The prevalence of dementia: A quantitative integration of the literature
ABSTRACT Data from studies of dementia prevalence between 1945 to 1985 were analyzed statistically. Prevalence rates were found to vary as a function of methodological differences between studies. However, despite these differences, the relationship between prevalence and age was found to be consistent across studies, with rates doubling every 5.1 years. Across studies, Alzheimer's disease (AD) was found to be more common in women, with a tendency for multi-infarct dementia (MID) to be more common in men. There were also national differences in the relative prevalence of AD and MID, with MID being more common in Japanese and Russian studies, no difference in Finnish and American studies, and an excess of AD in other Western European countries.
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ABSTRACT: The growing incidence of dementia in ageing societies is a major concern of health care organizations. Because of its detrimental influence on the mental and functional statuses of elderly people, it leads to increased economic burdens caused by the social and financial needs of patients with dementia and their caregivers. There has been no data concerning the prevalence of dementia in the elderly in the general Polish community so far. The main aim of the study was to assess the prevalence of cognitive impairment suspected of dementia among the Polish elderly and the relationships between cognitive performance and age, gender, place of residence and educational status. The presented data was the result of nationwide, multicentre PolSenior Study conducted from 2007 to 2011 in the Polish elderly population. Cognitive functions were evaluated using Mini-Mental State Examination (MMSE) performed by pre-trained nurses. The result of MMSE lower than 24 points was classified as cognitive impairment suspected of dementia and divided according to its severity into three stages: mild, moderate and severe dementia. The results were analysed in two ways: raw MMSE and MMSE scores after Mungas adjustment (MMSEadj), that is, corrected for age and educational level, and these were compared. To verify the suspicion of dementia an assessment was complemented by an interview of carers for the occurrence and course of memory disorders, treatment of dementia and by functional status assessment. In order to assess the prevalence of suspicion of dementia in the general Polish population, statistical analyses based on weighting were done. The suspicion of dementia on the basis of raw MMSE was made in 20.4% of respondents aged 65years and more, and after Mungas adjustment in 12.1% of older subjects. The prevalence of cognitive impairment grew with increasing age, as well as depending on the educational status of elderly respondents in both types of analyses; raw MMSE and MMSEadj. There was no significant difference in the prevalence of cognitive impairment according to gender in the general population (raw MMSE); however in analyses including MMSEadj results, the suspicion of dementia was made more often among men. Suspicion of dementia based on raw MMSE and MMSEadj results was made significantly more often among men than women at the age of 65-69years, and significantly more often among the oldest women, aged 90years and more. Suspicion of dementia was diagnosed more often in respondents living in rural communities (based on raw MMSE, but not on MMSEadj), which might be related to the differences in their educational status.Experimental Gerontology 06/2014; 57. DOI:10.1016/j.exger.2014.06.003 · 3.53 Impact Factor
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ABSTRACT: Dementia syndromes are characterized by the presence of deficit progressive cognitive function. Vascular dementia (VD) is the most prevalent between secondary dementias, ranking second among all dementia after Alzheimer's disease (AD). The aim of this study was to evaluate the cognitive aspects of elderly patients with diagnoses of AD and VD. Participants were 256 elderly patients with mean age of 78 years and both sexes who received a diagnosis of Alzheimer's disease by the Diagnostic Statistic Manual (DSM-IV) and National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). The diagnosis of vascular dementia was done according to National Institute of Neurological Disorders and Stroke (NINDS) and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINCDS-AIREN). The results showed that the prevalence of AD was superior to VD, mean age increases the ratio DA / VD, with women and people with lower education levels most affected. VD and AD patients have had similar cognitive abilities and VD patients exhibit more temporal orientation impairments than AD.
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ABSTRACT: Studies have shown differences in specific cognitive ability domains and risk of Alzheimer's disease between the men and women at later age. However it is important to know that sex differences in cognitive function during adulthood may have their basis in both organizational effects, i.e., occurring as early as during the neuronal development period, as well as in activational effects, where the influence of the sex steroids influence brain function in adulthood. Further, the rate of cognitive decline with aging is also different between the sexes. Understanding the biology of sex differences in cognitive function will not only provide insight into Alzheimer's disease prevention, but also is integral to the development of personalized, gender-specific medicine. This review draws on epidemiological, translational, clinical, and basic science studies to assess the impact of sex differences in cognitive function from young to old, and examines the effects of sex hormone treatments on Alzheimer's disease in men and women.Frontiers in Neuroendocrinology 01/2014; 35(3). DOI:10.1016/j.yfrne.2014.01.002 · 7.58 Impact Factor