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1.
Paola Gilsanz Maria M. Corrada Claudia H. Kawas Elizabeth Rose Mayeda M. Maria Glymour Charles P. Quesenberry Catherine Lee Rachel A. Whitmer 《Alzheimer's & dementia》2019,15(4):497-505
Introduction
Little is known about dementia incidence in diverse populations of oldest-old, the age group with highest dementia incidence.Methods
Incident dementia diagnoses from 1/1/2010 to 9/30/2015 were abstracted from medical records for 2350 members of an integrated health care system in California (n = 1702 whites, n = 375 blacks, n = 105 Latinos, n = 168 Asians) aged ≥90 in 2010. We estimated race/ethnicity-specific age-adjusted dementia incidence rates and implemented Cox proportional hazards models and Fine and Gray competing risk of death models adjusted for demographics and comorbidities in midlife and late-life.Results
Dementia incidence rates (n = 771 cases) were lowest among Asians (89.9/1000 person-years), followed by whites (96.9/1000 person-years), Latinos (105.8/1000 person-years), and blacks (121.5/1000 person-years). Cox regression and competing risk models estimated 28% and 36% higher dementia risk for blacks versus whites adjusting for demographics and comorbidities.Discussion
Patterns of racial/ethnic disparities in dementia seen in younger older adults continue after the age of 90 years, though smaller in magnitude. 相似文献2.
Kieu T.T. Phung Monique Chaaya Martin Prince Samir Atweh Khalil El Asmar Georges Karam Rose Mary Khoury Lilian Ghandour Husam Ghusn T. Rune Nielsen Gunhild Waldemar 《Alzheimer's & dementia》2017,13(12):1317-1326
Introduction
In North Africa and the Middle East, studies about dementia prevalence are scarce. A pilot study was conducted in Lebanon to assess dementia prevalence, using the Arabic-validated 10/66 Dementia Research Group (DRG) diagnostic assessment for case ascertainment. The study also examined care arrangement and access to care.Methods
A random sample of 502 persons older than 65 years and their informant were recruited from Beirut and Mount Lebanon governorates through multistage cluster sampling.Results
The crude and age-standardized dementia prevalences were 7.4% and 9.0%, respectively. People with dementia were mainly cared for by relatives at home. Access to formal care was very limited.Discussion
Dementia prevalence in Lebanon ranks high within the global range of estimates. These first evidence-based data about disease burden and barriers to care serve to raise awareness and call for social and health care reform to tackle the dementia epidemic in Lebanon and in North Africa and the Middle East. 相似文献3.
Laura Frain David Swanson Kelly Cho David Gagnon Kun Ping Lu Rebecca A. Betensky Jane Driver 《Alzheimer's & dementia》2017,13(12):1364-1370
Introduction
To examine the risk of Alzheimer's disease (AD) among cancer survivors in a national database.Methods
Retrospective cohort of 3,499,378 mostly male US veterans aged ≥65 years were followed between 1996 and 2011. We used Cox models to estimate risk of AD and alternative outcomes (non-AD dementia, osteoarthritis, stroke, and macular degeneration) in veterans with and without a history of cancer.Results
Survivors of a wide variety of cancers had modestly lower AD risk, but increased risk of the alternative outcomes. Survivors of screened cancers, including prostate cancer, had a slightly increased AD risk. Cancer treatment was independently associated with decreased AD risk; those who received chemotherapy had a lower risk than those who did not.Discussion
Survivors of some cancers have a lower risk of AD but not other age-related conditions, arguing that lower AD diagnosis is not simply due to bias. Cancer treatment may be associated with decreased risk of AD. 相似文献4.
