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A cross-sectional survey was conducted to consider whether there is agreement between self-report and clinical diagnosis in the prevalence of selected common chronic diseases among elderly Taiwanese. Between July 1992 and June 1993, both face-to-face interview and clinical evaluation were applied to a sample of 228 Taiwanese aged 65 y and older to estimate the prevalence of heart diseases, hypertension and diabetes. The results showed that a self-reported history of diabetes had the highest sensitivity (66.7%) and specificity (95.2%). The self-report of heart diseases was the least sensitive (20.5%), while self-reports of hypertension was the least specific (82.8%). Multivariate analyses showed that age, education and number of self-reported diseases suffered from, appeared to influence the accuracy of the self reported data. Our data suggest a notable lack of agreement abetween self-report and clinical diagnosis for medical conditions, even for those with clear and unambiguous diagnostic criteria. The elderly in Taiwan tended to under report (with a consistently higher false negative rate than false positive rate) the existence of the three selected medical conditions. This was especially so for heart diseases. Our findings suggest that, if the level of disease prevalence in the population needs to be known for health planning estimates for hypertension and diabetes would not necessarily be a problem. However, the prevalence for heart disease would be seriously under-estimated. We also argue that information obtained by self-report should be validated before use, especially in the case of assessment of the prevalence of medical conditions in the elderly. Public Health (2000) 114, 137–142 [ABSTRACT FROM AUTHOR]

Previous studies have failed to estimate the size of population at risk and underestimated the incidence of varicella among susceptible population. In this study, we calculated the incidence of varicella and its complications in Taiwan based on a life table method, in which the size of population at risk was taken into account. Population-based data were obtained from the Bureau of National Health Insurance. The age-specific incidences estimated by the uncorrected and corrected methods were compared. The incidence of varicella increased sharply after infancy and peaked at 16.7% in children aged 5 years. A correction which assumes the introduction of varicella vaccine resulted in a higher incidence of 19.5% in children aged 5 years. The lifetime cumulative incidence increased to around 76%. Sensitive surveillance of varicella and correct incidence estimate among susceptible population are essential in countries that have implemented or are about to implement varicella vaccination. [Copyright &y& Elsevier]

Using a prospective hospital-based registry, 146 patients with transient ischaemic attack (TIA) were compared with 376 patients with minor first-ever ischaemic stroke with respect to the 3-month risk of subsequent vascular events, in order to clarify the distinctions between the disease entities. All patients were enrolled within 48 h of onset. The risk factor distribution for the two groups was comparable, except that the TIA patients had more previous TIAs. Large artery atherosclerosis (34%) and small vessel occlusion (32%) were the main aetiologies in the TIA group, whereas small vessel occlusion (49%) was the major cause in the stroke group. The 3-month risk of combined endpoints of stroke, myocardial infarction, and vascular death for TIA patients was higher than that for the minor stroke group (15.1% vs. 3.2%; hazard ratio 4.6, 95% confidence interval 2.3-9.3 in multivariate analysis). Large artery atherosclerosis and male sex were the other significant predictors. TIA may demand more urgent management than minor stroke. The fact that aetiology is a predictor, highlights the need for rapid diagnostic tests to establish pathogenesis.

Platelet plays a pivotal role in the pathogenesis of thrombotic cardiovascular diseases. Recently, the polymorphism of platelet glycoprotein (GP) genes has been reported to be associated with an increased risk for ischemic stroke. The purpose of this study is to evaluate the association between platelet GP genetic variants and ischemic stroke in young Taiwanese. We conducted a case-control study in 157 young ischemic stroke patients recruited between September 2001 and March 2003 and 157 age- and sex-matched controls. The genotypes of platelet GP Ia C807T, GP Ib C3550T, and GP IIIa Pl(A1/A2) polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism. Student's t-test, chi-square test, and logistic regression modeling were used for data analyses. The GP Ia C807T CC, CT and TT genotype frequencies were similar between patients (50.3%, 43.9%, 5.7%) and controls (53.5%, 38.9%, 7.6%; p=0.58). There were no significant differences in GP Ib C3550T CC and CT genotype distributions between patients (91.1%, 8.9%) and controls (91.7%, 8.3%; p=0.84). Of all subjects, none carries GP IIIa Pl(A2) mutation. In conclusion, platelet GP Ia C807T and GP Ib C3550T polymorphisms in our population are less common compared with Caucasians, and GP IIIa Pl(A1/A2) genetic mutation is not found, and all of them are not associated with ischemic stroke in young Taiwanese.

A random sample of nursing home residents over 65 years of age were interviewed. Two hundred ninety-two participants received the Short Portable Mental Status Questionnaire. Two hundred eleven were unable to answer the questionnaire, but their caregivers provided information about their daily activities and performance ability. We found that 255 (50.9%) fit our criteria of cognitive impairment and 236 (47.7%) had both impaired cognition and impaired performance in activities of daily living. Similar to statistics in the US, the prevalence of cognitive impairment in Taipei nursing home residents was much higher than that observed in the community elderly and probably in Taiwan as well. Therefore, public health care policy for cognitively impaired elderly in Taiwan should not simply rely on data from community studies.