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研究生:顏啟華
研究生(外文):Chi-Hua
論文名稱:台灣老人認知功能障礙危險因子研究
論文名稱(外文):Risk Factors of Cognitive Impairment among the Elderly in Taiwan
指導教授:李孟智李孟智引用關係
指導教授(外文):Meng-Chih Lee
學位類別:博士
校院名稱:中山醫學大學
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:99
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目的
隨著人口的快速老化,認知功能障礙的人口增加速度逐年加快,積極找出其危險因子,並加以預防,是防治的重點。本研究藉由國民健康局「台灣中老年人身心社會狀況長期追蹤調查」1999-2003的資料,以探討影響台灣老人認知功能障礙的相關因子。
方法
研究選取1999年調查無認知功能障礙的老人並於2003年再次進行追蹤。調查於1999年完訪個案數為2,310人,扣除掉認知障礙的個案,死亡及資料不全者,有效樣本為1,224人。個案的認知功能狀況是以9題式SPMSQ量表於1999及2003年予以評估,每答對一題一分,共9分。答對六題及以下者為認知功能障礙。研究以1999年無認知功能障礙的老人之年齡、性別、籍貫、教育、婚姻狀態、高血壓、糖尿病,心血管疾病、中風、癌症、肺部疾病、憂鬱、自覺健康、ADL、IADL、身體活動能力、參與志工、宗教信仰、參與社團、蔬菜攝取、食用水果、喝茶習慣、BMI指數及跌倒、住院、急診、入住機構等過去史作為自變項,並以2003年後續追蹤老人之認知功能障礙與否為依變項。先以卡方檢定作為各相關因子與老人認知功能障礙的單變項分析,再將卡方檢定分析所得有顯著差異的變項,依據(1)人口特質、(2)慢性疾病、(3)活動功能、(4)健康習慣、(5)社會參與及(6)營養狀態等六類變項,建立了六種模式,依序逐步進入階層邏輯斯迴歸分析,並分析其勝算比(Odds Ratio;OR)與95%信賴區間(95%confideace interval;95% CI)。
結果
從1999年至2003年,共有155位經評估為認知功能障礙,累積發生率為31.1/千人年。透過階層邏輯斯迴歸分析發現,六種模式的整體適配度良好。年齡75歲以上者(OR=2.45, 95% CI=1.59-3.76; p < 0.0001)、教育程度低者(OR = 2.24, 95% CI = 1.05-4.76)、有癌症病史(OR=3.25, 95% CI=1.26-8.38)、過去一年中曾經住院 (OR=1.858, 95% CI=1.23-3.11)、工具性日常生活活動功能障礙者(OR=3.09, 95% CI=1.98-4.83),顯著增加認知功能障礙的風險。相反的,男性(OR=0.56, 95%CI=0.35-0.87)則與認知功能障礙呈現負相關。
結論
年齡75歲以上、女性、低教育程度、有癌症病史、過去一年中曾經住院、工具性日常生活活動功能障礙者,為台灣老人認知障礙顯著且獨立的預測因子。


Objectives
The population of cognitive impairment increases rapidly because of fast growing elderly population. The importance is to explore and prevent the risk factors that affect the cognitive function. This study aims to explore the risk factors of cognitive impairment in elderly persons without dementia from a longitudinal study of “Survey of Health and Living Status of the Elderly in Taiwan”, during a 4-year period (1999~2003).
Methods
Data were derived from a population-based cohort study of 2,310 elderly Taiwanese that were collected in 1999. Cognitive function was measured by the Short Portable Mental Status Questionnaire (SPMSQ) both in 1999 and in 2003. Each item scored one point, and the scores ranged from 0 to 9. The nine item SPMSQ was adequate to assess cognitive function. To reconcile this inconsistency, we chose the nine items shared by the 1999 and 2003 SPMSQ. Using nine-item criterion, a score of 6–9 was intact cognition; accordingly, in the present study, normal cognitive function was defined as a score of six or greater. A total of 1,224 participants free of cognitive impairment at baseline were included in these analyses. Gender, age, race, marriage, chronic diseases, voluntary, BMI, dietary behavior (intake of vegetable, fruit and drinking tea), depression, ADL, IADL, physical activity, falls, religion, and self-perceived health status, has been admitted to a hospital, ER, or any hospitalization were independent variables and the cognitive function in 2003 was the dependent variable. A Chi-square test was used to analyze the relationships among dependent variable and independent variables first. Secondly, the stratum logistic regression was used to establish six models by using the significant variables based on the results of chi-square including (1). basic characteristics, (2). chronic diseases, (3). Physical activity, (4). Health behaviors, (5). Social participation, and (6). nutrition and then analyze the Odds Ratio and the 95%confidence interval.
Results
One hundred and fifty-five out of 1,224 elderly were diagnosed with cognitive impairment between 1999 and 2003. The accumulated prevalence rate was 31.1 persons/1,000 persons. Through the stratum logistic regression analysis, it’s found that the goodness of fit is adequate enough for the purpose to predict cognitive impairment among the elderly. In the logistic regression model adjusted for age, education, hypertension, cancer, heart disease, stroke and so on at baseline, persons who are 75 (Odds ratio = OR = 2.45; 95% CI = 1.59-3.76; p < 0.0001), those who had lower educational background (OR = 2.24, 95% CI = 1.05-4.76), those who were diagnosed with cancer (OR = 3.25, 95% CI = 1.26-8.38), those who has been admitted to hospital in the past year (OR = 1.96, 95% CI = 1.23-3.11), those who has IADL impairment (OR = 3.09, 95% CI = 1.98-4.83) were significantly to develop cognitive impairment. On the contrary, males has lower risk to develop cognitive impairment. (OR = 0.56, 95% CI = 0.35-0.87).
