A cohort study on mortality and risk of death among population diagnosis as dementia, at base-line survey, in Beijing / 中华流行病学杂志

Objective To study the mortality and risk of death on dementia among ageing population.Methods A random sample including 2788 elderly residents was studied.Dementia was diagnosed under the two-phase procedure in 1997.In phase 1,questionnaire was administered,including the Mini-Mental State Examination (MMSE) tested.In phase 2,all the elderly who showed low MMSE score and some with normal MMSE score,were examined by neurologists.The clinical diagnosis of dementia was set up by two neurologists according to the criteria of DSM- Ⅲ -R and NINCDS-ADRDA.The same sample was followed up in 2000 and 2004 the same way and data on deaths and causes was gathered.The overall time for follow-up was 7.25 years.Results 171 cases with dementia were diagnosed from 2788 subjects in 1997,with a crude death rate(CDR) of dementia was 7.8 per 1000 person-years and age-standardized CDR as 5.5 per 1000 person-years.The death rate was increased exponentially with age.In the dementia group,the total number of deaths was 133,with the CDR as 236 per 1000 person-years and the age-standardized CDR as 206 per 1000 person-years,in the end of the survey.In the non-dementia group,the total number of deaths was 680,with CDR as 40 per 1000 person-years and the age-standardized CDR as 31 per 1000 person-years.The difference in the two groups was statistically significant.The hazard ratio (HR) of dementia death appeared to be the biggest in the 60-74-year group than the other groups.Data was analyzed with the Cox proportional hazards model after making necessary adjustment on potential covariates with the HR of dementia as 2.181 (95％CI:1.751-2.717).The HRs were 2.524 (95％CI:1.964-3.243) in Alzheimer's disease and 1.859 (95％ CI:1.213-2.850) in vascular dementia.Conclusion The CDR and HR of dementia were higher than the non-dementia group in the aging population,showing that dementia was one of the most important risk factors on death in the aging population.

Study on the incidence and risk factors of dementia in elderly residents from communities in Beijing / 中华流行病学杂志

Objective To study the incidence of dementia and its risk factors among the elderly living in the community of Beijing. Methods A sample of 2788 elderly residents from Beijing were investigated regarding the incidence of dementia which was diagnosed using two-stage method in 1997. In the first stage, questionnaire was filled, including MMSE checked up. In the second stage, all the elderly who had lower MMSE score and some with normal MMSE score were examined by neurologists. The clinical diagnosis of dementia was set up by two neurologists according to the criteria of DSM- Ⅲ -R and NINCDS-ADRDA. The same sample was followed up on 2000 and 2004 by the same way, with the overall time for following-up as 7.25 years. Results 171dementias cases were diagnosed among the 2788 elderly in 1997. At the end of the survey, another 180 new cases developed. The average weighted incidence was 0.84/100 person year, adjusted by age (it's same followed), with 0.64/100 person year in males and 1.01/100 person years in females. The incidence of vascular dementia was 0.35/100 person years, with male as 0.39/100 person year and female as 0.32/100 person years. The incidence of dementia was increasing with age, but decreasing with time of education by Multinomial Logistic Regression Analysis. Old age and illiterate appeared to be the risk factors for dementia. People with stroke history and elevated systolic blood pressure were risk factors for vascular dementia. Conclusion The incidence of dementia in the elderly in Beijing was higher than in other areas of China. Old age and illiterate were risk factors for dementia. Being male, illiterate, with stroke history and elevated systolic blood pressure were risk factors for vascular dementia.

Study on the relationship between somatic health and incidence of depression in the elderly / 中华流行病学杂志

<p><b>OBJECTIVE</b>In order to explore the risk factors of geriatric depression, a longitudinal follow-up study was conducted on elderly population living in the community so as to provide evidence for the development of depression prevention and control.</p><p><b>METHODS</b>A sampled population consisting 2506 elderly was selected from urban and rural communities in Beijing, using well-established sampling techniques as cluster, stratification and random selection. Data was collected by trained staff members, using standard survey instruments in 2000 and 2004.</p><p><b>RESULTS</b>Longitudinal study showed that the four-year cumulative incidence of the geriatric depression in Beijing was 10.58%. Difference on were evident intelligence/education, with the rates for illiteracy (15.2%) and primary school (10.5%) significantly higher than that of junior high school and above (5.1%) (chi2 = 26.587, P = 0.000). Rates also varied substantially with place of residence, individuals living in rural areas had a substantially higher rate of depression (15.4%) than those individuals dwelling in urban district (6.1%) (chi2 = 31.163, P = 0.000). Poor self-rated health condition (chi2 = 23.385, P = 0.000), cognitive impairment (chi2 = 11.947, P = 0.001) and limitations in physical functioning (ADL: chi2 = 15.930, P = 0.000; IADL: chi2 = 9.501, P = 0.002) were related to the worsening of depressive symptoms. Results from logistic regression analysis indicated that education level, dwelling area, self-rated health condition and ADL were the independent risk factors.</p><p><b>CONCLUSION</b>Lower educational level, dwelling situation, poor self-rated health condition as well as ADL damage might increase the incidence of depression, suggesting more attention needs to be paid to improve somatic function of elderly in order to decrease the incidence of geriatric depression and to improve the prognosis of the disease and the quality of life.</p>

