The Enigma of Decreasing Dementia Incidence

Knopman, David S.

doi:10.1001/jamanetworkopen.2020.11199

Cited by 12 publications

(10 citation statements)

References 9 publications

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“…Metformin in persons with Type 2 diabetes mellitus reduces dementia (17,18). The prevalence of dementia has been reduced in the USA over the last decade, most probably due to the treatment of hypertension (19,20).…”

Section: Sleep Apneamentioning

confidence: 99%

Management of Cognitive Dysfunction

Morley

2021

The Journal of nutrition, health and aging

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Section: Sleep Apneamentioning

confidence: 99%

Management of Cognitive Dysfunction

Morley

2021

The Journal of nutrition, health and aging

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“…3,6,[9][10][11][12][13][14][15][16][17][18] Some have addressed the decreasing dementia incidence in the past 30 years as a mystery of the unexpected trend. 19…”

Section: Introductionmentioning

confidence: 99%

Global, regional, and national trends of dementia incidence and risk factors, 1990–2019: A Global Burden of Disease study

Avan

Hachinski

2022

Alzheimer's & Dementia

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Background: An ample literature documents the growing prevalence of dementia and associated costs. Less attention has been paid to decreased dementia incidence in some countries. Methods:We analyzed trends in age-standardized dementia, stroke, and ischemic heart disease (the triple threat) incidence rates and population attributable fraction of death and disability attributable to 12 risk factors in 204 countries and territories and 51 regions using Global Burden of Disease 2019 data.Results: During 1990 to 2019, dementia incidence declined in 71 countries; 18 showed statistically significant declines, ranging from -12.1% (95% uncertainty intervals -16.9 to -6.8) to -2.4% (-4.6 to -0.5). During 2010 to 2019, 16 countries showed non-significant declines. Globally, the burden of the triple threat attributable to air pollution, dietary risks, non-optimal temperature, lead exposure, and tobacco use decreased from 1990 to 2019. Conclusion:The declining incidence of dementia in some countries, despite growing prevalence, is encouraging and urges further investigation.

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“…1 Although the incidence rates of dementia have decreased modestly over the last 30 years, the prevalence of dementia is increasing worldwide, likely due to increased life expectancy. 2 This has enormous costs for the individuals and families affected, as well as the healthcare and society. 3 Kidney disease is another disorder with a high (close to 10%) and increasing prevalence, partly due to ageing population, and increased incidence rates of hypertension and diabetes mellitus.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Kidney disease and risk of dementia: a Danish nationwide cohort study

et al. 2021

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ObjectivesIt is unclear whether kidney disease is a risk factor for developing dementia. We examined the association between kidney disease and risk of future dementia.Design and settingNationwide historical registry-based cohort study in Denmark based on data from 1 January 1995 until 31 December 2016.ParticipantsAll patients diagnosed with kidney disease and matched general population cohort without kidney disease (matched 1:5 on age, sex and year of kidney disease diagnosis).Primary and secondary outcome measuresAll-cause dementia and its subtypes: Alzheimer’s disease, vascular dementia and other specified or unspecified dementia. We computed 5-year cumulative incidences (risk) and hazard ratios (HRs) for outcomes using Cox regression analyses.ResultsThe study cohort comprised 82 690 patients with kidney disease and 413 405 individuals from the general population. Five-year and ten-year mortality rates were twice as high in patients with kidney disease compared with the general population. The 5-year risk for all-cause dementia was 2.90% (95% confidence interval: 2.78% to 3.08%) in patients with kidney disease and 2.98% (2.92% to 3.04%) in the general population. Compared with the general population, the adjusted HRs for all-cause dementia in patients with kidney disease were 1.06 (1.00 to 1.12) for the 5-year follow-up and 1.08 (1.03 to 1.12) for the entire study period. Risk estimates for dementia subtypes differed substantially and were lower for Alzheimer’s disease and higher for vascular dementia.ConclusionsPatients diagnosed with kidney disease have a modestly increased rate of dementia, mainly driven by vascular dementia. Moreover, patients with kidney disease may be underdiagnosed with dementia due to high mortality and other comorbidities of higher priority.

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The Enigma of Decreasing Dementia Incidence

Cited by 12 publications

References 9 publications

Management of Cognitive Dysfunction

Management of Cognitive Dysfunction

Global, regional, and national trends of dementia incidence and risk factors, 1990–2019: A Global Burden of Disease study

Kidney disease and risk of dementia: a Danish nationwide cohort study

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