Conclusion
Aged 75 years old, females, lower educational background, who were diagnosed with cancer, has been admitted to hospital in the past year, has IADL deficit were found to be the risk factors of cognitive impairment in this study.


中文摘要----------------------------------------------------------------------------------------- I
英文摘要------------------------------------------------------------------------------ ---------- III
第一章 緒論------------------------------------------------------------------------------------- 1
第一節 研究背景------------------------------------------------------------------------- 1
第二節 研究目的------------------------------------------------------------------------- 3
第三節 名詞解釋及定義---------------------------------------------------------------- 4
第二章 文獻回顧------------------------------------------------------------------------------- 6
第一節 認知障礙/失智症的流行病學---------------------------------------------- 6
第二節 認知障礙/失智症的危險因子─人口特質------------------------------ 12
第三節 認知障礙/失智症的危險因子─心血管因子--------------------------- 15
第四節 認知障礙/失智症的危險因子─心理社會因子與其他-------------- 21
第三章 研究方法------------------------------------------------------------------- ----------- 25
第一節 研究架構及假說------------------------------------------------------------- 25
第二節 研究設計、研究資料及樣本---------------------------------------------- 28
第三節 研究變項---------------------------------------------------------------------- 30
第四節 統計分析---------------------------------------------------------------------- 33
第四章 研究結果------------------------------------------------------------------------------ 36
第一節 研究對象的基本資料------------------------------------------------------- 36
第二節 認知功能障礙相關因子---------------------------------------------------- 38
第五章 討論------------------------------------------------------------------------------------ 44
第一節 樣本人口學特性------------------------------------------------------------- 44
第二節 認知功能障礙的相關因素探討------------------------------------------- 45
第三節 研究限制---------------------------------------------------------------------- 49
第六章 結論與建議--------------------------------------------------------------------------- 50
第一節 結論---------------------------------------------------------------------------- 50
第二節 建議---------------------------------------------------------------------------- 51
參考文獻---------------------------------------------------------------------------------------- 53
圖一 「台灣老人認知功能障礙危險因子研究」樣本數變化情形---------------------82
表一 1999年樣本的人口特質-------------------------------------------------------------83
表二 存活與死亡樣本分析---------------------------------------------------------------- 84
表三 認知障礙危險因子之單變項分析------------------------------------------------- 86
表四 認知障礙危險因子之多變項分析-模式一--------------------------------------- 89
表五 認知障礙危險因子之多變項分析-模式二--------------------------------------- 90
表六 認知障礙危險因子之多變項分析-模式三--------------------------------------- 92
表七 認知障礙危險因子之多變項分析-模式四--------------------------------------- 94
表八 認知障礙危險因子之多變項分析-模式五--------------------------------------- 96
表九 認知障礙危險因子之多變項分析-模式六--------------------------------------- 98

附錄

附錄1: 台灣中老年人身心社會狀況長期追蹤調查簡介(1996年)
附錄2: 台灣中老年人身心社會狀況長期追蹤調查1999年問卷


內政部戶政司: 戶籍人口統計年報,2009。 http://www.ris.gov.tw/version96/stpeqr_01_03.html (2009年12月查詢)
內政部統計處: 97年臺灣地區簡易生命,2009。 http://www.moi.gov.tw/stat/life.aspx (2009年12月查詢)
行政院衛生署:國民營養現況:1993-1996國民營養健康狀況變遷調查結果。台北,行政院衛生署,1998。
行政院經建會:中華民國台灣民國97年至14 5年人口推計,2008。
台灣臨床失智症協會:台灣失智症照顧需求之調查-長期照護機構失智症患者之盛行率調查。行政院衛生署九十三年度委託研究計畫,2006。
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
Anderson EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D. Am J Prev Med 1994; 10, 77–84
Andersen K, Launer LJ, Dewey ME, et al. Gender differences in the incidence of AD and vascular dementia: the EURODEM Studies. EURODEM Incidence Research Group. Neurology 1999; 53: 1992–7.
Anttila T, Helkala EL, Viitanen M, Kåreholt I, Fratiglioni L, Winblad B, Soininen H, Tuomilehto J, Nissinen A, Kivipelto M. Alcohol drinking in middle age and subsequent risk of mild cognitive impairment and dementia in old age: a prospective population based study. BMJ 2004; 329:539–542.
Barberger-Gateau P, Letenneur L, Deschamps V, Peres K, Dartigues JF, Renaud S. Fish, meat, and risk of dementia: cohort study. BMJ 2002;325:932-3.
Barberger-Gateau P, Raffaitin C, Letenneur L, Berr C, Tzourio C, Dartigues JF, Alpérovitch A. Dietary patterns and risk of dementia: the Three-City cohort study. Neurology. 2007;69(20):1921-30.
Bassey EJ. The benefits of exercise for health of older people. Rev Clin Gerontol 2000; 10: 17–30.
Berkman LF, Glass TA, Brisette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Soc Sci Med 2000; 51: 843–57.
Biessels GJ, Staekenborg S, Brunner E, et al. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol 2006; 5:64–74.
Bieliauskas LA, Costello S, Terpenning M. Depression and screening for cognitive deficit in elderly patient. J Clin Exp Neuropsychol. 1991;13:101
Bergem AL, Lannfelt L. Apolipoprotein E type epsilon4 allele, heritability and age at onset in twins with Alzheimer disease and vascular dementia. Clin Genet. 1997;52(5):408-13.
