title: A Population-based study of dementia in the oldest old: the Monzino 80-plus study.
abstract: BACKGROUND
  Despite being the fastest growing and the most cognitively impaired age group, the oldest olds are under-represented in clinical research. The purpose of this study was to describe the design, methods, and baseline characteristics of the survey population and investigate possible differences in demographic, cognitive, functional, and behavioral characteristics between oldest old with and without any performance on cognitive tests and between oldest old alive and those deceased prior to the interview.
  
  
  METHODS
  The Monzino 80-plus Study is a prospective door-to-door population-based survey among 80 years or older residents in the municipalities in the province of Varese, Italy. Dementia cases were identified with a one-phase design. Trained psychologists interviewed both the subject and a proxy informant. The interview included a comprehensive standardized questionnaire together with an array of rating scales and a multidomain cognitive battery to assess cognitive and functional ability, behavioral disturbances and mood.
  
  
  RESULTS
  Information was available for 2,139 of the 2,428 registered individuals aged 80 years or older. Main baseline characteristics of the population are reported and discussed. In comparison with those living, elderly persons who had died before the first visit were older, had twice the rate of institutionalization, poorer cognitive performance and competence, and significantly greater instrumental and basic functional disability. The percentage of elderly persons, alive at baseline, without Mini-Mental State Examination rose rather evenly with age. Moreover, they had significantly worse cognitive competence and functional ability, and reported higher prevalences of depressive symptoms and problem behaviors than those with Mini-Mental State Examination.
  
  
  CONCLUSIONS
  Prospective investigation of a large population of oldest old can contribute significantly to understanding the relations between age, cognitive decline, and dementia occurrence. Use of informant-based instruments in surveys in the oldest old is crucial in assessing everyday functioning and changes, especially in participants with no cognitive test performance available. Failure to include information on deceased elderly would underestimate, increasingly with age, the prevalence of cognitive and functional disability in the elderly population.
authors: Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy. lucca@marionegri.it
authors: Ugo
authors: U
authors: Lucca
authors: Mariateresa
authors: M
authors: Garrì
authors: Angela
authors: A
authors: Recchia
authors: Giancarlo
authors: G
authors: Logroscino
authors: Pietro
authors: P
authors: Tiraboschi
authors: Massimo
authors: M
authors: Franceschi
authors: Chiara
authors: C
authors: Bertinotti
authors: Anna
authors: A
authors: Biotti
authors: Elena
authors: E
authors: Gargantini
authors: Marilena
authors: M
authors: Maragna
authors: Alessandro
authors: A
authors: Nobili
authors: Luca
authors: L
authors: Pasina
authors: Carlotta
authors: C
authors: Franchi
authors: Emma
authors: E
authors: Riva
authors: Mauro
authors: M
authors: Tettamanti
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