The Newly Diagnosed Amnestic Disorders and Dementia: A Nationwide, Cohort Study in Taiwan

新診斷失憶症與失智症：一項全國性之世代研究

高廉程(Lien-Cheng Kao)；簡戊鑑(Wu-Chien Chien)；鍾其祥(Chi-Hsian Chung)；葉慧雯(Hui-Wen Yeh)；周雨青(Yu-Ching Chou)；黃三原(San-Yuan Huang)；葉啟斌(Chin-Bin Yeh)；張勳安(Hsin-An Chang)；高譽誠(Yu-Chen Kao)；江瑋珊(Wei-Shan Chiang)；葉奕緯(Yi-Wei Yeh)；曾念生(Nian-Sheng Tzeng)

amnestic disorders ； dementia ； National Health Research Institute Database ； cohort study ； 失憶症 ； 失智症 ； 全民健保資料庫 ； 世代研究

台灣精神醫學

32卷1期（2018 / 03 / 01）

18 - 28+i

英文

Objective: We intended to study the association between the newly diagnosed amnestic disorders and dementia. Methods: We used a subset of Taiwan’s National Health Research Institute Database, containing one million randomly sampled subjects to identify 5,396 patients aged ≥ 20 years without a history of amnestic disorders. We enrolled 1,349 patients with newly diagnosed amnestic disorders, and propensity score-matched 4,047 controls for age, gender, demographic covariates, Charlson comorbidity index, and index-date at a ratio of 1: 3. After adjusting for confounding factors, we used Fine and Gray’s competing risk survival analysis to compare the risk of developing dementia of the two groups during a 10-year follow-up. Results: Of the study subjects, 440 in 1,349 (32.62%) developed dementia compared to 155 in 4,047 (3.83%) of the controls. The study subjects were significantly to develop dementia (hazard ratio = 17.536, 95% confidence interval = 14.487 - 21.226, p ＜ 0.001). After adjusting for confounding factors, the HR for dementia was 16.531 (95% CI =13.611 - 20.078), which also significantly different (p ＜ 0.001). Amnestic disorders were significantly associated with the increased risk of Alzheimer, vascular, senile and pre-senile, and alcoholic types of dementia (all p ＜ 0.001) Conclusion: The patients with newly diagnosed amnestic disorder had a 16-fold increased risk of developing dementia.

目的：探討新診斷失憶症與失智症之關聯性。方法：我們使用全民健保資料庫之百萬歸人檔，辨識出 5,396 位年齡 20 歲以上且無過去失憶症病史之研究組病人。其中，1,349 位為新診斷失憶症病人，依據年齡、性別、人口學變項、查爾森共病指數及指標日期等變項，以傾向分數進行配對，依1：3 之比例，取得4,062 位為對照組。以范—葛瑞二氏競爭風險存活分析比較10 年追蹤期間兩組發生失智症之風險。結果：個案組中，1,349 位病人有440 位(32.62%) 出現失智症而控制組中4,047 位病人有155 位 (3.83%) 出現失智症。競爭風險存活分析呈現研究組個案有顯著的較高風險出現失智症 (hazard ratio = 17.536, 95% confidence interval= 14.487 - 21.226, p ＜ 0.001)。經過性別、年齡、月收入、都市化程度、居住區域及共伴疾病之校正後，其出現顯著的失智症之風險比為 17.222 (95% CI = 13.611 - 20.078)，而且也有顯著的高風險性 (p ＜ 0.001)。結論：新診斷失憶症之病人出現失智症之風險為16 倍。

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