Beydoun MA, Beydoun HA, Wang Y. Obesity and central obesity as risk factors for incident dementia and its subtypes: a systematic review and meta-analysis. Obes Rev 2008;9:204–18.
Bertram L, Busch R, Spiegl M, et al. Paternal age is a risk factor for Alzheimer disease in the absence of a major gene. Neurogenetics 1998;1:277–80.
Bickel H, Cooper B. Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study. Psychol Med 1994; 24: 179–92.
Bosma H, van Boxtel MP, Ponds RW, Jelicic M, Houx P, Metsemakers J, Jolles J. Engaged lifestyle and cognitive function in middle and oldaged, non-demented persons: a reciprocal association? Z Gerontol Geriatr 2002; 35: 575–81.
Breteler MM, Claus JJ, Grobbee DE, Hofman A. Cardiovascular disease and distribution of cognitive function in elderly people: the Rotterdam Study. BMJ 1994; 308: 1604–8.
Breteler MM. Ott A. Hofman A. The new epidemic: frequency of dementia in the Rotterdam Study. Haemostasis. 1998; 28(3-4):117-23,
Buchman AS, Wilson RS, Bienias JL, Shah RC, Evans DA, Bennett DA. Change in body mass index and risk of incident Alzheimer disease. Neurology 2005; 65:892–897.
Cacciatore F, Abete P, Ferrara N, et al. The role of blood pressure in cognitive impairment in an elderly population. J Hypertens 1997;15: 135–42.
Carmelli D, Swan GE, LaRue A, Eslinger PJ. Correlates of change in cognitive function in survivors from the Western Collaborative Group Study. Neuroepidemiology 1997; 16: 285–95.
Chen HH, Hu CJ. Genetic characteristics of dementia in Taiwan. Acta Neurol Taiwan. 2006;15(3):161-9.
Chen P, Ganguli M, Mulsant BH, DeKosky ST. The temporal relationship between depressive symptoms and dementia: a community-based prospective study. Arch Gen Psychiatry. 1999;56, 261–6.
Chen JH, Lin KP, Chen YC. Risk Factors for Dementia. J Formos Med Assoc 2009; 108(10):754–764.
Chi I, Boey KW. Validation of Measuring Instruments of Mental Health Status of the Elderly in Hong Kong. Department of Social Work and Administration, University of Hong Kong, Hong Kong, 1992.
Chodosh J, Seeman TE, Keeler E, Sewall A, Hirsch SH, Guralnik JM, Reuben DB. Cognitive decline in high-functioning older persons is associated with an increased risk of hospitalization. J Am Geriatr Soc. 2004; 52, 1456-62.
Clarke R, Smith AD, Jobst KA, Refsum H, Sutton L, Ueland PM. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease. Arch Neurol 1998;55:1449-55.
Crystal HA, Ortof E, Frishman WH, Gruber A, Hershman D, Aronson M. Serum vitamin B12 levels and incidence of dementia in a healthy elderly population: a report from the Bronx Longitudinal Aging Study. J Am Geriatr Soc 1994;42:933-6.
Davidson Y, Gibbons L, Purandare N, Byrne J, Hardicre J, Wren J, Payton A, Pendleton N, Horan M, Burns A, Mann DM. Apolipoprotein E epsilon4 allele frequency in vascular dementia. Dement Geriatr Cogn Disord. 2006;22(1):15-9.
Davis RN, Massman PJ, Doody RS. Effects of blood pressure on neuropsychological functioning in Alzheimer’s disease. Arch Clin Neuropsychol 2003; 18: 19–32.
de Pedro-Cuesta J, Virués-Ortega J, Vega S, Seijo-Martínez M, Saz P, Rodríguez F, Rodríguez-Laso A, Reñé R, de las Heras SP, Mateos R, Martínez-Martín P, Manubens JM, Mahillo-Fernandez I, López-Pousa S, Lobo A, Reglà JL, Gascón J, García FJ, Fernández-Martínez M, Boix R, Bermejo-Pareja F, Bergareche A, Benito-León J, de Arce A, del Barrio JL. Prevalence of dementia and major dementia subtypes in Spanish populations: a reanalysis of dementia prevalence surveys, 1990-2008. BMC Neurol. 2009;19;9:55.
de la Torre JC. Is Alzheimer’s disease a neurodegenerative or a vascular disorder? Data, dogma, and dialectics. Lancet Neurol 2004;3: 184–90.
Di Carlo A, Baldereschi M, Amaducci L, et al. Cognitive impairment without dementia in older people: prevalence, vascular risk factors, impact on disability. The Italian Longitudinal Study on Aging. J Am Geriatr Soc 2000; 48: 775–82.
Dong MJ, Peng B, Lin XT, Zhao J, Zhou YR, Wang RH. The prevalence of dementia in the People''s Republic of China: a systematic analysis of 1980-2004 studies. Age Ageing. 2007;36(6):619-24.
Dufouil C, Richard F, Fiévet N, Dartigues JF, Ritchie K, Tzourio C, Amouyel P, Alpérovitch A. APOE genotype, cholesterol level, lipid-lowering treatment, and dementia: the Three-City Study. Neurology. 2005; 64(9): 1531-8.
Eastley R, Wilcock GK, Bucks RS. Vitamin B12 deficiency in dementia and cognitive impairment: the effects of treatment on neuropsychological function. Int J Geriatr Psych 2000;15:226-33.