María M. Corrada Kathleen M. Hayden Annlia Paganini-Hill Szofia S. Bullain Jaime DeMoss Colette Aguirre Ron Brookmeyer Claudia H. Kawas 《Alzheimer's & dementia》2017,13(2):103-110
Introduction
We investigated the association between age of onset of hypertension and dementia risk in an oldest-old cohort.Methods
Participants are from The 90+ Study, a population-based longitudinal study of people aged 90+ who are survivors from the Leisure World Cohort Study. We estimated hypertension onset age using self-reported information from The 90+ Study and Leisure World Cohort Study, collected about 20 years earlier. A total of 559 participants without dementia were followed every 6 months for up to 10 years.Results
A total of 224 participants developed dementia during follow-up (mean = 2.8 years). Compared with those without hypertension, participants whose hypertension onset age was 80 to 89 years had a lower dementia risk (hazard ratio = 0.58, P = .04) and participants with an onset age of 90+ years had the lowest risk (hazard ratio = 0.37, P = .004).Discussion
Developing hypertension at older ages may protect against dementia. Understanding the mechanisms for this lower risk is important for determining ways to prevent dementia in the very elderly. 相似文献5.
Objective
To identify incidence and prevalence of dementia in racial and ethnic populations in the United States.Methods
A systematic review of literature.Results
A total of 1215 studies were reviewed; 114 were included. Dementia prevalence rates reported for age 65+ years from a low of 6.3% in Japanese Americans, 12.9% in Caribbean Hispanic Americans, 12.2% in Guamanian Chamorro and ranged widely in African Americans from 7.2% to 20.9%. Dementia annual incidence for African American (mean = 2.6%; SD = 1%; range, 1.4%–5.5%) and Caribbean Hispanic populations were significantly higher (mean, 3.6%; SD, 1.2%; range, 2.3%–5.3%) than Mexican American and Japanese Americans and non-Latino white populations (0.8%–2.7%), P < .001.Conclusions
Data are needed for American Indian, most Asian, and Pacific Islander populations. Disaggregation of large race/ethnic classifications is warranted due to within-population heterogeneity in incidence and prevalence. African American and Caribbean Hispanic studies showed higher incidence of dementia. A nationwide approach is needed to identify communities at high risk and to tailor culturally appropriate services accordingly. 相似文献6.
Francisca S. Then Tobias Luck Kathrin Heser Annette Ernst Tina Posselt Birgitt Wiese Silke Mamone Christian Brettschneider Hans-Helmut König Siegfried Weyerer Jochen Werle Edelgard Mösch Horst Bickel Angela Fuchs Michael Pentzek Wolfgang Maier Martin Scherer Michael Wagner Martin Scherer 《Alzheimer's & dementia》2017,13(4):431-440
Introduction
Previous studies have demonstrated that an overall high level of mental work demands decreased dementia risk. In our study, we investigated whether this effect is driven by specific mental work demands and whether it is exposure dependent.Methods
Patients aged 75+ years were recruited from general practitioners and participated in up to seven assessment waves (every 1.5 years) of the longitudinal AgeCoDe study. Analyses of the impact of specific mental work demands on dementia risk were carried out via multivariate regression modeling (n = 2315).Results
We observed a significantly lower dementia risk in individuals with a higher level of “information processing” (HR, 0.888), “pattern detection” (HR, 0.878), “mathematics” (HR, 0.878), and “creativity” (HR, 0.878). Yet, exposure-dependent effects were only significant for “information processing” and “pattern detection.”Discussion
Our longitudinal observations suggest that dementia risk may be reduced by some but not all types of mental work demands. 相似文献7.
Introduction
We estimate the burden of late-onset dementia in the United Kingdom through to 2025 and assess the impact of potential interventions.Methods
We compute disability adjusted life years (DALYs) through to 2025 and consider three interventions, all assumed launched in 2018; (1) an optimistic limiting case of a 100% preventive intervention with immediate uptake of 100% of the population at risk; (2) an intervention which delays onset by 5 years, linear uptake to 50% after 5 years; (3) as (2) but uptake 75% after 5 years.Results
By 2025, the DALY burden will have increased by 42% from the Global Disease Burden 2010 estimate. Intervention results: (1) a 9% decrease by 2025; (2) a 33% increase; and (3) a 28% increase.Discussion
At current prevalence rates, the ability of an intervention to offset the projected increase in DALY burden of dementia in the United Kingdom by 2025 appears low. 相似文献8.