Study on the isolated systolic hypertension and its prognosis among 2866 elderly residents at the community level in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>We followed a group of community residents above 60 years old to investigate how isolated systolic hypertension (ISH) could influence the prognosis in the long run among the elderly.</p><p><b>METHODS</b>A selected sample of 60 year olds and over from the Beijing residential communities was randomized ascertained to a longitudinal study. Baseline data was collected in 1993 and 11 years later in 2004, the all-cause death, mortality of cardiovascular and cerebrovascular diseases were observed and analyzed.</p><p><b>RESULTS</b>(1) The morbidity of hypertension(HT) was 61.7% and ISH was 27.8% seen in baseline survey while the SBP was increasing with age. (2) The longitudinal study showed that the total mortality and the mortality of cardiovascular and cerebrovascular diseases in HT group were higher than in the normal blood pressure(BP) group. The total mortality in the group ISH was higher than in normal BP group (55.2%: 46.2%; P < 0.01). The mortality OR for group ISH/group normal BP was 1.4 and group DSH/group normal BP was 1.6. The level of SBP was related to prognosis too which showed that the mortality appeared the lowest in 120-139 mm Hg group, and increased when the level of SBP was above 140 mm Hg.</p><p><b>CONCLUSION</b>SBP was an independent risk factor on the all-cause mortality and the mortality of cerebrovascular diseases in eldevly. ISH also appeared a risk factor on the prognosis among the elderly, suggesting that more attention should be paid to it and treatment be carefully addressed.</p>

Effect of Hypertension on Life Quality in Elderly / 中华高血压杂志

Objective To explore the effect of hypertension on the life quality in elderly.Methods A cohort of 1847 elderly in community in Beijing was recruited.Blood pressur,body structural and mental heath,cognition, activity and life satisfaction were evaluated by physical examination,CES-D scale,MMSE,and ADL,IADL scale.Results The life quality of the elderly hypertension was worse than those of normotensive;the morbidi- ties of chronic disease related to hypertension were higher and the cognitive ability worse with the duration of hy- pertension.The prevalence of depression was higher and the vitality was decreased as the rising of blood pres- sure.Conclusion Prevention and control hypertension improve life quality in elderly hypertension.

Study on Depression of Hypertension and Associated Factors in Elderly Population in the Community of Beijing / 中华高血压杂志

Objective To explore the depression status of hypertension and analyze the associated factors in the elderly population in a community of Beijing.Methods This cohort of 1064 elderly people in the community were screened with Centerfor Epidemiology Scale(CES-D). Results Those who lived in rural(21.6% vs city 7.3%),illiterate(19.9% vs literate 11.2%),mateless(19.7% vs mate 12.4%),lower income(21.9% vs high in- come 9.8%),life accidents(23.2% vs without life accidents 8.6%),sleep disorder(31.0% vs sleep good 8.7%) and lower living abilities(26.7% vs high living ability 9.0%)had higher incidence of depression(all P

