台灣一個失智症門診的早發性與晚發性失智症比率研究：林新失智症登錄計畫的首次報告

Frequency of Early and Late-onset Dementias in a Taiwanese Dementia Clinic: First Report on the Lin-Shin Dementia Registry Project

背景：隨著對非阿茲海默類型失智症的逐漸重視與了解，台灣不同失智症的類型比率需要再重新調查研究。在台灣失智症的研究之中，早發性與晚發性失智症的類型也未曾比較。方法：所有參加登錄計畫的病患都接受結構性的面談，內容包括基本資料、臨床病史詢問、神經心理檢查、睡眠評估與神經精神症狀評估。本研究的結果為分析登錄計畫中的早發性與晚發性失智症的類型分布與比較。結果：自2009至2011年，總共968位病患參加了這項計畫，其中795位符合失智症診斷。在全部失智病患之中，最常見的是阿茲海默症（47.5%），其次是血管性失智症（19.0%），路易氏體失智症（16.6%），巴金森病失智症（8.1%），額顳型失智症（4.2%），及正常腦壓性水腦症（1.4%）。超過60%的額顳型失智症病患屬於早發型（病發小於65歲）；相反的超過80%以上的其他類型失智症病患屬於晚發型（病發大於等於65歲）。結論：本研究調查常見失智症的比率與西方國家的研究類似，路易氏體失智症在本研究的比率高於大部分亞洲其他國家的近期研究。

Objectives: The frequency of dementia subtypes in Taiwan need to be resurveyed in light of the increased awareness and recognition of non-Alzheimer type dementias. Early- and late-onset dementias have not been compared among Taiwanese patients with dementia. Methods: All patients participating in the Lin- Shin dementia registry project were required to complete a structured interview form every six months to record their basic data, clinical history, neuropsychological tests, sleep quality, and neuropsychiatric symptoms. In the current study, basic demographic characteristics of participants were summarized, and subtypes of dementia were compared between early- and late-onset patients. Results: From February 1, 2009 to January 31, 2011, a total of 968 patients was investigated; 795 patients fulfi lled the criteria for dementia and 173 patients were not demented. Among all the patients under study (n = 795), Alzheimer’s disease (AD, n = 378, 47.5%) was the most prevalent cause of dementia, followed by vascular dementia (VaD, n = 151, 19.0%), Dementia with Lewy bodies (DLB, n = 132, 16.6%), Parkinson’s disease with dementia (PDD, n = 64, 8.1%), frontotemporal lobar degeneration (FTLD, n = 33, 4.2%), normal pressure hydrocephalus (NPH, n = 11, 1.4%), and other dementia/undetermined dementia (OD/UD, n = 26, 3.3%). More than 60 percent of FTLD patients were early onset (< 65 years); on the other hand, more than 80 percent of AD, VaD, DLB, PDD, and NPH were late onset (? 65 years). Conclusion: The frequency of AD, DLB, PDD, VaD in our subjects are similar to the fi ndings in several Western countries; but the frequency of DLB is higher than most of the recent clinical studies in Asian countries. The results of this study remind clinicians of paying attention to the high frequency of non-AD degenerative dementias and to the potential difference of treatment among patients with AD and non-AD dementias.