Engelhart MJ, Geerlings MI, Ruitenberg A, van Swieten JC, Hofman A, Witteman JC, Breteler MM. Dietary intake of antioxidants and risk of Alzheimer disease. JAMA 2002;287:3223-9.
Ernst RL, Hay JW. The US economic and social costs of Alzheimer disease revisited. Am J Public Health.1994;84:1261-4.
Espeland MA, Gu L, Masaki KH, Langer RD, Coker LH, Stefanick ML, Ockene J, Rapp SR. Association between reported alcohol intake and cognition: results from the Women’s Health Initiative Memory Study. Am J Epidemiol 2005;161:228–38.
Euser sm, Schram MT, Hofman A, Westendorp RGJ, Breteler, MMB. Measuring cognitive function with age: the influence of selection by health and survival. Epidemiology. 2008; 19, 440-7
Evans DA. Estimated prevalence of Alzheimer disease in the United States. Milbank Q. 1990;68:289-97.
Evans DA, Funkenstein HH, Albert MS, Scherr PA, Cook NR, Chown MJ. Prevalence of Alzheimer’s disease in a community population of older persons: higher than previously reported. JAMA 1989;262:2551–6.
Fabrigoule C, Letenneur L, Dartigues JF, Zarrouk M, Commenges D, Barberger-Gateau P. Social and leisure activities and risk of dementia: a prospective longitudinal study. J Am Geriatr Soc 1995; 43: 485–90.
Farrer LA, Cupples LA, Haines JL, et al. Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. JAMA 1997;278:1349–56.
Fewlass DC, Noboa K, Pi-Sunyer FX. Johnston JM, Yan SD, Tezapsidis N. Obesity-related leptin regulates Alzheimer’s Abeta. FASEB J 2004; 18:1870–78.
Fillenbaum G G, Smyer M A. The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. J Gerontol. 1981;36, 428-34.
Folin M, Baiguera S, Conconi MT, Di Liddo R, De Carlo E, Parnigotto PP, Nussdorfer GG. Apolipoprotein E as vascular risk factor in neurodegenerative dementia. Int J Mol Med. 2004;14(4):609-13.
Forette F, Seux ML, Staessen JA, Thijs L, Birkenhäger WH, Babarskiene MR, Babeanu S, Bossini A, Gil-Extremera B, Girerd X, Laks T, Lilov E, Moisseyev V, Tuomilehto J, Vanhanen H, Webster J, Yodfat Y, Fagard R. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet. 1998;352(9137):1347-51.
Forette F, Seux ML, Staessen JA, Thijs L, Babarskiene MR, Babeanu S, Bossini A, Fagard R, Gil-Extremera B, Laks T, Kobalava Z, Sarti C, Tuomilehto J, Vanhanen H, Webster J, Yodfat Y, Birkenhäger WH; Systolic Hypertension in Europe Investigators. The prevention of dementia with anti-hypertensive treatment: new evidence from the Systolic Hypertension in Europe (Syst-Eur) study. Arch Intern Med. 2002;162(18):2046-52.
Fratiglioni L, Launer LJ, Andersen K, et al. Incidence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic diseases in the elderly research group. Neurology 2000;54(11 suppl 5):S10–15.
Fratiglioni L, Wang HX, Ericsson K, Maytan M, Winblad B. Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet 2000; 355: 1315–19.
Fratiglioni L, Paillard-Borg S, Winblad B. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol 2004; 3: 343–53.
Fuh JL, Wan SJ, Liu HC, Wang HC. The caregiving burden scale among Chinese caregivers of Alzheimer patients. Dement Geriatr Cogn Disord. 1999; 10(3):186-91.
Ganguli M, Dodge HH, Shen C, Pandav RS, DeKosky ST. Alzheimer disease and mortality: a 15-year epidemiological study. Arch Neurol. 2005;62(5):779-84.
Gatz M, Fratiglioni L, Johansson B, et al. Complete ascertainment of dementia in the Swedish Twin Registry: the HARMONY study. Neurobiol Aging 2005;26:439–47.
Geerlings MI, Schmand B, Jonker C, Lindeboom J, Bouter LM. Education and incident Alzheimer’s disease: a biased association due to selective attrition and use of a two-step diagnostic procedure? Int J Epidemiol 1999;28:492–7.
Gregg EW, Yaffe K, Cauley JA, Rolka DB, Blackwell TL, Narayan KM, Cummings SR. Is diabetes associated with cognitive impairment and cognitive decline among older women? Study of Osteoporotic Fractures Research Group. Arch Intern Med. 2000;160(2):174-80.
Grossberg GT, Nakra R, Woodward V, Russell T. Smoking as a risk factor for Alzheimer’s disease. J. Am. Geriatr. Soc. 1989;37: 819.
Guo Z, Viitanen M, Winblad B. Clinical correlates of low blood pressure in very old people: the importance of cognitive impairment. J Am Geriatr Soc 1997; 45: 701–05.
Gustafson D, Rothenberg E, Blennow K. Steen B, Skoog I. An 18-year follow-up of overweight and risk of Alzheimer disease. Arch Intern Med 2003; 163: 1524–28.
Gustafson D. Adiposity indices and dementia. Lancet Neurol 2006; 5:713–720.
Hall KS, Gao S, Unverzagt FW, Hendrie HC. Low education and childhood rural residence:risk for Alzheimer’s disease in African Americans. Neurology 2000;54:95–9.