Kathleen M. Hayden Daniel P. Beavers Susan E. Steck James R. Hebert Fred K. Tabung Nitin Shivappa Ramon Casanova JoAnn E. Manson Claudia B. Padula Elena Salmoirago-Blotcher Linda G. Snetselaar Oleg Zaslavsky Stephen R. Rapp 《Alzheimer's & dementia》2017,13(11):1187-1196
Introduction
The Mediterranean and Dietary Approaches to Stop Hypertension diets have been associated with lower dementia risk. We evaluated dietary inflammatory potential in relation to mild cognitive impairment (MCI)/dementia risk.Methods
Baseline food frequency questionnaires from n = 7085 women (aged 65–79 years) were used to calculate Dietary Inflammatory Index (DII) scores that were categorized into four groups. Cognitive function was evaluated annually, and MCI and all-cause dementia cases were adjudicated centrally. Mixed effect models evaluated cognitive decline on over time; Cox models evaluated the risk of MCI or dementia across DII groups.Results
Over an average of 9.7 years, there were 1081 incident cases of cognitive impairment. Higher DII scores were associated with greater cognitive decline and earlier onset of cognitive impairment. Adjusted hazard ratios (HRs) comparing lower (anti-inflammatory; group 1 referent) DII scores to the higher scores were group 2-HR: 1.01 (0.86–1.20); group 3-HR: 0.99 (0.82–1.18); and group 4-HR: 1.27 (1.06–1.52).Conclusions
Diets with the highest pro-inflammatory potential were associated with higher risk of MCI or dementia. 相似文献9.
Elizabeth R. Mayeda M. Maria Glymour Charles P. Quesenberry Julene K. Johnson Eliseo J. Pérez-Stable Rachel A. Whitmer 《Alzheimer's & dementia》2017,13(7):761-769
Introduction
Information on anticipated survival time after dementia diagnosis among racially/ethnically diverse patients is needed to plan for care and evaluate disparities.Methods
Dementia-free health care members aged ≥64 years were followed (1/1/2000–12/31/2013) for dementia diagnosis and subsequent survival (n = 23,032 Asian American; n = 18,778 African American; n = 21,000 Latino; n = 4543 American Indian/Alaska Native; n = 206,490 white). Kaplan–Meier curves were estimated for survival after dementia diagnosis by race/ethnicity. We contrasted mortality patterns among people with versus without dementia using Cox proportional hazards models.Results
After dementia diagnosis (n = 59,494), whites had shortest median survival (3.1 years), followed by American Indian/Alaska Natives (3.4 years), African Americans (3.7 years), Latinos (4.1 years), and Asian Americans (4.4 years). Longer postdiagnosis survival among racial/ethnic minorities compared with whites persisted after adjustment for comorbidities. Racial/ethnic mortality inequalities among dementia patients mostly paralleled mortality inequalities among people without dementia.Discussion
Survival after dementia diagnosis differs by race/ethnicity, with shortest survival among whites and longest among Asian Americans. 相似文献10.
