Trends in dementia incidence: Evolution over a 10‐year period in France

Grasset, Leslie; Brayne, Carol; Joly, Pierre; Jacqmin‐Gadda, Hélène; Pérès, Karine; Foubert‐Samier, Alexandra; Dartigues, Jean‐François; Helmer, Catherine

doi:10.1016/j.jalz.2015.11.001

Cited by 89 publications

(110 citation statements)

References 29 publications

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“…Different trends have been reported for men and women, though results are conflicting [11,32,33]. We found similar trends for both sexes, even though overall rates were higher among women.…”

Section: Discussionsupporting

confidence: 70%

“…However, our analyses did not show any change in the overall incidence rate trend following initiation of these programs compared to the years prior to their introduction, nor did including a longer time period affect the overall incidence rate trend. Nevertheless, secular trends towards diagnosis in earlier stages of dementia are suggested by studies that compared clinical diagnosis with Mini-Mental State Examination (MMSE) scores over time, and found higher scores on the MMSE in patients diagnosed with dementia in more recent years [11,28]. Another limitation might be the inability to fully correct for increased overall life expectancy over time and the national development towards an increasing share of non-institutionalized older people [29].…”

Section: Discussionmentioning

confidence: 99%

“…Compared to our findings, age-specific rates were similar, and considering the time period since the 1990s, only small changes in the rates over time were found in both studies. Other studies in Sweden, France, and the US found small, nonsignificant changes in incidence rates over time [7,8,11,34]. Based on integration of prevalence and mortality figures, a study conducted in Stockholm, Sweden, suggested the possibility of reduced dementia incidence [35], and findings from a study in Zaragoza, Spain, showed a significant reduction in dementia prevalence only in men [32].…”

Section: Discussionmentioning

confidence: 99%

“…Based on integration of prevalence and mortality figures, a study conducted in Stockholm, Sweden, suggested the possibility of reduced dementia incidence [35], and findings from a study in Zaragoza, Spain, showed a significant reduction in dementia prevalence only in men [32]. Main limitations of these studies concerned decreasing response rates [5,11,32], with varying ability to assess the potential effects of such changes on the findings. Inflation of estimates may have taken place if nonstandardized diagnostic criteria were used [7,34] or when medical records were retrospectively used to supplement incomplete information [9,32], because of the increased inclusiveness of broader diagnostic criteria across time [5,32].…”

Section: Discussionmentioning

confidence: 99%

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Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data

et al. 2017

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BackgroundRecent reports have suggested declining age-specific incidence rates of dementia in high-income countries over time. Improved education and cardiovascular health in early age have been suggested to be bringing about this effect. The aim of this study was to estimate the age-specific dementia incidence trend in primary care records from a large population in the Netherlands.Methods and findingsA dynamic cohort representative of the Dutch population was composed using primary care records from general practice registration networks (GPRNs) across the country. Data regarding dementia incidence were obtained using general-practitioner-recorded diagnosis of dementia within the electronic health records. Age-specific dementia incidence rates were calculated for all persons aged 60 y and over; negative binomial regression analysis was used to estimate the time trend. Nine out of eleven GPRNs provided data on more than 800,000 older people for the years 1992 to 2014, corresponding to over 4 million person-years and 23,186 incident dementia cases. The annual growth in dementia incidence rate was estimated to be 2.1% (95% CI 0.5% to 3.8%), and incidence rates were 1.08 (95% CI 1.04 to 1.13) times higher for women compared to men. Despite their relatively low numbers of person-years, the highest age groups contributed most to the increasing trend. There was no significant overall change in incidence rates since the start of a national dementia program in 2003 (−0.025; 95% CI −0.062 to 0.011). Increased awareness of dementia by patients and doctors in more recent years may have influenced dementia diagnosis by general practitioners in electronic health records, and needs to be taken into account when interpreting the data.ConclusionsWithin the clinical records of a large, representative sample of the Dutch population, we found no evidence for a declining incidence trend of dementia in the Netherlands. This could indicate true stability in incidence rates, or a balance between increased detection and a true reduction. Irrespective of the exact rates and mechanisms underlying these findings, they illustrate that the burden of work for physicians and nurses in general practice associated with newly diagnosed dementia has not been subject to substantial change in the past two decades. Hence, with the ageing of Western societies, we still need to anticipate a dramatic absolute increase in dementia occurrence over the years to come.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data

et al. 2017

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“…4 A key determinant of the future burden of dementia will be the underlying incidence trend. Although the balance of evidence suggests dementia incidence is declining, [12][13][14][15][16][17][18] the magnitude of the decline is less certain. The ideal approach to determine time trends in dementia incidence would be based on continuous monitoring of a defined and representative population using a standard approach for case identification.…”

