Trends in the incidence and prevalence of Alzheimer's disease, dementia, and cognitive impairment in the United States.
Declines in heart disease and stroke mortality rates are conventionally attributed to reductions in cigarette smoking, recognition and treatment of hypertension and diabetes, effective medications to improve serum lipid levels and to reduce clot formation, and general lifestyle improvements. Recent evidence implicates these and other cerebrovascular factors in the development of a substantial proportion of dementia cases. Analyses were undertaken to determine whether corresponding declines in age-specific prevalence and incidence rates for dementia and cognitive impairment have occurred in recent years. Data spanning 1 or 2 decades were examined from community-based epidemiological studies in Minnesota, Illinois, and Indiana, and from the Health and Retirement Study, which is a national survey. Although some decline was observed in the Minnesota cohort, no statistically significant trends were apparent in the community studies. A significant reduction in cognitive impairment measured by neuropsychological testing was identified in the national survey. Cautious optimism appears justified.
Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA. rocca@mayo.edu
Walter A
WA
Rocca
Ronald C
RC
Petersen
David S
DS
Knopman
Liesi E
LE
Hebert
Denis A
DA
Evans
Kathleen S
KS
Hall
Sujuan
S
Gao
Frederick W
FW
Unverzagt
Kenneth M
KM
Langa
Eric B
EB
Larson
Lon R
LR
White
D000367:Age Factors; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D018672:Community Health Planning / Q000379:methods / Q000639:trends*; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D015995:Prevalence; D012111:Residence Characteristics; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology
J Am Geriatr Soc. 1988 May;36(5):402-8
3361042
J Gen Intern Med. 2001 Nov;16(11):770-8
11722692
J Alzheimers Dis. 2003 Oct;5(5):349-55
14646025
J Alzheimers Dis. 2009;18(3):713-25
19661625
Alzheimers Dement. 2007 Jul;3(3):186-91
19595937
Arch Neurol. 2006 Feb;63(2):218-21
16476810
Ann Neurol. 2010 Jan;67(1):114-21
20186856
Alzheimer Dis Assoc Disord. 1999 Oct-Dec;13 Suppl 3:S131-9
10609692
Lancet Neurol. 2004 Jun;3(6):343-53
15157849
Stroke. 1989 May;20(5):577-82
2718196
Dement Geriatr Cogn Disord. 2006;21(3):175-81
16401889
Arch Neurol. 2002 Oct;59(10):1589-93
12374497
J Lipid Res. 1990 Mar;31(3):545-8
2341813
Neurology. 2000;54(11 Suppl 5):S38-40
10854361
Am J Epidemiol. 1998 Jul 1;148(1):51-62
9663404
Hypertension. 2010 Jun;55(6):1352-9
20404223
Neurology. 2010 Aug 31;75(9):786-91
20805524
Am J Epidemiol. 1983 Nov;118(5):613-9
6356888
J Clin Epidemiol. 1992 Apr;45(4):393-402
1569435
Arch Neurol. 2003 Aug;60(8):1119-22
12925369
N Engl J Med. 2010 Jan 28;362(4):329-44
20107219
Mayo Clin Proc. 1996 Mar;71(3):266-74
8594285
Neurology. 2007 Dec 11;69(24):2197-204
17568013
Alzheimers Dement. 2005 Oct;1(2):152-60
19595848
Stroke. 1996 Mar;27(3):373-80
8610298
Am J Psychiatry. 1995 Oct;152(10):1485-92
7573588
Adv Gerontol. 2005;16:30-7
16075674
Neurology. 2009 Jan 27;72(4):368-74
19171835
Health Aff (Millwood). 2001 Sep-Oct;20(5):11-29
11558696
Alzheimer Dis Assoc Disord. 2006 Jul-Sep;20(3 Suppl 2):S69-74
16917199
Aust N Z J Psychiatry. 1998 Oct;32(5):698-706
9805594
J Alzheimers Dis. 2009;18(3):691-701
19749406
J Alzheimers Dis. 2003 Oct;5(5):383-90
14646029
Neurology. 1984 Jul;34(7):939-44
6610841
Alzheimers Dement. 2008 Mar;4(2):134-44
18631957
J Gerontol B Psychol Sci Soc Sci. 2002 Mar;57(2):P163-72
11867664
Am J Public Health. 1998 Sep;88(9):1337-42
9736873
Neuropsychobiology. 1986;15(3-4):122-9
3785641
Neuroepidemiology. 2005;25(4):181-91
16103729
Alzheimers Dement. 2007 Apr;3(2 Suppl):S16-22
19595969