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Italian Multicentre Study on Dementia (Dre. Rocca and Lippi), SMID Centre, Florence; Istituto Nazionale di Riposo e Cura per Anziani (INRCA) (Drs. Bonaiuto, Luciani, and Turtù), Istituto di Ricerca a Carattere Scientifico, Appignano (Macerata); Department of Biostatistics and Epidemiology (Dr. Cavarzeran), Fidia, Abano Terme (Padua); and Department of Neurology and Psychiatry (Dr. Amaducci), University of Florence, Florence, Italy.
The purpose of this study was to investigate the prevalence of dementia in an Italian population using a door-to-door 2-phase design. As part of a social and health survey, we administered the Hodkinson abbreviated mental test to all persons over age 59 residing in the Commune of Appignano on January 1, 1987 (N = 778). We then investigated all subjects scoring 7 or less on the cognitive test following a standardized diagnostic protocol. We found 48 patients affected by dementia, yielding a crude prevalence ratio (cases per 100 population over age 59) of 6.2; prevalence ratios were 2.6 for Alzheimer's disease, 2.2 for multi-infarct dementia, 0.8 for mixed dementia, 0.4 for secondary dementia, and 0.3 for unspecified dementia. Age- and sex-specific prevalence ratios increased steeply with age and were consistently higher in women for Alzheimer's disease and in men for dementia of all types and multi-infarct dementia. Alzheimer's disease was slightly more frequent than multi-infarct dementia; however, the most common type of dementia varied across age groups. Most cases of Alzheimer's disease were sporadic and had a late age of onset. Comparison with other populations suggests that dementia of all types is as frequent in Appignano as elsewhere, and that Alzheimer's disease might be more frequent in rural than in urban populations.
Address correspondence and reprint requests to Dr. Walter A. Rocca, Centro SMID, Viale Morgagni 2/B, 50134 Firenze, Italy.
Supported by the Istituto Nazionale di Riposo e Cura per Anziani (INRCA), Istituto di Ricerca a Carattere Scientifico—Grant No. 1033 of June 16, 1988. Research was facilitated by collaboration with the Amministrazione comunale di Appignano (Appignano municipal administration) and the Unità Sanitaria Locale N. 15 della Regione Marche (Local Health Unit no. 15 of the Marche region).
Presented in part at the 41st annual meeting of the American Academy of Neurology, Chicago, IL, April 1989.
Received May 31, 1989. Accepted for publication in final form September 5, 1989.
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