Hall KS, Gureje O, Gao S, Ogunniyi A, Hui SL, Baiyewu O, Unverzagt FW, Oluwole S, Hendrie HC. Risk factors and Alzheimer''s disease: a comparative study of two communities. Aust N Z J Psychiatry. 1998 Oct;32(5):698-706.
Harrington F, Saxby BK, McKeith IG, Wesnes K, Ford GA. Cognitive performance in hypertensive and normotensive older subjects. Hypertension 2000; 36: 1079–82.
Hebert, R. & Brayne, C. Epidemiology of vascular dementia. Neuroepidemiology, 1995;14, 240–257.
Heflin LH, Meyerowitz BE, Hall P, Lichtenstein P, Johansson B, Pedersen NL, Gatz M. Cancer as a risk factor for long-term cognitive deficits and dementia. J Natl Cancer Inst. 2005 ;97(11):854-6.
Helmer C, Damon D, Letenneur L, Fabrigoule C, Barberger-Gateau P, Lafont S, Fuhrer R, Antonucci T, Commenges D, Orgogozo JM, Dartigues JF. Marital status and risk of Alzheimer’s disease: a French population-based cohort study. Neurology 1999; 53: 1953–58.
Henderson AS. The risk factors for Alzheimer''s disease: a review and a hypothesis. Acta Psychiatr Scand. 1988;78(3):257-75.
Hendrie HC, Osuntokun BO, Hall KS, Ogunniyi AO, Hui SL, Unverzagt FW, Gureje O, Rodenberg CA, Baiyewu O, Musick BS. Prevalence of Alzheimer’s disease and dementia in two communities: Nigerian Africans and African Americans. Am J Psychiatry. 1995; 152:1485–92
Hendrie HC. Epidemiology of dementia and Alzheimer’s disease. Am J Geriatr Psychiatry 1998; 6(Suppl.1): S3–18.
Hendrie HC, Albert MS, Butters MA, Gao S, Knopman DS, Launer LJ, Yaffe K, Cuthbert BN, Edwards E, Wagster MV. The NIH cognitive and emotional health project: report of the critical evaluation study committee. Alzheimer Dement. 2006;2:12–32.
Ho SC, Woo J, Sham A, Chan SG, Yu AL. A 3-year follow-up study of social, lifestyle and health predictors of cognitive impairment in a Chinese older cohort. Int J Epidemiol 2001; 30: 1389–96.
Hong CJ, Liu TY, Liu HC, Wang SJ, Fuh JL, Chi CW, Lee KY, Sim CB. Epsilon 4 allele of apolipoprotein E increases risk of Alzheimer''s disease in a Chinese population. Neurology. 1996 ;46(6):1749-51.
Hsu HC. Gender disparity of successful aging in Taiwan. Women Health. 2004; 42(1):1-21
Ikeda M, Hokoishi K, Maki N, Nebu A, Tachibana N, Komori K, Shigenobu K, Fukuhara R, Tanabe H. Increased prevalence of vascular dementia in Japan: a community-based epidemiological study. Neurology. 2001;57(5):839-44.
Jagust W, Harvey D, Mungas D. Haan M. Central obesity and the aging brain. Arch Neurol 2005; 62: 1545–48.
Jarvis MJ. Does caffeine intake enhance absolute levels of cognitive performance? Psychopharmacology (Berl) 1993;110, 45-52.
Jones GM, Sahakian BJ, Levy R, Warburton DM, Gray JA. Effects of acute subcutaneous nicotine on attention, information processing and short-term memory in Alzheimer’s disease. Psychopharmacology. (Berl.) 1992;108,485–94.
Jönsson L, Eriksdotter Jönhagen M, Kilander L, Soininen H, Hallikainen M, Waldemar G, Nygaard H, Andreasen N, Winblad B, Wimo A. Determinants of costs of care for patients with Alzheimer''s disease. Int J Geriatr Psychiatry. 2006;21(5):449-59.
Jorm, A. F., Korten, A. E. & Henderson, A. S. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand. 1987;76, 465–479.
Jorm AF. Is depression a risk factor for dementia or cognitive decline? A review. Gerontology. 2000;46:219–27.
Kalmijn S, Foley D, White L, Burchfiel CM, Curb JD, Petrovitch H, Ross GW, Havlik RJ, Launer LJ. Metabolic cardiovascular syndrome and risk of dementia in Japanese-American elderly men. The Honolulu-Asia aging study. Arterioscler Thromb Vasc Biol. 2000;20(10):2255-60.
Kalmijn S, van Boxtel MP, Verschuren MW, Jolles J, Launer LJ. Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age. Am J Epidemiol. 2002 Nov 15;156(10):936-44.
Kaplan GA, Camacho T. Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol 1983;117:292-304.
Kawas C, Gray S, Brookmeyer R, et al. Age-specific incidence rates of Alzheimer’s disease: the Baltimore Longitudinal Study of Aging. Neurology 2000;54:2072–7.
Kelman HR, Thomas C, Kennedy GJ, Cheng J. Cognitive impairment and mortality in older community residents. Am J Public Health. 1994;84(8):1255-60.
Kilander L, Nyman H, Boberg M, Lithell H. The association between low diastolic blood pressure in middle age and cognitive function in old age: a population-based study. Age Ageing 2000;29: 243–48.
Kramer AF, Hahn S, Cohen NJ, Banich MT, McAuley E, Harrison CR, Chason J, Vakil E, Bardell L, Boileau RA, Colcombe A. Ageing, fitness and neurocognitive function. Nature 1999; 400: 418–19.