Richard A. Goodman Kimberly A. Lochner Madhav Thambisetty Thomas S. Wingo Samuel F. Posner Shari M. Ling 《Alzheimer's & dementia》2017,13(1):28-37
Introduction
Rapid growth of the older adult population requires greater epidemiologic characterization of dementia. We developed national prevalence estimates of diagnosed dementia and subtypes in the highest risk United States (US) population.Methods
We analyzed Centers for Medicare & Medicaid administrative enrollment and claims data for 100% of Medicare fee-for-service beneficiaries enrolled during 2011–2013 and age ≥68 years as of December 31, 2013 (n = 21.6 million).Results
Over 3.1 million (14.4%) beneficiaries had a claim for a service and/or treatment for any dementia subtype. Dementia not otherwise specified was the most common diagnosis (present in 92.9%). The most common subtype was Alzheimer's (43.5%), followed by vascular (14.5%), Lewy body (5.4%), frontotemporal (1.0%), and alcohol induced (0.7%). The prevalence of other types of diagnosed dementia was 0.2%.Discussion
This study is the first to document concurrent prevalence of primary dementia subtypes among this US population. The findings can assist in prioritizing dementia research, clinical services, and caregiving resources. 相似文献11.
Ron L.H. Handels Stephanie J.B. Vos Milica G. Kramberger Vesna Jelic Kaj Blennow Mark van Buchem Wiesje van der Flier Yvonne Freund-Levi Harald Hampel Marcel Olde Rikkert Ania Oleksik Zvezdan Pirtosek Philip Scheltens Hilkka Soininen Charlotte Teunissen Magda Tsolaki Asa K. Wallin Bengt Winblad Pieter Jelle Visser 《Alzheimer's & dementia》2017,13(8):903-912
Introduction
We aimed to determine the added value of cerebrospinal fluid (CSF) to clinical and imaging tests to predict progression from mild cognitive impairment (MCI) to any type of dementia.Methods
The risk of progression to dementia was estimated using two logistic regression models based on 250 MCI participants: the first included standard clinical measures (demographic, clinical, and imaging test information) without CSF biomarkers, and the second included standard clinical measures with CSF biomarkers.Results
Adding CSF improved predictive accuracy with 0.11 (scale from 0–1). Of all participants, 136 (54%) had a change in risk score of 0.10 or higher (which was considered clinically relevant), of whom in 101, it was in agreement with their dementia status at follow-up.Discussion
An individual person's risk of progression from MCI to dementia can be improved by relying on CSF biomarkers in addition to recommended clinical and imaging tests for usual care. 相似文献12.
Catherine Feart Catherine Helmer Bénédicte Merle François R. Herrmann Cédric Annweiler Jean-François Dartigues Cécile Delcourt Cécilia Samieri 《Alzheimer's & dementia》2017,13(11):1207-1216
Introduction
Hypovitaminosis D has been associated with several chronic conditions; yet, its association with cognitive decline and the risk of dementia and Alzheimer's disease (AD) has been inconsistent.Methods
The study population consisted of 916 participants from the Three-City Bordeaux cohort aged 65+, nondemented at baseline, with assessment of vitamin D status and who were followed for up to 12 years.Results
In multivariate analysis, compared with individuals with 25(OH)D sufficiency (n = 151), participants with 25(OH)D deficiency (n = 218) exhibited a faster cognitive decline. A total of 177 dementia cases (124 AD) occurred: 25(OH)D deficiency was associated with a nearly three-fold increased risk of AD (hazard ratio = 2.85, 95% confidence interval 1.37–5.97).Discussion
This large prospective study of French older adults suggests that maintaining adequate vitamin D status in older age could contribute to slow down cognitive decline and to delay or prevent the onset of dementia, especially of AD etiology. 相似文献13.
Eric Jutkowitz Karen M. Kuntz Bryan Dowd Joseph E. Gaugler Richard F. MacLehose Robert L. Kane 《Alzheimer's & dementia》2017,13(7):801-809
Introduction
Clinical features of dementia (cognition, function, and behavioral and psychological symptoms) may differentially affect out-of-pocket medical and nursing home (NH) expenditures and informal care received (outcomes).Methods
We used cross-sectional data (Aging, Demographics, and Memory Study) to estimate probabilities of experiencing outcomes by clinical features. For those experiencing an outcome, we estimated effects of clinical features on the amount of the outcome.Results
No clinical feature predicted the probability of having out-of-pocket medical expenditures. For those with medical expenditures, higher cognition and poorer function were associated with more spending. Poorer function predicted having out-of-pocket NH expenditures. For those with NH expenditures, no clinical feature predicted the amount. Poorer function and a greater number of behavioral and psychological symptoms predicted the probability of receiving caregiving. For those receiving care, poorer function was associated with more caregiving.Conclusions
Clinical features differentially impact outcomes with poorer function associated with all types of costs and caregiving received. 相似文献14.