Section: Resultsmentioning

confidence: 99%

Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study

Ahmadi‐Abhari

Guzman-Castillo

Bandosz

et al. 2017

BMJ

199

159

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Objective To forecast dementia prevalence with a dynamic modelling approach that integrates calendar trends in dementia incidence with those for mortality and cardiovascular disease. Design Modelling study. Setting General adult population of England and Wales. Participants The English Longitudinal Study of Ageing (ELSA) is a representative panel study with six waves of data across 2002-13. Men and women aged 50 or more years, selected randomly, and their cohabiting partners were recruited to the first wave of ELSA (2002-03). 11392 adults participated (response rate 67%). To maintain representativeness, refreshment participants were recruited to the study at subsequent waves. The total analytical sample constituted 17 906 people. Constant objective criteria based on cognitive and functional impairment were used to ascertain dementia cases at each wave. Main outcome measures To estimate calendar trends in dementia incidence, correcting for bias due to loss to follow-up of study participants, a joint model of longitudinal and time-to-event data was fitted to ELSA data. To forecast future dementia prevalence, the probabilistic Markov model IMPACT-BAM (IMPACT-Better Ageing Model) was developed. IMPACT-BAM models transitions of the population aged 35 or more years through states of cardiovascular disease, cognitive and functional impairment, and dementia, to death. It enables prediction of dementia prevalence while accounting for the growing pool of susceptible people as a result of increased life expectancy and the competing effects due to changes in mortality, and incidence of cardiovascular disease. Results In ELSA, dementia incidence was estimated at 14.3 per 1000 person years in men and 17.0/1000 person years in women aged 50 or more in 2010. Dementia incidence declined at a relative rate of 2.7% (95% confidence interval 2.4% to 2.9%) for each year during 2002-13. Using IMPACT-BAM, we estimated there were approximately 767 000 (95% uncertainty interval 735 000 to 797 000) people with dementia in England and Wales in 2016. Despite the decrease in incidence and age specific prevalence, the number of people with dementia is projected to increase to 872 000, 1 092 000, and 1 205 000 in 2020, 2030, and 2040, respectively. A sensitivity analysis without the incidence decline gave a much larger projected growth, of more than 1.9 million people with dementia in 2040. Conclusions Age specific dementia incidence is declining. The number of people with dementia in England and Wales is likely to increase by 57% from 2016 to 2040. This increase is mainly driven by improved life expectancy.

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Sample Surveys in the Health Sciences

Beckett

Brock

Bienias³

et al. 2017

Wiley StatsRef: Statistics Reference Online

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The use of sample surveys in biostatistics arises from the need to answer questions about health issues in the community. The earliest uses of survey methodology in health research in the United States were motivated more by policy issues than by epidemiologic questions and paralleled the use of surveys by the US Census Bureau and other Federal agencies to address social and economic concerns. More recently, it has been recognized that research into the causes and outcomes of disease can benefit from studies in the entire community, rather than just in the formal health care system, particularly in countries such as the United States, where access to health care is not uniform. The Affordable Care Act, passed in 2010 with the goals of increasing access to and reducing the costs of health care in the United States, has motivated both government and nongovernment studies to assess its impact. A number of practical concerns about conducting studies in the community then lead to the use of sample surveys, rather than complete enumeration. In this article, we review the history of sample surveys in the health sciences, present an overview of the major elements and features in the design of sample surveys and analysis of data from such studies, and discuss major methodological advances especially in the last decade. Finally, we provide a large set of references that might be of use to the reader wishing to delve more deeply into specific areas.

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Trends in dementia incidence: Evolution over a 10‐year period in France

Abstract: Our study provides further support for a decrease in dementia incidence in women using algorithmic diagnosis. Changes in diagnostic boundaries mask this reduction.

Cited by 89 publications

References 29 publications

Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data

Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data

Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study

Sample Surveys in the Health Sciences

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