Kukull WA, Higdon R, Bowen JD, McCormick WC, Teri L, Schellenberg GD, van Belle G, Jolley L, Larson EB. Dementia and Alzheimer disease incidence: a prospective cohort study. Arch Neurol. 2002;59(11):1737-46.
Kuller LH, Shemanski L, Manolio T, Haan M, Fried L, Bryan N, Burke GL, Tracy R, Bhadelia R. Relationship between ApoE, MRI findings, and cognitive function in the Cardiovascular Health Study. Stroke 1998; 29: 388–98.
Kuo HK, Sorond F, Iloputaife I, Gagnon M, Milberg W, Lipsitz LA. Effect of blood pressure on cognitive functions in elderly persons. J Gerontol A Biol Sci Med Sci 2004; 59: 1191–94.
Kwok T, Tang C, Woo J, Lai WK, Law LK, Pang CP. Randomized trial of the effect of supplementation on the cognitive function of older people with subnormal cobalamin levels. Int J Geriatr Psych 1998;13:611-6.
Landin K, Blennow K, Wallin A, Gottfries CG. Low blood pressure and blood glucose levels in Alzheimer’s disease: evidence for a hypometabolic disorder? J Intern Med 1993; 233: 357–63.
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.
Launer LJ. Demonstrating the case that AD is a vascular disease: epidemiologic evidence. Ageing Res Rev 2002; 1: 61–77.
Lerner A J. Alzheimer’s disease in males: endocrine issues and prospects. J Clin Endocrinol Metab 1999;84, 3416–9.
Lin RT, Lai CL, Tai CT, Liu CK, Yen YY, Howng SL. Prevalence and subtypes of dementia in southern Taiwan: Impact of age, sex, education and urbanization. J Neurol Sci. 1998;160:67-75
Li S, Yan F, Li G, Chen C, Zhang W, Liu J, Jia X, Shen Y. Is the dementia rate increasing in Beijing? Prevalence and incidence of dementia 10 years later in an urban elderly population. Acta Psychiatr Scand. 2007;115(1):73-9.
Lin RT, Liu CK, Lai CL, Tai CT, Howng SL. Patterns of mortality from dementia associated with stroke in southern Taiwan. Acta Neurol Taiwan, 1999; 8, 201.
Lindsay, J., Hebert, R. & Rockwood, K. The Canadian Study of Health and Aging – Risk Factors for Vascular Dementia. Stroke. 1997;28, 526–530.
Liu CK, Hong SL, Ueng TS. Dementia in the general hospital of Taiwan-A prospective study. Kaohsiung J Med Sci. 1992;8:290-8.
Liu CK, Lai CL, Tai CT, Lin RT, Yen YY, Howng SL. Incidence and subtypes of dementia in southern Taiwan: impact of socio-demographic factors. Neurology. 1998 ;50(6):1572-9.
Liu HC, Lin KN, Teng EL, Wang SJ, Fuh JL, Guo NW, Chou P, Hu HH, Chiang BN. Prevalence and subtypes of dementia in Taiwan: a community survey of 5297 individuals. J Am Geriatr Soc. 1995;43(2):144-9.
Liu HC, Fuh JL, Wang SJ, Liu CY, Larson EB, Lin KN, Wang HC, Chou P, Wu ZA, Lin CH, Wang PN, Teng EL. Prevalence and subtypes of dementia in a rural Chinese population. Alzheimer Dis Assoc Disord. 1998 ;12(3):127-34.
Llinàs-Regla J, López-Pousa S, Vilalta-Franch J, Garre-Olmo J, Román GC. Mortality after a diagnosis of dementia in a population aged 75 and over in Spain. Neuroepidemiology. 2008;31(2):80-8.
Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, Copeland JR, Dartigues JF, Jagger C, Martinez-Lage J, Soininen H, Hofman A. Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology. 2000; 54(11 Suppl 5): S4-9
Loeb C, Gandolfo C, Croce R, Conti M. Dementia associated with lacunar infarction. Stroke. 1992; 23, 1225–9.
Logroscino G, Kang JH, Grodstein F. Prospective study of type 2 diabetes and cognitive decline in women aged 70-81 years. BMJ. 2004;328(7439):548.
Lopez OL, Boller F, Becker JT, Miller M, Reynolds CF 3rd. Alzheimer''s disease and depression: neuropsychological impairment and progression of the illness.Am J Psychiatry. 1990;147(7):855-60.
Luchsinger JA, Mayeux R. Dietary factors and Alzheimer’s disease. Lancet Neurol 2004; 3:579–587.
McCallum J, Shadbolt B, Wang D. Self-related health and survival: a 7-yaer follow-up study of Australian elderly. Am J Pub Health 1994;84:1100-5.
McCullagh CD, Craig D,McIlroy SP, Passmore AP. Risk factors for dementia. Adv Psychiatr Treat. 2001;7: 24–31
Miech RA, Breitner JC, Zandi PP, et al. Incidence of AD may decline in the early 90s for men, later for women: the Cache County study. Neurology 2002;58:209–18.
Mielke MM, Zandi PP, Sjogren M, et al. High total cholesterol levels in late life associated with a reduced risk of dementia. Neurology 2005; 64:1689–1695.
Morris MC, Evans DA, Bienias JL, et al. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol 2003;60:940-6.
Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Aggarwal N, Wilson RS, Scherr PA. Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA 2002;287:3230-7.
Mukamal KJ, Kuller LH, Fitzpatrick AL, Longstreth WT Jr, Mittleman MA, Siscovick DS. Prospective study of alcohol consumption and risk of dementia in older adults. JAMA 2003;289: 1405-13.
