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Risk factors for incident dementia in the very old

Published online by Cambridge University Press:  11 April 2013

Karin Wallin ,
Gustaf Boström ,
Miia Kivipelto  and
Yngve Gustafson
Karin Wallin*
Affiliation:
Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden Karolinska Institutet Alzheimer Disease Research Center (KI-ADRC), Karolinska Institutet, Stockholm, Sweden Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Gustaf Boström
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Miia Kivipelto
Affiliation:
Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden Karolinska Institutet Alzheimer Disease Research Center (KI-ADRC), Karolinska Institutet, Stockholm, Sweden Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland Department of Neurology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
Yngve Gustafson
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
*
Correspondence should be addressed to: Karin Wallin, Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, SE-11330 Stockholm, Sweden. Phone: +46-730-52-48-94; Fax: +46-8-690-59-54. Email: Karin.Wallin@ki.se.
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Abstract

Background: Several risk factors for dementia, Alzheimer's disease, and cognitive impairment have been established; however, knowledge about risk factors in the very old population (≥85 years) is limited. This study describes the association of several baseline factors with dementia in participants aged ≥85 years, and investigates factors associated with a higher risk of incident dementia over five years.

Methods: The participants in this population-based cohort study were aged 85, 90, and ≥95 years at baseline (2000–2002). Data were collected during home visits for interviews and testing, from a review of medical records, and/or interviewing the caregiver or next of kin. After five years 212 participants could be followed up concerning incident dementia. Multivariate logistic regression was used.

Results: At baseline, 100/353 (28%) of participants had a dementia diagnosis. Over five years, 71/212 (33.5%) participants developed dementia. Few participants with dementia at baseline remained alive after five years (12%). Depression at the baseline and follow-up time were associated with a higher risk of dementia, odds ratio (OR) (95% CI, p-value) 2.91 (1.37–6.16, 0.005) and 1.61 (1.26–2.05, <0.001) respectively. More social contact and a higher Mini-Mental State Examination score at baseline were associated with lower risk of incident dementia, OR (95% CI, p-value) 0.87 (0.78–0.97, 0.009) and 0.83 (0.74–0.93, 0.001) respectively.

Conclusions: Prevalence and incidence of dementia are high in very old people and dementia appears to be a fatal disorder. Depression is associated with higher risk of incident dementia over five years whereas more frequent social contacts and a higher MMSE score are associated with lower risk.

