Objective: We describe the design and methods of the Aging, Demographics, and Memory Study (ADAMS), a new national study that will provide data on the antecedents, prevalence, outcomes, and costs of dementia and ‘cognitive impairment, not demented’ (CIND) using a unique study design based on the nationally representative Health and Retirement Study (HRS). We also illustrate potential uses of the ADAMS data and provide information to interested researchers on obtaining ADAMS and HRS data. Methods: The ADAMS is the first population-based study of dementia in the United States to include subjects from all regions of the country, while at the same time using a single standardized diagnostic protocol in a community-based sample. A sample of 856 individuals age 70 or older who were participants in the ongoing HRS received an extensive in-home clinical and neuropsychological assessment to determine a diagnosis of normal, CIND, or dementia. Within the CIND and dementia categories, subcategories (e.g. Alzheimer’s disease, vascular dementia) were assigned to denote the etiology of cognitive impairment. Conclusion: Linking the ADAMS dementia clinical assessment data to the wealth of available longitudinal HRS data on health, health care utilization, informal care, and economic resources and behavior, will provide a unique opportunity to study the onset of CIND and dementia in a nationally representative population-based sample, as well as the risk factors, prevalence, outcomes, and costs of CIND and dementia.
Less than half of community-dwelling adult U.S. women with symptoms of urinary incontinence have talked with a physician about urinary incontinence. In addition to duration of symptoms, factors associated with treatment seeking included the impact of incontinence on quality of life, lack of embarrassment about talking to a physician about urinary symptoms, and attitudes toward healthcare use. Concerns about the meaning of incontinence for overall and future health were important reasons for women choosing to seek treatment.
revalence and incidence represent important characteristics of urinary incontinence as it appears in the population. Prevalence estimates P provide an indication of how widespread involuntary urine loss is and have important implications for the level of medical and self-care that is needed. Incidence estimates provide an indication of the onset of the condition and are critical when studying its development, risk factors, and sequelae.Early estimates of prevalence of incontinence in the community came almost exclusively from European studies. Several reviews of these studies are The reviews point out that prevalence estimates vary, and they suggest that differences in the definition of incontinence and in the sample account for much of the variability. More recently, several prevalence estimates have become available from regional or national US samples that had not been previously reviewed nor, in several instances, been formally published. This article complles prevalence and incidence estimates from American and non-American studies published or conducted since 1970. These studies used survey respondents' reports of involuntary urine loss to measure prevalence and, in some cases, incidence and symptoms of types of urinary incontinence. Some estimates had to be calculated from reported or computerized data. Because information regarding study design and measurement was incomplete for some of the studies, the estimates must be taken as close approximations only. Further details about the reestimation procedures are given in the Appendix.
Even though the direct psychosocial impact of urine loss may be minor in many cases, UI is associated with a constellation of physical and behavioral factors that can impose a social and emotional burden. This suggests that UI cannot be adequately evaluated or treated without consideration of the patient's overall quality of life.
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