Munoz D, Ganapathy G, Eliasziw M, Hachinski V. Educational attainment and socioeconomic status of patients with autopsy-confirmed Alzheimer disease. Arch Neurol 2000;57:85–9.
Newman AB, Fitzpatrick AL, Lopez O, Jackson S, Lyketsos C, Jagust W, Ives D, Dekosky ST, Kuller LH. Dementia and Alzheimer’s disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort. J Am Geriatr Soc 2005; 53:1101–1107.
Orgogozo JM, Dartigues JF, Lafont S, Letenneur L, Commenges D, Salamon R, Renaud S, Breteler MB. Wine consumption and dementia in the elderly: a prospective community study in the Bordeaux area. Rev Neurol (Paris) 1997;153:185-192.
Panza F, Solfrizzi V, Colacicco AM, D''Introno A, Capurso C, Torres F, Del Parigi A, Capurso S, Capurso A.Mediterranean diet and cognitive decline. Public Health Nutr. 2004 ;7(7):959-63.
Pappolla MA, Bryant-Thomas TK, Herbert D, Pacheco J, Fabra Garcia M, Manjon M, Girones X, Henry TL, Matsubara E, Zambon D, Wolozin B, Sano M, Cruz-Sanchez FF, Thal LJ, Petanceska SS, Refolo LM. Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology. Neurology. 2003;61(2):199-205.
Pearson JL, Teri L, Reifler BV, Raskind MA.Functional status and cognitive impairment in Alzheimer''s patients with and without depression. J Am Geriatr Soc. 1989 ;37(12):1117-21.
Peila R, Rodriguez BL, Launer LJ; Honolulu-Asia Aging Study. Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies: The Honolulu-Asia Aging Study. Diabetes. 2002;51(4):1256-62.
Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975; 23, 433-41.
Ptok U, Papassotiropoulos A, Maier W, et al. Advanced parental age: a risk factor for Alzheimer’s disease or depression in the elderly? Int Psychogeriatr 2000;12:445–51.
Purandare N, Burns A, Daly KJ, Hardicre J, Morris J, Macfarlane G, McCollum C. Cerebral emboli as a potential cause of Alzheimer’s disease and vascular dementia: case-control study. BMJ 2006;332:1119–1124.
Qiu C, von Strauss E, Fastbom J, Winblad B, Fratiglioni L. Low blood pressure and risk of dementia in the Kungsholmen Project: a 6-year follow-up study. Arch Neurol 2003; 60: 223–28.
Qiu C, Winblad B, Marengoni A, Klarin I, Fastbom J, Fratiglioni L. Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study. Arch Intern Med 2006;166:1003–1008.
Ravaglia G, Forti P, Maioli F, Sacchetti L, Mariani E, Nativio V, Talerico T, Vettori C, Macini PL. Education, occupation, and prevalence of dementia: findings from the Conselice study. Dement Geriatr Cogn Disord. 2002;14(2):90-100.
Radloff LS. The CES-D Scale: a self-report depression scale for researchin the general population. Appl Psychol Meas. 1977;1:385-401
Rice DP, Fox PJ, Max W, Webber PA, Lindeman DA, Hauck WW. The economic burden of Alzheimer’s disease care. Health Aff (Millwood) 1993;12:164–76.
Ritchie K, Kildea D. Is senile dementia "age-related" or "ageing-related"?--evidence from meta-analysis of dementia prevalence in the oldest old. Lancet. 1995;7;346(8980):931-4.
Rocca W, Cha R, Waring S, Kokmen E. Incidence of dementia and Alzheimer’s disease: a reanalysis of data from Rochester, Minnesota, 1975–1984.Am J Epidemiol 1998;148:51–62.
Román GC. Vascular dementia prevention: a risk factor analysis. Cerebrovasc Dis. 2005;20 Suppl 2:91-100.
Ruitenberg A, Ott A, van Swieten JC, Hofman A, Breteler MM. Incidence of dementia: does gender make a difference? Neurobiol Aging. 2001;22(4):575-80.
Ruitenberg A, van Swieten JC, Witteman JC, Mehta KM, van Duijn CM, Hofman A, Breteler MM. Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet 2002;359:281-6.
Saha S, Barnett AG, Foldi C, Burne TH, Eyles DW, Buka SL, McGrath JJ. Advanced paternal age is associated with impaired neurocognitive outcomes during infancy and childhood. PLoS Med. 2009;10;6(3):e40.
van der Flier WM, Scheltens P. Epidemiology and risk factors of dementia. J Neurol Neurosurg Psychiatry. 2005 Dec;76 Suppl 5:v2-7.
Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol 2006; 59:912–921.
Schnaider-Beeri M, Goldbourt U, Silverman JM, Noy S, Schmeidler J, Ravona- Springer R, Sverdlick A, Davidson M. Diabetes mellitus in midlife and the risk of dementia three decades later. Neurology. 2004; 63:1902-07
Shadlen MF, Siscovick D, Fitzpatrick AL, et al. Education, cognitive test scores, and black-white differences in dementia risk. J Am Geriatr Soc 2006;54:898–905.
Shumaker SA, Legault C, Rapp SR, Thal L, Wallace RB, Ockene JK, Hendrix SL, Jones BN 3rd, Assaf AR, Jackson RD, Kotchen JM, Wassertheil-Smoller S, Wactawski-Wende J; WHIMS Investigators. Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: the Women''s Health Initiative Memory Study: a randomized controlled trial. JAMA. 2003 ;289(20):2651-62.