A comprehansive evaluation on stroke prevalence among elderly in urban and rural areas of Beijing, 2002 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the prevalence and disability of stroke as well as the stroke-related diseases among elderly in urban and rural regions of Beijing.</p><p><b>METHODS</b>In 2002, three communities were selected from urban, suburb and rural regions from Beijing areas, respectively. Twenty percent of the elderly were randomly selected from three communities. The information about history of stroke, hypertension, heart diseases and diabetes, self-rated health (SRH), activity of daily living (ADL) and instrumental ADL (IADL), smoking and drinking habits, knowledge about cardiovascular diseases prevention were collected.</p><p><b>RESULTS</b>A total of 2487 elderly were interviewed and the prevalence of stroke was 12.9% (321/2481). Eighty-seven of the stroke patients were diagnosed by CT/MRI. 19.9% of stroke patients had experienced 2 or more attacks. The highest prevalence of stroke was in the urban region and the lowest in the rural region (16.9% vs. 8.5%, P for trend < 0.01) while it was higher in males than in females (P < 0.05). The prevalence of stroke tended to increase with age in urban and 34.6% of the stroke patients had recovered completely. The proportions of poor SRH, ADL and IADL dependence, as well as the prevalences of hypertension, heart diseases and diabetes were higher among the elderly with stroke than those without. Although rates of awareness and treatment of hypertension were at the high levels among the elderly with stroke , the control rate was low, especially in the rural region (as low as 4.3%). The level of knowledge on the prevention of cardiovascular diseases, and the rates of smoking and drinking were similar between the elderly with or without stroke.</p><p><b>CONCLUSION</b>The prevalence of stroke had increased dramatically during the past decade in Beijing. The proportion of poor SHR, ADL and IADL dependence, prevalence rates of stroke related diseases were higher among the elderly with stroke than those without. Secondary prevention of stroke among Beijing elderly called for urgent action.</p>

Evaluation of predictive effect of some health-related indices on deaths among ageing residents through a 8-years' follow-up study in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the predictive effects of some health status indicators to deaths in the elderly population.</p><p><b>METHODS</b>In 1992, a cohort of 3257 people older than 55 years old was formed from Beijing urban and suburb area. Demographic and information of activity of daily living (ADL), self-rated health (SRH), chronic diseases history and other related variables were collected at baseline survey in 1992. MMSE and CES-D were studied in 2101 on 3257 elderly people. Follow-up surveys were conducted in 1994, 1997 and 2000, to find that a total number of or= 75), resident place (suburb) and education level (illiteracy). The functional disability, poor self-rated health status, history of chronic diseases and abnormal cognition function were the major predictors of deaths. Multinomial logistic regression analysis showed that after adjustment for sex, age, residential place, education level and history of chronic diseases, functional disability, poor self-rated health status and abnormal cognition function remained as significant independent predictors to death.</p><p><b>CONCLUSIONS</b>Functional disability, poor self-rated health status and abnormal cognition function were the most valuable indicators of death. Not only they had joined predictive effects to death, but also remained relatively independent. They had important value in the evaluation on healthy prognosis and the life quality of the elderly.</p>

Study on the relationship between self-rated health situation and health status in the elderly-an 8-year follow-up study from Multidimentional Longitudinal Study of Aging in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the relationship between self-rated health (SRH) and prevalence of chronic diseases, and all-cause mortality in the elderly population.</p><p><b>METHODS</b>In 1992, a cohort of 3257 people > or = 55 years old was selected from Beijing, the information of SRH and other related variables were collected from 3 157 subjects at the baseline survey. Three follow-up surveys were conducted in 1994, 1997 and 2000, respectively.</p><p><b>RESULTS</b>The SRH was influenced by age, gender, marriage status and satisfaction on their own economic condition. Comparing the subjects with excellent SRH, the prevalence rates of chronic diseases, stroke, heart diseases and respiratory system diseases were almost doubled among those with average and poor SRH. By 2000, 993 death occurred. All-cause mortality was negatively associated with SRH, i.e. the risk of death was 12% which was 53% higher for the subjects with average SRH (HR = 1.12, 95% CI: 0.93 - 1.35) and poor SRH (HR = 1.53, 95% CI: 1.25 - 1.88) than those with excellent SRH, respectively. The risks of death from stroke and heart disease were 2.25 (HR = 2.25, 95% CI: 1.67 - 3.04) and 2.22 (HR = 2.22, 95% CI: 1.61 - 3.07) times higher among the subjects with poor SRH than those with excellent SRH respectively. After adjustment for age, gender, resident place, marriage status, education, satisfaction on their own economic condition, seeing doctors or hospitalized within the last 1 year, history of chronic disease, cognition function, body mass index, activities of daily living and depression, as well as deleted the subjects died within first or third year of the baseline survey respectively, poor SRH remained a significantly independent predictor to all-cause death as well as to the death of stroke and heart diseases.</p><p><b>CONCLUSIONS</b>The frequency of poor SRH was influenced by age, gender, marriage status and satisfaction on their own economic condition. Poor SRH was associated with the prevalence of chronic conditions and mortality among the elderly. The findings suggested that SRH might have served as an important indicator in the evaluation on health status among the elderly.</p>