Keywords

aged80 and overlongitudinalpopulation-baseddepressionsocial isolationprevalenceincidence
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 7 , July 2013 , pp. 1135 - 1143
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Bennett, D. A., Schneider, J. A., Tang, Y., Arnold, S. E. and Wilson, R. S. (2006). The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal study. Lancet Neurology, 5, 406–412.CrossRefGoogle Scholar
Butters, M. A.et al. (2008). Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues in Clinical Neuroscience, 10, 345–357.CrossRefGoogle ScholarPubMed
Byers, A. L. and Yaffe, K. (2011). Depression and risk of developing dementia. Nature Reviews. Neurology, 7, 323–331.CrossRefGoogle ScholarPubMed
Christmas, D. M., Potokar, J. and Davies, S. J. (2011). A biological pathway linking inflammation and depression: activation of indoleamina 2,3-dioxygenase. Neuropsychiatric Disease and Treatment, 7, 431–439.Google ScholarPubMed
Dziedzic, T. (2006). Systemic inflammatory markers and risk of dementia. American Journal of Alzheimer's Disease and other Dementias, 21, 258–262.CrossRefGoogle ScholarPubMed
Enache, D., Winblad, B. and Aarsland, D. (2011). Depression in dementia: epidemiology, mechanisms, and treatment. Current Opinion in Psychiatry, 24, 461–472.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fratiglioni, L., Paillard-Borg, S. and Winblad, B. (2004). An active and socially integrated lifestyle in late life might protect against dementia . Lancet Neurology, 3, 343–353.CrossRefGoogle ScholarPubMed
Fratiglioni, L., von Strauss, E. and Qiu, C. (2008). Epidemiology of the dementias of old age. In Jacoby, R., Oppenheimer, C., Dening, T. and Thomas, A. (eds.), Oxford Textbook of Old Age Psychiatry (pp. 391–506). Oxford, UK: Oxford University Press.Google Scholar
Fratiglioni, L. and Wang, H. X. (2007). Brain reserve hypothesis in dementia. Journal of Alzheimer's Disease, 12, 11–22.CrossRefGoogle ScholarPubMed
Guigoz, Y., Vellas, B. and Garry, P. J. (1994). Mini-Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts, Research and Intervention in Geriatrics, 4, 15–59.Google Scholar
Jensen, E., Dehlin, O. and Gustafson, L. (1993). A comparison between three psychogeriatric rating scales. International Journal of Geriatric Psychiatry, 8, 215–229.CrossRefGoogle Scholar
Lawton, M. P. (1975). The Philadelphia Geriatric Center Morale Scale: a revision. Journal of Gerontology, 30, 85–89.CrossRefGoogle ScholarPubMed
Mahoney, F. I. and Barthel, D. W. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
Mangialasche, F., Kivipelto, M., Solomon, A. and Fratiglioni, L. (2012). Dementia prevention: current epidemiological evidence and future perspective. Alzheimer's Research and Therapy, 4, 6.CrossRefGoogle ScholarPubMed
Mathillas, J., Lövheim, H. and Gustafson, Y. (2011). Increasing prevalence of dementia among very old people. Age and Aging, 40, 243–249.CrossRefGoogle ScholarPubMed
Mitchell, A. J. and Shiri-Feshki, M. (2009). Rate of progression of mild cognitive impairment to dementia – meta-analysis of 41 robust inception cohort studies. Acta Psychiatrica Scandinavica, 119, 252–265.CrossRefGoogle ScholarPubMed
Molander, L., Gustafson, Y. and Lövheim, H. (2010a). Low blood pressure is associated with cognitive impairment in very old people. Dementia and Geriatric Cognitive Disorders, 29, 335–341.CrossRefGoogle ScholarPubMed
Molander, L., Gustafson, Y. and Lövheim, H. (2010b). Longitudinal associations between blood pressure and dementia in the very old. Dementia and Geriatric Cognitive Disorders, 30, 269–276.CrossRefGoogle ScholarPubMed
Montgomery, S. A. and Åsberg, M. (1979). A new depression scale designed to be sensitive to change. The British Journal of Psychiatry, 40, 382–389.CrossRefGoogle Scholar
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194.CrossRefGoogle ScholarPubMed
Qiu, C., De Ronchi, D. and Fratiglioni, L. (2007). The epidemiology of the dementias: an update. Current Opinion in Psychiatry, 20, 380–385.CrossRefGoogle ScholarPubMed
Rastas, S.et al. (2010). Vascular risk factors and dementia in the general population aged >85 years: prospective population-based study. Neurobiology of Aging, 31, 1–7.CrossRefGoogle ScholarPubMed
Rodda, J., Walker, Z. and Carter, J. (2011). Depression in older adults. BMJ, 343, d5219.CrossRefGoogle ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165–172.Google Scholar
Spira, A. P., Rebok, G. W., Stone, K. L., Kramer, J. H. and Yaffe, K. (2012). Depressive symptoms in oldest-old women: risk of mild cognitive impairment and dementia. The American Journal of Geriatric Psychiatry, 20, 1006–1015. doi:10.1097/JGP.0b013e318235b611.CrossRefGoogle ScholarPubMed
United Nations, Population Division. (2010). World Population Prospects, the 2010 Revision (database on the Internet). Available at: http://esa.un.org/wpp/Documentation/pdf/WPP2010_Highlights.pdf; last accessed 31 May 2012.Google Scholar
von Heideken Wågert, P.et al. (2006). Health status in the oldest old. Age and sex differences in the Umea 85+study. Aging Clinical and Experimental Research, 18, 116–126.CrossRefGoogle ScholarPubMed
Wallin, K., Solomon, A., Kåreholt, I., Tuomilehto, J., Soininen, H. and Kivipelto, M. (2012). Midlife rheumatoid arthritis increases the risk of cognitive impairment two decades later: a population-based study. Journal of Alzheimer's Disease, 31, 669–676.CrossRefGoogle ScholarPubMed