A cross-sectional prevalence study of Parkinson's disease in China was undertaken in 1997-98. We assessed 29?454 residents aged > or =55 years from 79 rural and 58 urban communities in Beijing, Xian, ...and Shanghai, who were selected through stratified, multistage, cluster sampling. With a standardised diagnostic protocol, we identified 277 people with the disease. Prevalence of Parkinson's disease for those aged > or =65 years was 1.7% (95% CI 1.5-1.9). We estimate that 1.7 million people in China have the disease (aged > or =55 years). Our findings suggest that prevalence of Parkinson's disease in China is similar to that in developed countries.
To characterize sociodemographic variations in the prevalence of AD and VaD in China.
Data were collected in a 1997-1998, cross-sectional, door-to-door prevalence survey of 34,807 community residents ...ages > or =55 years in Beijing, Shanghai, Chengdu and Xian. Initial diagnoses of AD and VaD were assessed by clinicians using standardized protocols, according to the NINCDS-ADRDA and NINDS-AIREN criteria; diagnoses were confirmed after 6 months by repeating neuropsychological evaluations. Prevalence odds ratios were estimated in logistic models adjusting for survey design, age, and other sociodemographic factors.
We identified 732 prevalent cases of AD and 295 cases of VaD. Adjusting for all sociodemographic factors concurrently, prevalence odds of AD and VaD were higher in northern versus southern China. Age trends for AD appeared different in western and eastern China. AD also showed an age-adjusted elevation among women and, in the fully adjusted model, a gender education interaction indicating a female preponderance in the highest education group. North-south variation for VaD was age-dependent. In the fully adjusted model, for AD, widowed had significantly higher prevalence odds; for VaD, widowed persons and minorities had significantly lower prevalence odds; professionals had statistically significant and borderline lower prevalence odds for both VaD and AD; sales-service occupations had significantly lower odds for AD only.
We observed variations in prevalence for AD and VaD in different regions and demographic groups in China that persisted after controlling for potential confounding factors. Sociodemographic factors are probable surrogates for conditions such as lifestyle, environment, comorbidities, and life expectancy.
This study was designed to identify factors associated with service use for child psychopathology in three settings: mental health, general health, and school.
Subjects were 2519 children, 6 to 11 ...years of age, assessed in two cross-sectional Connecticut surveys in the late 1980s. Three groups of variables (sociodemographics, child's illness profile, and parental attitudes) were examined through multivariate logistic regression.
Most sociodemographics showed moderate associations with all settings, although some previously reported effects (e.g. birth order, sibship size) were not observed. Of the illness profile measures, only Child Behavior Checklist total scores predicted use in the final model (odds ratio OR = 1.6, 95% confidence interval CI = 1.1, 2.3). Health problems were associated with increased use in all settings (OR = 1.5, 95% CI = 1.3, 1.9), while academic problems were associated only with increased school service use (OR = 5.2, 95% CI = 3.9, 7.0). Parental belief that the child needed help was most strongly associated with service use (common OR for all settings = 5.3, 95% CI = 4.1, 6.8).
Sociodemographics, parental attitudes, and children's illness profiles independently influence service use for psychopathology in school-aged children.
Prevalences of Alzheimer disease (AD) and vascular dementia (VaD) in China reportedly differ from those in Western countries.
To estimate prevalence of AD and VaD in 4 regions of China.
...Cross-sectional, population-based prevalence survey with a stratified, multistage cluster sampling design.
Rural (n = 99) and urbanized (n = 71) communities of Beijing, Xian, Shanghai, and Chengdu.
A sample of 34 807 community residents (94% of those eligible) 55 years or older.
Participants were screened with the Chinese Mini-Mental State Examination. Those who screened positive (n = 3950) underwent a standardized diagnostic workup. Screening sensitivity was assessed in a 3.3% random sample (n = 1008 of the 30 857 who passed the screening). Diagnoses of AD and VaD were made according to National Institute of Neurological and Communicative Diseases and Stroke-Alzheimer Disease and Related Disorders Association and National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences criteria, respectively. Final diagnoses were made after a 6-month confirmation interval.
