| 1. |
- De Ronchi, D, et al.
(author)
-
Occurrence of cognitive impairment and dementia after the age of 60: a population-based study from Northern Italy
- 2005
-
In: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 19:2-3, s. 97-105
-
Journal article (peer-reviewed)abstract
- <i>Objective:</i> To evaluate the age, gender and education distribution of both cognitive impairment and dementia in the whole old age range of the elderly (from 61 years of age and over). <i>Subjects and Methods:</i> The study population consisted of all subjects born in 1930 or before, living in the municipality of Faenza and Granarolo, Italy (n = 7,930). A two-phase study design was implemented, by using the Mini-Mental State Examination and Global Deterioration Scale as screening instruments. The DSM-III-R diagnostic criteria were used for the clinical diagnosis of dementia. A subject was classified as affected by cognitive impairment, no dementia (CIND) if he/she scored 2 or more standard deviations lower than the corrected mean MMSE score. <i>Results:</i> The prevalences of dementia and CIND were 6.5 per 100 (95% CI 5.9–7.0) and 5.1 per 100 (95% CI 4.6–5.6), respectively. The prevalence of CIND was higher than that of dementia in the youngest old groups (61–74 years), both in men and women, whereas the opposite pattern was present among the older old (75+). In the older age groups, dementia prevalence increased exponentially with age, while CIND prevalence was more stable. There was not a substantial gender difference in CIND prevalence in all ages. Only in the subpopulation of higher educated subjects, women had a higher prevalence of both dementia and CIND than men. Lower educated subjects had a higher prevalence of both dementia and CIND. When compared to higher educated persons, subjects without any schooling had odds ratios of 10.9 (CI 7.0–16.7) and 16.7 (CI 11.2–25.0) for dementia and CIND, respectively. <i>Conclusions:</i> Cognitive impairment is very common in the younger old ages (under 70 years of age), whereas dementia becomes predominant after 75 years of age. Both conditions are strongly related to the educational level.
|
|
| 2. |
- De Ronchi, D, et al.
(author)
-
The combined effect of age, education, and stroke on dementia and cognitive impairment no dementia in the elderly
- 2007
-
In: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 24:4, s. 266-273
-
Journal article (peer-reviewed)abstract
- <i>Background:</i> This study aims to detect the impact of stroke on the occurrence of dementia and cognitive impairment/no dementia (CIND) in different age, sex, and education groups. <i>Methods:</i> Persons with dementia (DSM-III-R) or CIND were identified by a two-phase study design among 7,930 persons from the population-based Faenza Community Aging Study. <i>Results:</i> Subjects with a history of stroke had increased risk of both dementia [risk ratio (RR) = 3.7; 95% confidence interval (CI) = 3.1–4.4] and CIND (RR = 1.7, 95% CI = 1.4–2.2). These associations were stronger in the younger-old (61–74 years) than in the older-old (75+ years), and among higher-educated (4+ years) than lower-educated (0–3 years of schooling) persons. Dementia and CIND prevalence among stroke subjects was similar to the prevalence detected among subjects 10 years older but without a history of stroke. In stroke subjects, dementia prevalence became higher than CIND prevalence 10 years earlier than in non-stroke subjects. A combined effect for dementia due to a history of stroke, increasing age, and decreasing years of schooling was detected. <i>Conclusions:</i> Stroke is a strong risk factor for dementia among younger-old and higher-educated subjects; in the presence of a stroke, dementia onset might occur about 10 years earlier, possibly by accelerating the progression from CIND to dementia.
|
|
| 3. |
- Eriksson, UK, et al.
