認知症の原因の内訳
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a（出典1）：32の研究を調査したSystematic review（平均年齢72.3歳）の内訳
b（出典2）：早期発症（65歳未満）認知症の内訳（オーストラリア）
c（出典3）：早期発症（65歳未満）認知症の内訳（日本）
出典
1:
The reversible dementias: do they reverse?
著者:
A M Clarfield
雑誌名:
Ann Intern Med. 1988 Sep 15;109(6):476-86.
Abstract/Text
Thirty-two studies (2889 subjects) that investigated the prevalence of the causes of dementia were critically reviewed. Particular attention was paid to potential and actual reversibility. Although dementia manifests itself primarily in old age (particularly age 75 and older), the mean age of patients for the studies that reported age data (56%) was 72.3 years. Twenty-five studies originated from secondary or tertiary centers, and four were community-based. Dementias consisted of Alzheimer disease, 56.8%; multi-infarct, 13.3%; depression, 4.5%; alcoholic, 4.2%; and drugs, 1.5%. No single other cause contributed more than 1.6% of the cases. Potentially reversible causes made up 13.2% of all cases. However, the more important question of whether patients with potentially reversible causes were followed and reversal actually seen was not always examined. In 11 studies (34%) that provided follow-up, 11% of dementias resolved, either partially (8%) or fully (3%). The commonest reversible causes were drugs, 28.2%; depression, 26.2%; and metabolic, 15.5%. Due to the presence of various biases (selection, lack of "blinded" investigators, and others) in the surveyed works, it is probable that the true incidence of reversible dementias in the community is even lower than that reported. Research implications as well as a conservative approach to the workup of a new case of dementia are offered.
Ann Intern Med. 1988 Sep 15;109(6):476-8･･･
2:
The diagnosis of young-onset dementia.
著者:
Martin N Rossor, Nick C Fox, Catherine J Mummery, Jonathan M Schott, Jason D Warren
雑誌名:
Lancet Neurol. 2010 Aug;9(8):793-806. doi: 10.1016/S1474-4422(10)70159-9.
Abstract/Text
A diagnosis of dementia is devastating at any age but diagnosis in younger patients presents a particular challenge. The differential diagnosis is broad as late presentation of metabolic disease is common and the burden of inherited dementia is higher in these patients than in patients with late-onset dementia. The presentation of the common degenerative diseases of late life, such as Alzheimer's disease, can be different when presenting in the fifth or sixth decade. Moreover, many of the young-onset dementias are treatable. The identification of causative genes for many of the inherited degenerative dementias has led to an understanding of the molecular pathology, which is also applicable to later-onset sporadic disease. This understanding offers the potential for future treatments to be tailored to a specific diagnosis of both young-onset and late-onset dementia.
Copyright 2010 Elsevier Ltd. All rights reserved.
Lancet Neurol. 2010 Aug;9(8):793-806. do･･･
3:
Prevalence and causes of early-onset dementia in Japan: a population-based study.
著者:
Chiaki Ikejima, Fumihiko Yasuno, Katsuyoshi Mizukami, Megumi Sasaki, Satoshi Tanimukai, Takashi Asada
雑誌名:
Stroke. 2009 Aug;40(8):2709-14. doi: 10.1161/STROKEAHA.108.542308. Epub 2009 May 28.
Abstract/Text
BACKGROUND AND PURPOSE:
Few studies are available that have addressed the prevalence of early-onset dementia (EOD), including early-onset Alzheimer disease and other forms of dementia in Japan.
METHODS:
A 2-step postal survey was sent to all of the 2475 institutions providing medical or care services for individuals with dementia in Japan's Ibaraki prefecture (population, 2 966 000) requesting information on EOD cases. Data were then reviewed and collated.
RESULTS:
We identified 617 subjects with EOD. The estimated prevalence of EOD in the target population was 42.3 per 100 000 (95% CI, 39.4 to 45.4). Of the illnesses that cause EOD, vascular dementia was the most frequent (42.5%) followed by Alzheimer disease (25.6%), head trauma (7.1%), dementia with Lewy bodies/Parkinson disease with dementia (6.2%), frontotemporal lobar degeneration (2.6%), and other causes (16.0%).
CONCLUSIONS:
The prevalence of EOD in Japan appeared to be similar to that in Western countries with the notable exception that vascular dementia was the most frequent cause of EOD in Japan.
Stroke. 2009 Aug;40(8):2709-14. doi: 10.･･･
