| Objective:To understand the proportion of dementia treatment and dementia subtype of neurology clinic patients over 55 years of age and investigate the clinical characteristics of the dementia subtypes; On this basis, understanding of APOE gene associated with Alzheimer's disease; To understand dementia of the economy cost situation.Methods: To select our hospital neurology clinic patients from September 25,2009 to December 25,2009 and take questionnaire survey, the elderly cognitive decline insiders questionnaire (IQCODE) score of more than 3.3 points into the mini-mental state of patients Scale (MMSE) screening, MMSE in patients with abnormal re-entering the Clinical Dementia Rating Scale (CDR) scale for blood tests to detect APOE gene. Single-factor analysis of variance of the clinical characteristics of subtypes of dementia were compared and analyzed, and tested with the Levene test of homogeneity of variance; with LSD-t for both the number of pairwise comparison; usingχ2 test for APOE gene frequency analysis.Results:A total of 14,286 out-patient department of neurology, of which over 55 years patients were 1056 cases. The total number of 40 cases dementia, accounting for over 55 years the proportion of the total number of patients was 3.79%, of which Alzheimer's disease (AD) 21 cases, accounting for 1.99%; vascular dementia (VD) 10 cases, accounting for 0.95%; 5 cases of mixed dementia, accounting for 0.47%; 2 cases of frontotemporal dementia, accounting for 0.19%; other types of dementia (1 case of dementia caused by brain trauma and 1 case of mental illness) 2 cases, accounting for 0.19%. In all patients, AD accounted for 52.5%, VD accounted for 25%,12.5% mixed dementia, frontotemporal dementia accounted for 5%, other types of dementia (dementia caused by brain trauma and mental illness) accounted for 5%. AD and VD patients showed a comprehensive cognitive impairment。in the memory area:Immediate memory and delayed memory impairment of AD and mixed dementia are heavy, long-delayed recognition can't be improved; and immediate memory, delayed memory impairment of VD are relatively light, long delay can improve recognition significantly.In the directional force, common sense and calculation, ADL, etc., AD,VD,and mixed dementia were not different; early AD patients prone to depression, in the late AD, VD, mixed dementia patients prone to hallucinations, paranoia and other mental symptoms. In the visual space, AD were heavier than the VD. APOE gene analysis:AD group and the non-AD group,ε3/3 genotype frequency maximum,ε3/4 andε2/3 type followed,ε4/4 and e2/4 type at least.ε3/4 genotype than non-AD Group AD Group, frequencies were 28.57% and 12.73%(χ2=15.68, P <0.05). s3/3 genotype frequency of AD group than non-AD group were 52.38% and 65.45%(χ2=5.36, P<0.05). ApoEε4 allele frequency in the AD group and the non-group were 21.43% and 10%. The economic cost of dementia cases are￥1000-2000 per month.Conclusion:In our hospital's neurology clinic patients over the age of 55, AD share of visits compared to 1.99%, VD accounted for 0.95%,0.47% mixed dementia, frontotemporal dementia, accounting for 0.19%, other types of dementia (brain injury and mental illness induced dementia) accounted for 0.19%, the proportion of dementia subtypes AD accounted for 52.5%, VD,25%, 12.5% mixed dementia, frontotemporal dementia,5%, other types of dementia (dementia caused by brain trauma and mental illness) accounted for 5%. AD and mixed dementia occurs in patients with early memory impairment, memory impairment was more serious than VD; early AD patients prone to depression, in the late AD, VD and mixed dementia patients prone to hallucinations, paranoia and other psychotic symptoms. In the visual space AD is more important than VD patients. AD and APOE4 gene showed significant correlation. Economic costs of dementia monthly high. |
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