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首页> 外文期刊>International Journal of Environmental Research and Public Health >Population Surveillance of Dementia Mortality
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Population Surveillance of Dementia Mortality

机译：痴呆症死亡率的人口监测

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Geographic and temporal variation in occurrence of dementia within the US has received little attention despite its importance for generation of new etiologic hypotheses and health services research. We examine methodological problems in the use of vital statistics data for assessing variation over time, among states and within states in the US. We analyzed the US multiple cause of death files for 2005–2006 and 1999–2000 US deaths with Alzheimer’s Disease (International Classification of Disease 10th revision code G30) and other dementias (codes F01, F02, R54) coded as underlying or contributing cause of death based on the death certificate. Age-adjusted death rates were computed by year, state or county for persons aged 65 years and over. In 2005–2006 combined, 555,904 total deaths occurred with any dementia type (212,386 for Alzheimer’s disease) coded as underlying or contributing cause. Among the states, age-adjusted rates per 100,000 per year varied by two fold ranging from 458 in New York to 921 in Oregon. Similar geographic patterns were seen for Alzheimer’s disease. However, between 1999–2000 and 2005–2006 the US death rate for all dementia increased only from 559 to 695 (24%) while that for Alzheimer’s disease doubled from 135 to 266. Use of specific (G30, F01) versus non-specific diagnoses (F02, R54) varied among states and over time, explaining most of the temporal increase in rate of Alzheimer’s disease. Further research is needed to assess artifacts of diagnosis, certification or coding, utilization of health services, versus biological variation as possible causes of temporal and geographic variation to enhance utility of mortality data for dementia monitoring and research.
机译：尽管在痴呆症的发生中地理和时间变化对于产生新的病因假说和卫生服务研究很重要，但很少受到关注。我们研究了使用生命统计数据评估美国各州之间以及各州内部随时间变化的方法学问题。我们分析了2005-2006年和1999-2000年美国因阿尔茨海默氏病（国际疾病分类第10版修订代码G30）和其他痴呆症（代码F01，F02，R54）编码的多位死亡原因，这些痴呆是其根本原因或促成原因根据死亡证明书死亡。按年龄，州或县计算的65岁及65岁以上人口的年龄调整死亡率。在2005-2006年期间，被编码为根本原因或诱因的任何痴呆类型（总共痴呆症为212,386）共发生555,904例死亡。在各州中，每10万人每年的年龄调整率变化了两倍，从纽约的458到俄勒冈的921。阿尔茨海默氏病的地理分布也相似。然而，在1999–2000年至2005–2006年期间，美国所有痴呆症的死亡率仅从559增加到695（24％），而阿尔茨海默氏病的死亡率从135增至266翻了一番。各州之间的诊断（F02，R54）随时间而变化，这解释了阿尔茨海默氏病发病率随时间的大部分升高。需要进一步的研究来评估诊断，证明或编码的伪像，卫生服务的利用以及生物变异作为时间和地理变异的可能原因，以提高死亡率数据在痴呆症监测和研究中的效用。

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