(author)
-
Asthma, eczema, rhinitis and the risk for dementia
- 2008
-
In: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 25:2, s. 148-156
-
Journal article (peer-reviewed)abstract
- <i>Background:</i> Inflammation is associated with Alzheimer’s disease (AD) and dementia. In light of the chronic inflammatory properties of the atopic disorders asthma, eczema and rhinitis, we hypothesized an association with dementia. <i>Methods:</i> Self-reported asthma, eczema or rhinitis was assessed (prior to dementia follow-up) through questionnaires in the 1960s or 1970s in twins from the population-based Swedish Twin Registry. Dementia was assessed both longitudinally (n = 22,188), through linkages to two population-based registers, and cross-sectionally (n = 7,800), through telephone cognitive screening followed by a clinical evaluation of suspects of dementia. Risk ratios were estimated with Cox and logistic regression models controlling for vascular disease and genetic confounding. <i>Results:</i> In the longitudinal study, a history of atopy was positively associated with dementia (HR = 1.16; 1.01–1.33). In the cross-sectional study we found overall lower risks, none of which was statistically significant. Asthma was associated with a shorter survival time following AD onset. <i>Conclusions:</i> Atopy is associated with a modestly increased risk of AD and dementia that is not mediated by vascular disease or due to genetic confounding. A history of asthma is associated with shorter life expectancy after AD diagnosis.
|
|
| 4. |
- Jones, S, et al.
(author)
-
A preclinical phase in vascular dementia: cognitive impairment three years before diagnosis
- 2004
-
In: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 18:3-4, s. 233-239
-
Journal article (peer-reviewed)abstract
- Alzheimer’s disease (AD) and vascular dementia (VaD) patients exhibit similar patterns of deficits in many cognitive tasks in the early clinical stages. Considering that preclinical cognitive deficits are well documented in AD, the purpose of the present study was to investigate if such deficits are also present in VaD. The cognitive outcome measure was the Mini-Mental State Examination (MMSE). The sample was taken from a population-based study and consisted of 699 persons who were nondemented at baseline, but out of whom 35 persons were diagnosed with VaD and 170 with AD at a 3-year follow-up. Both the incident VaD and AD cases exhibited baseline deficits on the total score of the MMSE and three of the subscales: orientation to time, orientation to place, and delayed memory. Further, both dementia groups exhibited precipitous decline on most MMSE subscales during the 3-year follow-up period. Logistic regression analyses showed that all subscales that revealed deficits at baseline predicted dementia status at follow-up. Delayed memory was the best predictor in both preclinical VaD and preclinical AD. Thus, these results demonstrate preclinical cognitive deficits in VaD in a measure of global cognitive functioning, which closely resemble those observed in AD. This observation suggests that circulatory disturbance is associated with cognitive problems several years before the actual VaD diagnosis.
|
|
| 5. |
- Karp, A, et al.
(author)
-
Mental, physical and social components in leisure activities equally contribute to decrease dementia risk
- 2006
-
In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 21:2, s. 65-73
-
Journal article (peer-reviewed)abstract
- Background: There is accumulating evidence in the literature that leisure engagement has a beneficial effect on dementia. Most studies have grouped activities according to whether they were predominantly mental, physical or social. Since many activities contain more than one component, we aimed to verify the effect of all three major components on the dementia risk, as well as their combined effect. Methods: A mental, social and physical component score was estimated for each activity by the researchers and a sample of elderly persons. The correlation between the ratings of the authors and the means of the elderly subjects' ratings was 0.86. The study population consisted of 776 nondemented subjects, aged 75 years and above, living in Stockholm, Sweden, who were still nondemented after 3 years and were followed for 3 more years to detect incident dementia cases. Results: Multi-adjusted relative risks (RRs) of dementia for subjects with higher mental, physical and social component score sums were 0.71 (95% CI: 0.49-1.03), 0.61 (95% CI: 0.42-0.87) and 0.68 (95% CI: 0.47-0.99), respectively. The most beneficial effect was present for subjects with high scores in all or in two of the components (RR of dementia = 0.53; 95% CI: 0.36-0.78). Conclusions: These findings suggest that a broad spectrum of activities containing more than one of the components seems to be more beneficial than to be engaged in only one type of activity
|
|
| 6. |
- Mecocci, P, et al.
