Predictive factors on mortality and survival of elderly dementia in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the predictive factors on mortality and survival of elderly dementia in Shanghai.</p><p><b>METHODS</b>Subjects were from people who had been screened in a prevalence survey study from the selected 5 urban and 4 rural communities from 1997 to 1998. Phase I screening was carried out by a brief memory testing with mini-mental state examination. In phase II, those who scored below the cutoff points and 4% of those whose score was in the normal range were interviewed to identify dementia through a set of diagnostic examinations according to the DSM IV criteria. In phase III which was six months later, a follow-up program was conducted for all persons who were involved in phase II to identify those with Alzheimer's dementia (AD) and vascular dementia (VaD) according to NINCDS-ADRDA and NINDA-AIREN criteria and other types of dementia.</p><p><b>RESULTS</b>The mortality of elderly dementia was 6.06/1000 person-years. Compared to nondementia group, the survival rate of dementia group had a decrease of 57% after 40 months of follow-up (P < 0.05). There was no statistical difference between AD and VaD groups. The relative risk of death caused by dementia, AD and VaD were 1.63 (95% CI: 1.42-1.86), 1.71 (95% CI: 1.44-2.03) and 1.45 (95% CI: 1.16-1.82), respectively. Some factors such as age (RR = 1.0685), severalty (RR = 1.5733), and high ADL (RR = 1.0368) might have increased the risk of death among those patients.</p><p><b>CONCLUSION</b>The mortality of elderly dementia in Shanghai was lower than that seen in other areas in the world. There was no obvious difference between the survival rates of AD and VaD patients. Age, severalty and high ADL seemed to be the risk factors to the death outcome.</p>

Evaluation of effectiveness of intervention on risk factors for cerebrovascular disease in three cities of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the effects of community intervention on risk factors of cerebrovascular disease.</p><p><b>METHODS</b>With cluster sampling, 2,586 and 2,723 women and men aged 35 to 74 were selected randomly as intervention cohort and control cohort, respectively, from about 300 thousand community population in Beijing, Shanghai and Changsha, during 1997 to 2000. Their blood pressure, levels of blood lipid, body mass index (BMI) were measured and status of smoking and alcohol consumption were surveyed as indices of evaluation. Health education for smoking quit, alcohol consumption restriction and reinforced treatment for diabetic and hypertensive patients were implemented in the intervention communities. And, 2,544 and 2,533 persons in the two cohorts responded three years after intervention, and then all the indices mentioned above were measure again for them.</p><p><b>RESULTS</b>Average reduction in systolic blood pressure by 3.21 mm Hg and serum level of total cholesterol by 0.58 mmol/L was achieved in intervention cohort after intervention, but with 0.48 mmol/L increase in triglyceride. Average blood levels of both high density lipoprotein-cholesterol (HDL-C) and glucose increased in the two cohorts after intervention, but with 0.30 mmol/L net increase of blood glucose in control cohort. There was no significant difference in average increase of HDL-C between the two cohorts. BMI increased by 0.56 in control cohort, and no significant change in intervention cohort. Proportion of smoking decreased by 5.4% in men and 2.4% in women of intervention cohort, and no change in control cohort.</p><p><b>CONCLUSION</b>Level of risk factors for cerebrovascular disease reduced significantly with community intervention.</p>

A case-control study on the risk factors and other socio-psychological factors of epilepsy / 中华流行病学杂志

<p><b>OBJECTIVE</b>To identify the risk factors and socio-psychological condition of epilepsy in general population.</p><p><b>METHODS</b>A community-based, pair-matched case-control study using the epileptic patients living in Zhujing town, Jinshan district, Shanghai was carried out. Patients were matched for age (+/-1 years) and gender to controls (81 cases and 81 controls). Data was analyzed with multiple conditional logistic regression.</p><p><b>RESULTS</b>As a result of multiple logistic regression, postnatal insults (OR = 6.517), alcohol intake (OR = 10.761) and family history (OR = 5.414) were powerfully associated with epilepsy. Compared with control group, epileptic patients were significantly different in socio-psychological condition, especially in > or = 17 years adult patients.</p><p><b>CONCLUSION</b>Postnatal insults, alcohol intake and family history were the risk factors of epilepsy. Psychological and psychiatric disorders were highly prevalent among epilepsy patients.</p>