title: Trends in dementia incidence: Evolution over a 10-year period in France.
abstract: BACKGROUND
  Few recent studies have suggested declining trends in dementia frequency. French cohorts with long follow-up allowed us to explore incidence evolution trends.
  
  
  METHODS
  Two different populations of subjects aged ≥65 years included in 1988-1989 (n = 1469) and 1999-2000 (n = 2104) were followed up over 10 years, with systematic assessment for cognition and dementia. Multistates illness-death models were used to compare dementia incidence using both clinical and algorithmic diagnoses.
  
  
  RESULTS
  Using the algorithmic diagnosis, incidence declined significantly overall and for women (age-adjusted hazard ratio [HR] = 0.62; confidence interval (CI) = 0.48-0.80 for women between the two populations). Differences in education, vascular factors, and depression accounted only to some extent for this reduction (women full-adjusted HR = 0.73; CI = 0.57-0.95). No significant decreasing trends were found for men or when using the clinical diagnosis for either sex.
  
  
  CONCLUSIONS
  Our study provides further support for a decrease in dementia incidence in women using algorithmic diagnosis. Changes in diagnostic boundaries mask this reduction.
authors.affiliation: INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France. Electronic address: Leslie.Grasset@isped.u-bordeaux2.fr.
authors.forename: Leslie
authors.initials: L
authors.lastname: Grasset
authors.affiliation: Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.affiliation: INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Joly
authors.affiliation: INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Jacqmin-Gadda
authors.affiliation: INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Peres
authors.affiliation: INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France; University Hospital, Memory Consultation, CMRR, Bordeaux, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Foubert-Samier
authors.affiliation: INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France; University Hospital, Memory Consultation, CMRR, Bordeaux, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.affiliation: INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France; INSERM, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Helmer
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D017678:Sex Distribution
keywords: Dementia; Diagnosis; Incidence; Risk factors; Time trends