Lars I. Eriksson Cecilia Lundholm Kaavya Narasimhalu Rolf Sandin Ya-Ping Jin Margaret Gatz Nancy L. Pedersen 《Alzheimer's & dementia》2019,15(4):534-542
Introduction
We evaluated whether hospitalization with or without surgery increases risk for dementia or Alzheimer's disease.Methods
A clinical sample (843 clinically diagnosed dementia cases; 1686 matched nondemented individuals) was identified from Swedish Twin Registry studies. A register-based sample (4293 cases; 21,465 matched controls) was identified by linkage of Swedish Twin Registry to Swedish Patient Registry records. Apolipoprotein E (APOE) status and within-pair comparisons of dementia discordant twins indicated genetic susceptibility.Results
Nonsurgical hospitalization is associated with greater dementia risk than hospitalization with surgical intervention. In the register sample, thoracic, abdominal, and major orthopedic procedures entailed dementia risk; in the clinical sample, orthopedic alone. Within-pair analyses indicate that associations in part reflect genetic susceptibility in common to hospitalization and dementia. Potential gene-environment interactions were indicated by greater risk due to hospitalization among APOE ε4 noncarriers.Discussion
We confirm hospitalization as a risk factor for dementia, with repeated hospitalizations a more important risk factor than surgery. 相似文献15.
Lidia Sarro Nirubol Tosakulwong Christopher G. Schwarz Jonathan Graff-Radford Scott A. Przybelski Timothy G. Lesnick Samantha M. Zuk Robert I. Reid Mekala R. Raman Bradley F. Boeve Tanis J. Ferman David S. Knopman Giancarlo Comi Massimo Filippi Melissa E. Murray Joseph E. Parisi Dennis W. Dickson Ronald C. Petersen Kejal Kantarci 《Alzheimer's & dementia》2017,13(3):257-266
Introduction
Cerebrovascular lesions on MRI are common in Alzheimer's disease (AD) dementia, but less is known about their frequency and impact on dementia with Lewy bodies (DLB).Methods
White-matter hyperintensities (WMHs) and infarcts on MRI were assessed in consecutive DLB (n = 81) and AD dementia (n = 240) patients and compared to age-matched and sex-matched cognitively normal subjects (CN) from a population-based cohort.Results
DLB had higher WMH volume compared to CN, and WMH volume was higher in the occipital and posterior periventricular regions in DLB compared to AD. Higher WMH volume was associated with history of cardiovascular disease and diabetes but not with clinical disease severity in DLB. Frequency of infarcts in DLB was not different from CN and AD dementia.Discussion
In DLB, WMH volume is higher than AD and CN and appears to be primarily associated with history of vascular disease. 相似文献16.
Camille Amadieu Sophie Lefèvre-Arbogast Cécile Delcourt Jean-François Dartigues Catherine Helmer Catherine Féart Cécilia Samieri 《Alzheimer's & dementia》2017,13(10):1125-1132
Introduction
Several nutrients may predict dementia risk. We characterized nutrient biomarker patterns, which integrate the complexity of nutrient exposure and biodisponibility associated with long-term risk of dementia in a large cohort of older persons, the Three-City study.Methods
We included 666 nondemented participants with plasma measurements of 22 fat-soluble nutrients at baseline, who were followed up for 12 years for dementia.Results
A “deleterious” pattern combining lower blood status in vitamin D, carotenoids, and polyunsaturated fats and higher saturated fats was strongly associated with a higher risk of dementia. Compared with individuals in the first quintile of the pattern score, participants in the highest quintile of score had an approximately fourfold increased risk of dementia (hazard ratio = 4.53 [95% confidence interval 1.99, 10.32], P for trend <.001) in multivariate models.Discussion
A blood pattern reflecting lower status in several nutrients among nondemented individuals appeared strongly associated with the long-term risk of dementia in this cohort. 相似文献17.
