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Korean Journal of Preventive Medicine 1999;32(3): 306-316.
Prevalence of Dementia in the Elderly of an Urban Community in Korea .
Dong Hyun Kim, Duk L Na, Byeon Gil Yeon, Yeonwook Kang, Kyung Bok Min, Soo Hyun Lee, Sang Suk Lee, Mi Ra Lee, Ok Jung Pyo, Chan Byung Park, Sunmean Kim, Sang Soo Bae
1Department of Social and Preventive Medicine, Hallym University College of Medicine, Korea.
2Department of Neurology, Sungkyunkwan University College of Medicine, Korea.
3Department of Psychiatry, Hallym University College of Medicine, Korea.
4Department of Neurology, Samsung Medical Center, Korea.
5Kwangmyung Health Center, Korea.
ABSTRACT
OBJECTIVES: In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. METHODS: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase I, 356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. RESULTS: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12.8%(age-adjusted rate: 13.0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.6-10.4%]). The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. CONCLUSIONS: These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.
Key words: Dementia; Prevalence; Alzheirmer's disease; Vascular dementia; Cross-sectional survey
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