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目的 描述北京市城乡两社区≥65岁老人老年期痴呆发病率及人群和城乡分布特征,并探讨发病的危险因素.方法 该研究为国际10/66痴呆协作研究5年随访研究的中国区域调查部分内容.研究采用一阶段痴呆研究方法,于2009年至2010年间对北京市西城区和大兴区2025名≥65岁的非痴呆老人进行随访,根据国际10/66标准进行痴呆诊断,并采用Cox比例风险回归模型进行危险因素的分析.结果 新发老年期痴呆病例173例,5年累积发病率为8.54％,平均年发病率为1.77％(95％可信区间:1.47 ～1.97).多因素Cox回归模型分析结果显示,高龄、吸烟、腰臀比大和脑卒中病史是老年期痴呆的危险因素(均P＜0.001或＜0.05),体育锻炼是保护因素(P =0.003).结论 北京市城乡两社区老年期痴呆发病率高于以往调查结果,控制吸烟、防治脑卒中和提倡体育锻炼可以降低老年期痴呆的发病危险.“,”Objective To describe the incidence in population and urban-rural distribution of dementia in elderly people aged 65 years and over in two communities in Beijing and to explore potential psychosocial and cardiovascular risk factors of dementia.Methods This 5-year follow-up study was a part of the 10/66 dementia study.Two thousands and twenty five non-dementia people aged 65 years and over in Xicheng District (urban) and Daxing District (rural) of Beijing were followed up during February,2009 to March,2010.The study was a comprehensive one-stage survey and diagnosis of dementia was based on 10/66 dementia criteria.Measurements included the Community Screening Interview for Dernentia,Geriatric Mental State-B3 version,Background Socio-demographic and Risk factor Questionnaire including self-report chronic diseases,Informant Interview Questionnaire,and physical examinations.Cox proportional hazard regression model was conducted to explore potential risk factors.Results One hundred and seventy three incident dememia patients were identified.The 5-year cumulative incidence rate of dementia was 8.54％ aud the average annual incidence rate was 1.77％.The rates increased consistently with aging.The incidence of dementia was higher in female than that in male,and the difference was statistically significant (2.00％ vs.1.42％,P ＜ 0.01).The incidence of dementia among lower education level group was higher than those in higher level groups,and different marriage statuses had significantly different incidence of dementia (P ＜ 0.01).The incidence difference between urban and rural communities was not statistically significant.Multivariate Cox regression model showed that older age,smoking,bigger waist hip ratio and stoke history were risk factors of dementia,and physical exercise was protective factor of dementia.Conclusions The incidence of dementia in the study is higher than those in previous studies.It should be advocated to reduce smoking,prevent and treat stroke,and exercise physically in order to decrease risk of dementia.