rev, 35, pp.24~29 (2007)
- Craft S, "Insulin resistance and Alzheimer’s disease pathogenesis : potential mechanisms and implications for treatment", Curr Alzheimer Res, 4, pp.147~152 (2007)
- Craft S, "The role of metabolic disorders in Alzheimer disease and vascular dementia : two roads converged", Arch Neurol, 66, pp.300~305 (2009)
- Biessels GJ, "Risk of dementia in diabetes mellitus: a systematic review", Lancet Neurol, 5, pp.64~74 (2006)
- Qiu C, "The age-dependent relation of blood pressure to cognitive function and dementia", Lancet Neurol, 4, pp.487~499 (2005)
- Guo Z, "Low blood pressure and dementia in elderly people : the Kungsholmen project", BMJ, 312, pp.805~808 (1996)
- Morris MC, "The cross-sectional association between blood pressure and Alzheimer’s disease in a biracial community population of older persons", J Gerontol A Biol Sci Med Sci, 55, pp.130~136 (2000)
- Kokmen E, "Clinical risk factors for Alzheimer’s disease : a population-based casecontrol study", Neurology, 41, pp.1393~1397 (1991)
- Verghese J, "Low blood pressure and the risk of dementia in very old individuals", Neurology, 61, pp.1667~1672 (2003)
- Loy CT, "Genetics of dementia", Lancet, 383, pp.828~840 (2014)
