Incident Dementia in a Defined Older Chinese Population

Abstract

BackgroundCurrent knowledge about incident dementia is mainly derived from studies undertaken in the West, showing that dementia is related to older age, low socio-economic status, lack of social network, depression and cardiovascular disease risk factors. We know little about incidence and predictors of dementia in China, where the prevalence is increasing and the patterns of risk factors are different.MethodsUsing a standard interview method, we examined 1526 non-demented people aged ≥65 years who had at least minimal educational level in China in a 7.5-year follow up. Incident dementia was diagnosed by GMS-AGECAT algorithms and psychiatrists.ResultsAge-standardised incidence of dementia was 14.7 per 1000 person-years (95%CI 11.3–18.2 per 1000 person-years). The increased risk was significantly associated with age, female gender (adjusted odds ratio 2.48, 95%CI 1.20–5.13), low educational levels, smoking, angina (2.58, 1.01–6.59) and living with fewer family members. Among participants with low educational level, the increased risk was associated with higher income, and with the highest and lowest occupational classes; adjusted odds ratio 2.74 (95%CI 1.12–6.70) for officers/teachers, 3.11 (1.61–6.01) for manual labourers/peasants.ConclusionsOur findings of high incidence of dementia and increased risk among people having low education levels but high income suggest a more potential epidemic and burden of dementia populations in China. Maintaining social network and activities and reducing cardiovascular factors in late life could be integrated into current multi-faceted preventive strategies for curbing the epidemic of dementia.

Angiotensin-Receptor Blockers and Risk of Alzheimer’s Disease in Hypertension Population

“…In order to study the effect of ARBs on AD, we excluded subjects with dementia or any diagnosis of apparent cerebrovascular disease before the start of antihypertensive treatment. In addition to the negative finding regarding ARB use and AD risk reduction, our data showed that traditional risk factors for dementia, such as age, DM, and female sex, 29 are also independent factors for the incidence of AD, supporting that our data are solid. However, antihypertensive regimens other than ARBs were not equally distributed in the 2 groups.…”

No Smoke Without Fire: Should We Be More Concerned About the Association Between Smoking and dementia?

“…Recently, we have examined a populationbased cohort study in China, and found that compared with never smokers, current smokers at baseline had a substantial excess in incident dementia (i.e., multivariate adjusted odds ratio was 2.39 [1.21-4.72]). Former smokers were also found to have an increase in the risk, but not significantly (OR: 1.66; 95% CI: 0.53-5.16) [12], which is consistent with the findings reported in the review by Anstey et al probably suggesting that giving up smoking would reduce the risk of dementia [8]. This provides further confirmation of the dangers that smoking poses to dementia risk.…”

Socioeconomic Deprivation and Survival After Stroke

“…In Austria, Arrich et al 19 found that occupation and income have an independent effect on risk of death, which is sustained after adjusting for stroke severity. Analyzing the Anhui cohort data 20 and systematically reviewing literature of Chinese studies (the results are orally presented with the current SLSR study together in Asia Pacific Stroke Conference, Hong Kong, September 2013; the full article is submitted for journal publication), we have demonstrated that survival time CI indicates confidence interval; HR, hazard ratio; SED, socioeconomic deprivation; and SLSR, South London Stroke Register. *The number of patients at the follow-up time was derived from those who were actually followed up to the time, including deaths.…”