title: Trends in Prevalence of Dementia in French Farmers from Two Epidemiological Cohorts.
abstract: OBJECTIVE
  To determine the prevalence of dementia and cognitive impairment in older people across generations.
  
  
  METHODS
  Two prospective cohort studies (Personnes Agées QUID (PAQUID), Aging Multidisciplinary Investigation (AMI)).
  
  
  METHODS
  Baseline data from two subsamples of older farmers in southwestern France.
  
  
  METHODS
  PAQUID (n = 595) and AMI (n = 906) participants aged 65 and older living at home at baseline (1988 PAQUID, 2008 AMI).
  
  
  METHODS
  Two methods were used to diagnose dementia: a clinical consensus diagnosis and a computer-assisted taxonomy approach (cognitive impairment with disability (CIWD)) using Mini-Mental State Examination and instrumental activity of daily living scores. Crude and standardized prevalences (using PAQUID age-sex structure) and 95% confidence intervals were calculated, and logistic regression was used to explore confounding.
  
  
  RESULTS
  The prevalence of consensus diagnosis of dementia was higher in AMI in 2008 than in PAQUID in 1988 (12.0% vs 5.7%, P < .001), whereas the reverse was observed for CIWD (14.8% vs 23.8%, P < .001), confirmed by logistic regressions (odds ratio (OR)AMIvsPAQUID= 2.50, 95% confidence interval (CI) = 1.52-4.12; ORAMIvs.PAQUID= 0.60, 95% CI = 0.42-0.87, respectively). Educational level increased and management of vascular risk factors improved over the study period, and health and living conditions improved globally.
  
  
  CONCLUSIONS
  These findings suggest global cognitive and functional improvement in old farmers (the prevalence of CIWD decreased by 40% over 20 years) and simultaneously a marked change in the subjective boundary between dementia and nondementia according to clinicians.
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Pérès
authors.affiliation: Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge, United Kingdom.
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Matharan
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.
authors.forename: Leslie
authors.initials: L
authors.lastname: Grasset
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|Clinical Investigation Center-Clinical Epidemiology 1401, INSERM, Bordeaux, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Helmer
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Letenneur
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|Memory Consultation, Centre Mémoire de Ressource et de Recherche, University Hospital, Bordeaux, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Foubert-Samier
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Baldi
authors.affiliation: Memory Consultation, Centre Mémoire de Ressource et de Recherche, University Hospital, Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Tison
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Amieva
authors.affiliation: University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.|Memory Consultation, Centre Mémoire de Ressource et de Recherche, University Hospital, Bordeaux, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology; D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology*; D000067565:Farmers / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D016016:Proportional Hazards Models
keywords: cognitive disorders; cohort studies; dementia; prevalence studies