Alzheimer's, Dementia & Mental Health
Alzheimer’s and Dementia Continue to Rise Even Among
the Oldest of Senior Citizens
‘We must make the fight against Alzheimer's a
priority before it's too late,’ says chief medical officer at
Alzheimer’s Association
July 13, 2009 – New research presented today shows
that senior citizens can never relax and feel they have passed the age
when Alzheimer’s and dementia are a major threat. The studies show both
new cases and total numbers with the disease continues to rise among the
very oldest, which contradicts previous beliefs.
The was research presented today at the Alzheimer's
Association 2009 International Conference on Alzheimer's Disease (ICAD
2009) in Vienna.
Previous epidemiological studies have suggested
that the number of people with Alzheimer's and dementia begins to level
off and perhaps even go down a bit in people age 90 and above, known as
the "oldest old." This is the fastest growing segment of the population
in western countries.
"The number of people affected by Alzheimer's and
dementia is growing at an epidemic pace, and the skyrocketing financial
and personal costs will devastate the world's economies and healthcare
systems, and far too many families," said William Thies, Ph.D., Chief
Medical & Scientific Officer at the Alzheimer's Association.
"We must make the fight against Alzheimer's a
priority before it's too late."
"However there is hope. There are many drugs in
late stage clinical trials for Alzheimer's that show promise to slow or
stop the progression of the disease. This, combined with advancements in
early detection, has the potential to change the landscape of
Alzheimer's in our lifetimes. But we need more funding for research to
see these possibilities through to completion," Thies said.
The research reported at ICAD 2009 includes a study
of more than 2,100 individuals age 80 years or older in eight
municipalities of Varese province, Italy, and a systematic review and
collaborative analysis of studies reporting the prevalence of dementia
in Europe.
Most dementia sufferers are eighty years or older,
the fastest growing segment of the elderly population in western
countries. Because of the small number of persons in this age class
usually included in population-based studies, prevalence and incidence
estimates fluctuate widely in the oldest old, making it hard to
establish whether the risk of dementia (and Alzheimer's disease)
continues to rise also at very high ages.
The Monzino 80-plus Study – Dementia Risk
Continues to Rise in the "Oldest Old"
Ugo Lucca, head of the Laboratory of Geriatric
Neuropsychiatry at the Mario Negri Institute for Pharmacological
Research in Milano, Italy, and colleagues conducted a prospective,
door-to-door, population-based study of all people age 80 years or older
in eight municipalities of Varese province, Italy, roughly 30 kilometers
(20 miles) north of Milan (known as the Monzino 80-plus Study).
Their goal was to estimate the prevalence (total
number with the disease) and incidence (new cases of the disease) of
dementia in this population.
The researchers were able to gather information and
an initial dementia evaluation for 2,138 individuals. The mean age of
the population at that first evaluation was 87.5 years; 74.1% were
women. Mean education was 5.1 years, and mean MMSE score was 21.4.
After an average follow-up period of three years,
of the 1,085 survivors non-demented at baseline, 995 were re-evaluated
for dementia.
Prevalence of dementia standardized on the 2008
Italian population was 22.9% and was higher in women (25.8%) than in men
(17.1%).
Prevalence increased with advancing age:
● 13.5% at 80-84 years
● 30.8% at 85-89
● 39.5% at 90-94
● 52.8% over 94
The estimated annual incidence of dementia
standardized on the 2008 Italian population was 8.6% and was higher in
women (9.2%) than in men (7.2%).
Incidence also rose with increasing age:
● 6.0% at 80-84 years
● 12.4% at 85-89
● 13.1% at 90-94
● 20.7% over 94
"Gathering reliable information on such a large
number of the 'oldest old' makes this one of the largest studies
investigating dementia in this age segment of the population," Lucca
said.
"This study's results confirm that Alzheimer's and
dementia are very common among the oldest people in society. We believe
this strengthens the need to shift more of the focus of clinical
research to this segment of the elderly population."
According to the researchers, though the rate of
women who developed dementia during the follow-up period was higher than
in men in this study, no definite conclusion can be drawn about this
difference because the number of men in the oldest ages became very
small.
Systematic Review of Dementia in Europe – Higher
Prevalence in Female "Oldest Old"
The goal of Dr. Emma Reynish, a consultant
geriatrician and coordinator of the European Alzheimer's Disease
Consortium from the Victoria Hospital, Kirkcaldy, Scotland, UK, and
colleagues at the EuroCoDe (European Collaboration on Dementia) project,
was to determine the prevalence of dementia in Europe based on up to
date research findings and including data from Eastern Europe.
They conducted an extensive literature search using
Cochrane review methodologies and compiled a database of all European
epidemiological studies in the field up to the present date. 194
articles were identified by the review and 26 studies met inclusion
criteria to participate with raw data in the collaborative analysis.
According to the researchers, while dementia
prevalence rates for all men and for women up to age 85 confirmed
previous findings, age-specific prevalence rates were higher than
previously documented in the female "oldest old" age groups, rising to
over 50% in those over 95 years.
"Our key findings confirmed that age remains as the
single most important risk factor for dementia," Reynish said.
"Nevertheless, due to the lack of data in the oldest old in previous
prevalence studies, the prevalence of dementia of women over the age of
85 had been underreported."
Background Information
About ICAD 2009
The 2009 Alzheimer's Association International
Conference on Alzheimer's Disease (ICAD 2009) brings together more than
3,000 researchers from 70 countries to share groundbreaking research and
information on the cause, diagnosis, treatment and prevention of
Alzheimer's disease and related disorders. As a part of the
Association's research program, ICAD 2009 serves as a catalyst for
generating new knowledge about dementia and fostering a vital, collegial
research community. ICAD 2009 will be held in Vienna, Austria at Messe
Wien Exhibition and Congress Center from July 11.
About the Alzheimer's Association
The Alzheimer's Association is the leading
voluntary health organization in Alzheimer care, support and research.
Our mission is to eliminate Alzheimer's disease through the advancement
of research, to provide and enhance care and support for all affected,
and to reduce the risk of dementia through the promotion of brain
health. Our vision is a world without Alzheimer's. For more information,
visit
www.alz.org.
Reference: Ugo Lucca, et al – Risk of dementia
continues to rise in the oldest old: The Monzino 80-plus Study (Funder:
Fondazione Italo Monzino (Milano, Italy))
Reference: Emma Reynish, et al – Systematic Review
and Collaborative Analysis of the Prevalence of Dementia in Europe
(Funder: European Commission, coordinated by Alzheimer Europe)