We identified 732 AD cases and 295 VaD cases. Prevalence in persons 65 years or older was 3.5% (95% confidence interval, 3.0%-3.9%) for AD and 1.1% (95% confidence interval, 0.9%-1.1%) for VaD. After post hoc correction for negative screening errors, prevalence increased to 4.8% for AD and remained at 1.1% for VaD.
Prevalence of dementia subtypes in China is comparable with that in Western countries.
A central issue in studies of risk factors for childhood psychopathology is utilization of the information obtained about the child's mental health status from multiple informants. In this paper, the ...authors propose a new approach to the analysis of risk factor data when the outcomes are binary ratings (presence/absence of symptoms). This new approach has several attractive features in this setting. The strategy taken is to perform a single analysis using multivariate modeling, in which simultaneous logistic regressions are conducted for the outcomes given by each of several informants. The advantages of this approach include the following: 1) it retains the complete information about case status for each informant; 2) it permits assessment of informant-risk factor interactions as well as "overall" risk factor effects; 3) it provides measures of association between the multiple informants and adjusts for the association between responses in the analysis; and 4) missing data on a subset of respondents can be incorporated in a straightforward way, permitting all subjects with at least one informant to be used in the analysis. To illustrate the methods, the authors present findings on risk factors for measures of "Internalizing" and "Externalizing" behaviors from two surveys using parent and teacher ratings of 6- to 11-year-old children in Connecticut between 1986 and 1989.
In this article we describe a likelihood-based regression model appropriate for analyzing incomplete multivariate binary responses. We focus on "marginal models"; that is, models where the marginal ...mean or expectation of the binary response is related to a set of covariates. The association between the binary responses is modeled in terms of conditional log odds ratios. When the nonresponse mechanism is ignorable, it is not necessary to specify a nonresponse model, and valid inferences can be obtained provided that the likelihood for the responses has been correctly specified. But when the nonresponse mechanism is nonignorable, valid inferences can only be obtained by incorporating a model for nonresponse. An unresolved issue with nonignorable models concerns the identifiability of the parameters. So far, no general and practically useful necessary and sufficient conditions for identifiability are available. Here we suggest some simple procedures for examining the identifiability status of nonignorable models when the response variable is discrete. Finally, we present results for an analysis of multiple informant data from the New Haven Child Survey and the Eastern Connecticut Child Survey.
The association between expressed emotion (EE) and psychiatric disorders was investigated in a community survey of 108 preadolescent children. Results indicated that the two components of EE, ...critical comments and emotional overinvolvement, identified non-overlapping subsets of families and displayed diagnostic specificity. Significantly higher rates of disruptive behavior diagnoses were observed in children of parents who expressed high levels of criticism, while children of parents who expressed high levels of emotional overinvolvement were significantly more likely to have an anxiety disorder when compared to the remaining sample. Findings support the utility of this brief measure of EE in epidemiologic samples.
To assess children's mental health service needs and utilization patterns for a state planning effort, a cross-sectional survey that sampled 822 children aged 6 to 11 of a metropolitan center was ...conducted. When reports of parents and teachers were combined, 38.5% of children were screened to be at risk of psychiatric disturbance. Only 11% of children at risk received treatment in mental health settings, fewer than in schools (37%) or medical settings (13%). The findings illustrate the importance of interagency collaboration and the need to consider reports of parents and teachers and different dimensions of psychopathology in future planning and research.
A cross-sectional prevalence study of Parkinson's disease in China was undertaken in 1997–98. We assessed 29454 residents aged ⩾55 years from 79 rural and 58 urban communities in Beijing, Xian, and ...Shanghai, who were selected through stratified, multistage, cluster sampling. With a standardised diagnostic protocol, we identified 277 people with the disease. Prevalence of Parkinson's disease for those aged ⩾65 years was 1·7% (95% CI 1·5–1·9). We estimate that 1·7 million people in China have the disease (aged ⩾55 years). Our findings suggest that prevalence of Parkinson's disease in China is similar to that in developed countries.
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