Sjögren M, Mielke M, Gustafson D, Zandi P, Skoog I. Cholesterol and Alzheimer''s disease--is there a relation? Mech Ageing Dev. 2006;127(2):138-47.
Solfrizzi V, Capurso C, Panza F. Adherence to a Mediterranean dietary pattern and risk of Alzheimer''s disease. Ann Neurol. 2006;60(5):620
Stern Y, Albert S, Tang M, Tsai W. Rate of memory decline in AD is related to education and occupation: cognitive reserve? Neurology 1999;53:1942–7.
Stewart, R., Prince, M. & Mann, A. Vascular risk factors and Alzheimer’s disease. Aust N Z J Psychiatry, 1999;33, 809–813.
Stewart R, White LR, Xue QL, Launer LJ. Twenty-six-year change in total cholesterol levels and incident dementia: the Honolulu-Asia Aging Study. Arch Neurol 2007; 64:103–107.
Strawbridge WJ, Deleger S, Roberts RE, Kaplan GA. Physical activity reduces the risk of subsequent depression for older adults. Am J Epidemiol 2002; 156: 328–34.
Swan GE, DeCarli C, Miller BL, Reed T, Wolf PA, Jack LM, Carmelli D. Association of midlife blood pressure to late-life cognitive decline and brain morphology. Neurology 1998; 51: 986–93.
Swan GE, Lessov-Schlaggar NL. The effects of tobacco smoke and nicotine on cognition and the brain. Neuropsychol. Rev. 2007;17: 259–73.
Tatemichi, T. K., Desmond, D. W., Mayeux, R. Paik M, Stern Y, Sano M, Remien RH, Williams JB, Mohr JP, Hauser WA. Dementia after stroke: baseline frequency, risks, and clinical features in a hospitalized cohort. Neurology. 1992; 42, 1185–1193.
Tang WK, Chan SS, Chiu HF, Ungvari GS, Wong KS, Kwok TC, Mok V, Wong KT, Richards PS, Ahuja AT. Frequency and determinants of poststroke dementia in Chinese. Stroke. 2004;35(4):930-5.
Tyas SL. Are tobacco and alcohol use related to Alzheimer’s disease? A critical assessment of the evidence and its implications. Addict. Biol. 1996;1: 237–54.
van der Flier WM, Scheltens P. Epidemiology and risk factors of dementia. J Neurol Neurosurg Psychiatry. 2005;76 Suppl 5:v2-7.
Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G, Ambrose AF, Sliwinski M, Buschke H. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003; 348: 2508–16.
Wang CC, Lu TH, Liao WC, Yuan SC, Kuo PC, Chuang HL, Lee MC, Yen CH. Cigarette smoking and cognitive impairment: A 10-year cohort study in Taiwan. Arch. Gerontol. Geriatr. (2009), doi:10.1016/j.archger.2009.09.041
Wannamethee SG, Shaper AG, Alberti KG. Physical activity, metabolic factors, and the incidence of coronary heart disease and type 2 diabetes. Arch Intern Med 2000; 160: 2108–16.
Ward MA, Carlsson CM, Trivedi MA. Sager MA, Johnson SC. The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study. BMC Neurol 2005; 5: 23.
Whitmer RA, Sidney S, Selby J, Johnston SC, Yaffe K. Midlife cardiovascular risk factors and risk of dementia in late life. Neurology 2005; 64: 277–81.
Wilson RS, Mendes De Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, Bennett DA. Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA 2002; 287: 742–48.
Wolozin B, Wang SW, Li NC, et al. Simvastatin is associated with a reduced incidence of dementia and Parkinson’s disease. BMC Med 2007;5:20.
Xu W, Qiu C, Winblad B, Fratiglioni L. The effect of borderline diabetes on the risk of dementia and Alzheimer''s disease. Diabetes. 2007;56(1):211-6.
Xu G, Liu X, Yin Q, Zhu W, Zhang R, Fan X. Alcohol consumption and transition of mild cognitive impairment to dementia. Psychiatry Clin Neurosci 2009;63:43–9.
Yaffe K, Barnes D, Nevitt M, Lui LY, Covinsky K. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med 2001; 161: 1703–08.
Yasar S, Corrada M, Brookmeyer R, Kawas C. Calcium channel blockers and risk of AD: the Baltimore Longitudinal Study of Aging. Neurobiol Aging 2005; 26: 157–63.
Yen YC, Rebok GW, Yang MJ, Lung FW. A multilevel analysis of the influence of Apolipoprotein E genotypes on depressive symptoms in late-life moderated by the environment.Prog Neuropsychopharmacol Biol Psychiatry 2008;32, 479–86.
Yip PK, Shyu YI, Liu SI, Lee JY, Chou CF, Chen RC. An epidemiological survey of dementia among elderly in an urban district of Taipei. Acta Neurologica Sinica. 1992;1:347-54.
Zhang ZX, Zahner GE, Román GC, Liu J, Hong Z, Qu QM, Liu XH, Zhang XJ, Zhou B, Wu CB, Tang MN, Hong X, Li H. Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu. Arch Neurol. 2005;62(3):447-53.
Zec RF, Trivedi MA. Effects of hormone replacement therapy on cognitive aging and dementia risk in postmenopausal women: a review of ongoing large-scale, long-term clinical trials. Climacteric. 2002;5(2):122-34.
Zunzunegui MV, Alvarado BE, Del Ser T, Otero A. Social networks, social integration, and social engagement determine cognitive decline in community-dwelling Spanish older adults. J Gerontol B Psychol Sci Soc Sci 2003; 58: S93–100.


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