Decreasing prevalence of dementia in 85-year olds examined 22 years apart: the influence of education and stroke
Individuals aged 80 years and older constitute the fastest growing segment of the population worldwide, leading to an expected increase in dementia cases. Education level and treatment of vascular risk factors has increased during the last decades. We examined whether this has influenced the prevale...
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| Published in | Scientific reports Vol. 7; no. 1; pp. 6136 - 8 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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England
Nature Publishing Group
21.07.2017
Nature Publishing Group UK Nature Portfolio |
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| Abstract | Individuals aged 80 years and older constitute the fastest growing segment of the population worldwide, leading to an expected increase in dementia cases. Education level and treatment of vascular risk factors has increased during the last decades. We examined whether this has influenced the prevalence of dementia according to DSM-III-R using population-based samples of 85-year-olds (N = 1065) examined with identical methods 1986-87 and 2008-10. The prevalence of dementia was 29.8% in 1986-87 and 21.7% in 2008-10 (OR 0.66; 95%-CI: 0.50-0.86). The decline was mainly observed for vascular dementia. The proportion with more than basic education (25.2% and 57.7%), and the prevalence of stroke (20% and 30%) increased, but the odds ratio for dementia with stroke decreased from 4.3 to 1.8 (interaction stroke*birth cohort; p = 0.008). In a logistic regression, education (OR 0.70; 95%-CI 0.51-0.96), stroke (OR 3.78; 95%-CI 2.28-6.29), interaction stroke*birth cohort (OR 0.50; 95%-CI 0.26-0.97), but not birth cohort (OR 0.98; 95%-CI 0.68-1.41), were related to prevalence of dementia. Thus, the decline in dementia prevalence was mainly explained by higher education and lower odds for dementia with stroke in later born birth cohorts. The findings may be related to an increased cognitive reserve and better treatment of stroke in later-born cohorts. |
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| AbstractList | Individuals aged 80 years and older constitute the fastest growing segment of the population worldwide, leading to an expected increase in dementia cases. Education level and treatment of vascular risk factors has increased during the last decades. We examined whether this has influenced the prevalence of dementia according to DSM-III-R using population-based samples of 85-year-olds (N = 1065) examined with identical methods 1986–87 and 2008–10. The prevalence of dementia was 29.8% in 1986–87 and 21.7% in 2008–10 (OR 0.66; 95%-CI: 0.50–0.86). The decline was mainly observed for vascular dementia. The proportion with more than basic education (25.2% and 57.7%), and the prevalence of stroke (20% and 30%) increased, but the odds ratio for dementia with stroke decreased from 4.3 to 1.8 (interaction stroke*birth cohort; p = 0.008). In a logistic regression, education (OR 0.70; 95%-CI 0.51–0.96), stroke (OR 3.78; 95%-CI 2.28–6.29), interaction stroke*birth cohort (OR 0.50; 95%-CI 0.26–0.97), but not birth cohort (OR 0.98; 95%-CI 0.68–1.41), were related to prevalence of dementia. Thus, the decline in dementia prevalence was mainly explained by higher education and lower odds for dementia with stroke in later born birth cohorts. The findings may be related to an increased cognitive reserve and better treatment of stroke in later-born cohorts. Abstract Individuals aged 80 years and older constitute the fastest growing segment of the population worldwide, leading to an expected increase in dementia cases. Education level and treatment of vascular risk factors has increased during the last decades. We examined whether this has influenced the prevalence of dementia according to DSM-III-R using population-based samples of 85-year-olds (N = 1065) examined with identical methods 1986–87 and 2008–10. The prevalence of dementia was 29.8% in 1986–87 and 21.7% in 2008–10 (OR 0.66; 95%-CI: 0.50–0.86). The decline was mainly observed for vascular dementia. The proportion with more than basic education (25.2% and 57.7%), and the prevalence of stroke (20% and 30%) increased, but the odds ratio for dementia with stroke decreased from 4.3 to 1.8 (interaction stroke*birth cohort; p = 0.008). In a logistic regression, education (OR 0.70; 95%-CI 0.51–0.96), stroke (OR 3.78; 95%-CI 