Isabelle F. van der Velpen Stephanie Feleus Anne Suzanne Bertens Behnam Sabayan 《Alzheimer's & dementia》2017,13(4):441-453
Introduction
Cardiac function is a key player in maintaining energy homeostasis in the brain. Heart failure is closely related to higher risk of neurocognitive disorders. Recent evidence shows that this relationship might not be limited to patients with advanced heart failure, and even suboptimal cardiac functioning is associated with accelerated brain aging. Hence, hemodynamic and serum cardiac markers may provide valuable information about the risk of dementia.Methods
We provide an overview on the link between cardiac markers and cognitive function by a systematic search in five databases. Furthermore, we discuss the pathophysiological aspects of this link and highlight the pertinent clinical and public health implications.Results
Increasing evidence supports the associations of hemodynamic and serum cardiac markers with accelerated cognitive decline.Discussion
Hemodynamic and serum cardiac markers are closely linked with risk of cognitive impairment. This highlights the significance of the heart–brain connection in reducing the burden of dementia. 相似文献18.
Introduction
Spatial navigation deficits are reported in dementia, but their temporal relationship to cognitive decline is not established.Methods
This is a prospective cohort study in 442 nondemented adults (mean age 79.9 years). Spatial navigation measured with the Floor Maze Test and reported as immediate maze time (IMT) and delayed maze time (DMT). Predementia syndromes, mild cognitive impairment syndrome (MCI) and motoric cognitive risk syndrome (MCR), were primary outcomes.Results
Over a mean follow-up of 16.5 ± 13.7 months, 41 participants developed MCI and 30 participants developed MCR. In Cox models adjusted for age, sex, education, cognitive status, comorbid illnesses, and maze errors, a 10-second increment on IMT predicted incident MCI (adjusted hazard ratio [aHR]: 1.25; 95% confidence interval [CI]: 1.06–1.48) and MCR (aHR: 1.53; 95% CI: 1.23–1.90). DMT predicted MCR but not MCI.Discussion
Spatial navigation performance predicted predementia syndromes in aging and implicates navigational impairments as an early feature in dementias. 相似文献19.
Hugh C. Hendrie Mengjie Zheng Wei Li Kathleen Lane Roberta Ambuehl Christianna Purnell Frederick W. Unverzagt Alexia Torke Ashok Balasubramanyam Chris M. Callahan Sujuan Gao 《Alzheimer's & dementia》2017,13(2):111-118
Introduction
High blood glucose levels may be responsible for the increased risk for dementia in diabetic patients.Methods
A secondary data analysis merging electronic medical records (EMRs) with data collected from the Indianapolis–Ibadan Dementia project (IIDP). Of the enrolled 4105 African Americans, 3778 were identified in the EMR. Study endpoints were dementia, mild cognitive impairment (MCI), or normal cognition. Repeated serum glucose measurements were used as the outcome variables.Results
Diabetic participants who developed incident dementia had a significant decrease in serum glucose levels in the years preceding the diagnosis compared to the participants with normal cognition (P = .0002). They also had significantly higher glucose levels up to 9 years before the dementia diagnosis (P = .0367).Discussion
High glucose levels followed by a decline occurring years before diagnosis in African American participants with diabetes may represent a powerful presymptomatic metabolic indicator of dementia. 相似文献20.
Marc Teichmann Stéphane Epelbaum Dalila Samri Marcel Levy Nogueira Agnès Michon Harald Hampel Foudil Lamari Bruno Dubois 《Alzheimer's & dementia》2017,13(8):913-923