Alzheimer's, Dementia & Mental Health
Dementia, Mild Cognitive Impairment Common in
Rapidly Increasing 'Oldest Old' Women
Alzheimer's disease and mixed dementia account
about 80% of dementia cases; vascular dementia about 12.1%
May 9, 2011 - Mild cognitive
impairment, dementia, and their subtypes are common in the "oldest old"
women, which includes those 85 years of age and older, according to a
report in the May issue of Archives of Neurology, one of the JAMA/Archives
journals.
The oldest old is "the fastest
growing segment of the U.S. population and is expected to increase in
number by 40 percent during the next decade alone," the authors explain
as background information in the article.
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"Initial evidence suggests
that the incidence of all-cause dementia almost doubles with every 5
years of age and that the prevalence of dementia rises from
approximately 2 percent to 3 percent in those 65 to 75 years to 35
percent in those 85 years and older."
To characterize the prevalence
of mild cognitive impairment and its subtypes in oldest old women,
Kristine Yaffe, M.D., of the University of California at San Francisco,
and colleagues, evaluated data from 1,299 women enrolled in the Women
Cognitive Impairment Study of Exceptional Aging, an ancillary of the
Study of Osteoporotic Fractures.
The women had a mean (average)
age of 88.2 years and 27.0 percent were older than 90 years. Of the
women in the study, 231 (17.8 percent) were diagnosed as having dementia
and 301 (23.2 percent) as having mild cognitive impairment, for a
combined total of 41.0 percent with clinical cognitive impairment.
The prevalence of mild
cognitive impairment was higher in women 90 years or older than in women
85 to 89 years (24.5 percent vs. 22.7 percent).
Of the subtypes of mild
cognitive impairment, amnestic multiple domain (affecting multiple
cognitive functions, including memory difficulty) was most common,
followed by non-amnestic single domain (affecting one type of cognitive
function, not affecting memory) accounting for 33.9 percent and 28.9
percent respectively, with amnestic single domain (affecting one type of
cognitive function, including memory difficulty) affecting 21.9 percent
of women.
The prevalence of dementia in
women 90 years and older was approximately double that of women ages 85
to 89 years (28.2 percent vs. 13.9 percent), however the distribution of
dementia subtypes (Alzheimer's disease, vascular dementia, mixed or
other) was similar across all age groups.
Compared with women with
normal cognition, those with dementia were on average older, less likely
to have completed high school and more likely to live in a nursing home.
Women with dementia were also
more likely to have reported depression, a history of stroke, and to
have an apolipoprotein E ε4 (APOE ε4) allele (an alternative form of the
gene).
As treatment and course of
dementia differ by subtype, the authors note that, "the distribution of
dementia subtypes is vital for public health planning."
In the present sample of
oldest old women, Alzheimer's disease and mixed dementia accounted for
nearly 80 percent of dementia cases combined, and vascular dementia
accounted for 12.1 percent of cases. Therefore, "screening for cognitive
disorders in the oldest old is of the utmost importance, especially in
high-risk groups," the authors conclude.
This study was supported in
part by a grant from the National Institute of Aging and an Independent
Investigator Award from the Alzheimer's Association.