2.28–6.29), interaction stroke*birth cohort (OR 0.50; 95%-CI 0.26–0.97), but not birth cohort (OR 0.98; 95%-CI 0.68–1.41), were related to prevalence of dementia. Thus, the decline in dementia prevalence was mainly explained by higher education and lower odds for dementia with stroke in later born birth cohorts. The findings may be related to an increased cognitive reserve and better treatment of stroke in later-born cohorts. Abstract Individuals aged 80 years and older constitute the fastest growing segment of the population worldwide, leading to an expected increase in dementia cases. Education level and treatment of vascular risk factors has increased during the last decades. We examined whether this has influenced the prevalence of dementia according to DSM-III-R using population-based samples of 85-year-olds (N = 1065) examined with identical methods 1986–87 and 2008–10. The prevalence of dementia was 29.8% in 1986–87 and 21.7% in 2008–10 (OR 0.66; 95%-CI: 0.50–0.86). The decline was mainly observed for vascular dementia. The proportion with more than basic education (25.2% and 57.7%), and the prevalence of stroke (20% and 30%) increased, but the odds ratio for dementia with stroke decreased from 4.3 to 1.8 (interaction stroke*birth cohort; p = 0.008). In a logistic regression, education (OR 0.70; 95%-CI 0.51–0.96), stroke (OR 3.78; 95%-CI 2.28–6.29), interaction stroke*birth cohort (OR 0.50; 95%-CI 0.26–0.97), but not birth cohort (OR 0.98; 95%-CI 0.68–1.41), were related to prevalence of dementia. Thus, the decline in dementia prevalence was mainly explained by higher education and lower odds for dementia with stroke in later born birth cohorts. The findings may be related to an increased cognitive reserve and better treatment of stroke in later-born cohorts. |
| ArticleNumber | 6136 |
| Author | Falk, Hanna Johansson, Lena Kern, Silke Östling, Svante Börjesson-Hanson, Anne Sigström, Robert Skoog, Ingmar |
| Author_xml | – sequence: 1 givenname: Ingmar surname: Skoog fullname: Skoog, Ingmar email: ingmar.skoog@neuro.gu.se organization: Institute of Neuroscience and Physiology, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. ingmar.skoog@neuro.gu.se – sequence: 2 givenname: Anne surname: Börjesson-Hanson fullname: Börjesson-Hanson, Anne organization: Institute of Neuroscience and Physiology, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden – sequence: 3 givenname: Silke surname: Kern fullname: Kern, Silke organization: Institute of Neuroscience and Physiology, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden – sequence: 4 givenname: Lena surname: Johansson fullname: Johansson, Lena organization: Institute of Neuroscience and Physiology, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden – sequence: 5 givenname: Hanna surname: Falk fullname: Falk, Hanna organization: Institute of Neuroscience and Physiology, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden – sequence: 6 givenname: Robert surname: Sigström fullname: Sigström, Robert organization: Institute of Neuroscience and Physiology, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden – sequence: 7 givenname: Svante surname: Östling fullname: Östling, Svante organization: Institute of Neuroscience and Physiology, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28733627$$D View this record in MEDLINE/PubMed https://gup.ub.gu.se/publication/257161$$DView record from Swedish Publication Index |
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| Snippet | Individuals aged 80 years and older constitute the fastest growing segment of the population worldwide, leading to an expected increase in dementia cases.... Abstract Individuals aged 80 years and older constitute the fastest growing segment of the population worldwide, leading to an expected increase in dementia... Abstract Individuals aged 80 years and older constitute the fastest growing segment of the population worldwide, leading to an expected increase in dementia... |
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| SubjectTerms | alzheimers-disease Cognitive ability cognitive impairment Dementia Dementia disorders Education metaanalysis mortality Neurosciences Neurovetenskaper population Risk factors Stroke survival time trends united-states Vascular dementia |
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| Title | Decreasing prevalence of dementia in 85-year olds examined 22 years apart: the influence of education and stroke |
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