Dementia Incidence Continues to Increase with Age in the Oldest Old The 90+Study

Department of Neurology, University of California, Irvine, CA 92697-1400, USA.
Annals of Neurology (Impact Factor: 11.91). 01/2010; 67(1):114-21. DOI: 10.1002/ana.21915
Source: PubMed

ABSTRACT The oldest old are the fastest growing segment of the US population, and accurate estimates of dementia incidence in this group are crucial for healthcare planning. Although dementia incidence doubles every 5 years from ages 65 to 90 years, it is unknown if this exponential increase continues past age 90 years. Here, we estimate age- and sex-specific incidence rates of all-cause dementia in people aged 90 years and older, including estimates for centenarians.
Participants are from The 90+ Study, a population-based longitudinal study of aging and dementia. Three hundred thirty nondemented participants aged 90 years and older at baseline were followed between January 2003 and December 2007. Age- and sex-specific incidence rates of all-cause dementia were estimated by person-years analysis.
The overall incidence rate of all-cause dementia was 18.2% (95% confidence interval [CI], 15.3-21.5) per year and was similar for men and women (risk ratio, 0.94; 95% CI, 0.65-1.37). Rates increased exponentially with age from 12.7% per year in the 90-94-year age group, to 21.2% per year in the 95-99-year age group, to 40.7% per year in the 100+-year age group. The doubling time based on a Poisson regression was 5.5 years.
Incidence of all-cause dementia is very high in people aged 90 years and older and continues to increase exponentially with age in both men and women. Projections of the number of people with dementia should incorporate this continuing increase of dementia incidence after age 90 years. Our results foretell the growing public health burden of dementia in an increasingly aging population.

  • Source
    e-book Promoting conscious and active learning and aging; 01/2013
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic cigarette smoking is associated with increased risk for Alzheimer's disease (AD). The goal of this study was determine if smoking history moderated the associations of age and APOE genotype (the most robust risk factors for AD) on brain amyloid deposition, glucose metabolism, and neurocognition in cognitively-normal elders. Participants (n=264) were grouped according to their APOE ε4 carrier status (ε4 carrier: APOE4+; non-ε4 carrier: APOE4-) and smoking status (smokers: at least 1 year of smoking during lifetime; never-smokers: no history of smoking). Approximately 89% of the smoking sample was former-smokers. We specifically tested for interactions of smoking status with APOE ε4 carrier status and age on measures of cortical amyloid deposition, glucose metabolism, and neurocognition. (1) smoking status interacted with APOE ε4 carrier status, where smoker APOE4+ showed lower glucose metabolism and poorer auditory-verbal learning and memory than never-smoking APOE4-, never-smoking APOE4+, and smoking APOE4-; (2) smoking status interacted with age on measures of semantic fluency, processing speed/set-shifting and global neurocognition; smokers, irrespective of APOE ε4 carrier status, demonstrated poorer performance with increasing age than never-smokers. (3) smoking APOE4+ and never-smoking APOE4+ showed greater cortical amyloid deposition than never-smoking APOE4- and smoking APOE4-. The findings indicate consideration of smoking history is essential to both better understand the factors associated with neurobiological and neurocognitive abnormalities in elders, and the risk for development of AD-related neuropathology. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail:
    Nicotine & Tobacco Research 04/2015; DOI:10.1093/ntr/ntv075 · 2.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Despite the increasing older population providing care for family members with dementia at home, there is no consensus in the literature in terms of how caring impacts on their quality of life (QoL) and the association of the family carer’s age with QoL outcomes. Aims: To explore the available literature investigating the QoL of older family carers (family carers aged ≥ 60) and the association of family carers’ age and QoL outcomes in a dementia context. Methods: A review of the literature to December 2013 was conducted using Embase-OVID, CINAL, Medline-OVID, Psyc INFO-OVID, Grey literature and the references of the included studies. Cross-sectional or prospective longitudinal studies published in English were eligible. The selection and appraisal processes were performed by two reviewers independently and the methodological quality was assessed by STROBE statement. Results: From the 12 selected studies, 4 were carried out with older family carers’ samples and 8 associated the variable ‘age’ with QoL outcomes. Eight different instruments were used to assess family carers’ QoL, however none were designed specifically for older people or older family carers. The mean age of the carers’ samples ranged from 55.2 to 76.0 years old. Older family carers showed low levels of QoL and were often below the age-matched standard population. Carers’ age was negatively correlated with QoL outcomes in most of the studies. Conclusion: Older people are increasingly involved with dementia care and family carer’s advanced age was shown to be associated with low levels of QoL. Future research should investigate the QoL of older family carers separately and use QoL instruments containing older family carers’ specific needs and perspectives of QoL. In planning care and support, primaryhealth care practitioners should consider family carer’s age group and their specific needs
    Quality in primary care 03/2015; 23(1):18-30.

Full-text (2 Sources)

Available from
Jul 3, 2014