(author)
-
Cognitive Impairment Is the Major Risk Factor for Development of Geriatric Syndromes during Hospitalization : Results from the GIFA Study
- 2005
-
In: Dementia and Geriatric Cognitive Disorders. - Basel : Karger. - 1420-8008 .- 1421-9824. ; 20:4, s. 262-269
-
Journal article (peer-reviewed)abstract
- Objective: To detect the main factors associated with the occurrence of specific geriatric syndromes (namely pressure sores, fecal incontinence, urinary incontinence and falls) in elderly patients during hospitalization. Design: Observational prospective study. Setting: Eighty-one community and university hospitals throughout Italy. Participants: 13,729 patients aged 65 years and more, consecutively admitted to medical or geriatric acute wards during 20 months in the period between 1991 and 1998. Measurements: Occurrence of pressure sores, fecal incontinence, urinary incontinence and falls during the stay in hospital. Results: Pressure sores were already present in 3% of hospitalized subjects, fecal incontinence in 7.3%, while urinary incontinence, evaluated on a subgroup of total population (4,268 subjects), had a prevalence of 22.3%. During hospitalization (mean stay of 15 days), 74 subjects developed new pressure sores, 55 became fecal and 35 urinary incontinent, and 279 subjects had at least one episode of fall. In multivariate analyses, cognitive impairment, advanced age (85+ years), length of stay (more than 3 weeks) and severe disability were the main independent predictors of development of the four geriatric syndromes, with cognitive impairment as the most significant risk factor for all the four outcomes (OR 4.9, 95% CI 2.4–9.9 for pressure sores; OR 6.3, 95% CI 3.0–13.0 for fecal incontinence; OR 5.3, 95% CI 2.3–12.0 for urinary incontinence; OR 1.6, 95% CI 1.2–2.3 for falls). Conclusion: Very old people have a significant increased risk of several geriatric syndromes during the stay in hospital, particularly if it is long and they are cognitively impaired. A standardized comprehensive geriatric evaluation at admission could be helpful in detecting all subjects at risk and preventing the development of hospital-acquired geriatric syndromes.
|
|
| 7. |
- Paillard-Borg, Stéphanie, et al.
(author)
-
Leisure activities in late life in relation to dementia risk : principal component analysis
- 2009
-
In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 28:2, s. 136-144
-
Journal article (peer-reviewed)abstract
- AIMS: To explore the underlying dimensions of a set of interrelated lifestyle factors and test the hypothesis that an active lifestyle may protect against dementia. METHODS: The study population consisted of 776 participants aged >or=75 years who were dementia-free at both baseline and the first follow-up examinations. Participation in leisure activities was assessed at baseline of the survey, and principal component analysis was used to identify their underlying factors. RESULTS: During the 9-year follow-up from exposure assessment, 212 subjects developed dementia. Higher factor scores of physical, mental, and social dimensions of an active lifestyle was each related to a lower dementia risk. A significant dose-response association between participation in the diverse dimensions and lower dementia risk was observed. CONCLUSION: An active lifestyle may protect older people against dementia, and the higher level of engagement the stronger protection.
|
|
| 8. |
- Qiu, CX, et al.
(author)
-
Low diastolic pressure and risk of dementia in very old people: a longitudinal study
- 2009
-
In: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 28:3, s. 213-219
-
Journal article (peer-reviewed)abstract
- <i>Background/Aim:</i> Midlife high blood pressure is linked to late-life dementia. We sought to investigate the temporal relation of blood pressure to the risk of dementia and Alzhei-mer’s disease (AD) among older adults. <i>Methods:</i> A dementia-free cohort (n = 422) aged ≥81 years was followed for 3 years to detect dementia and AD cases (Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria). The blood pressure was measured 4 times over a 9-year period starting from ≥75 years of age. The data were analyzed with Cox models controlling for potential confounders. <i>Results:</i> During the 954 person-years of follow- up, 89 subjects developed dementia (72 AD cases). Low diastolic pressure (<70 vs. 70–89 mm Hg) was associated with a multiadjusted hazard ratio of 2.13 [95% confidence interval (CI) = 1.05–4.32] for dementia and 2.16 (95% CI = 0.98–4.73) for AD occurring over a 6-to 9-year period, whereas high diastolic pressure (≥90 mm Hg) was marginally related to a decreased hazard ratio of 0.58 (95% CI = 0.33–1.02) for dementia and 0.57 (95% CI = 0.30–1.09) for AD. Systolic pressure was not significantly related to dementia risk. Subjects who developed dementia had a greater decline in blood pressure than persons who did not, mainly during the 3-year period before dementia diagnosis. <i>Conclusion:</i> Low diastolic pressure predicts the risk of dementia among very old people, and the blood pressure exhibits a substantial decline over around 3 years before the dementia syndrome becomes clinically evident.
|
|
