The number of people with Alzheimer's and dementia – both new cases and total numbers with the disease – continues to rise among the very oldest segments of the population in contradiction of the conventional wisdom.
"The number of people affected by Alzheimer's and dementia is growing at an epidemic pace, and the skyrocketing financial and personal costs will devastate the world's economies and healthcare systems, and far too many families," said William Thies, Ph.D., Chief Medical & Scientific Officer at the Alzheimer's Association. "We must make the fight against Alzheimer's a priority before it's too late."
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New Research Shows that the Proportion of People with Alzheimer's and Dementia also Rises in the Oldest Age Groups
The number of people with Alzheimer's and dementia – both new cases and total numbers with the disease – continues to rise among the very oldest segments of the population in contradiction of the conventional wisdom, according to research reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.
Previous epidemiological studies have suggested that the number of people with Alzheimer's and dementia begins to level off and perhaps even go down a bit in people age 90 and above, known as the "oldest old." This is the fastest growing segment of the population in western countries.
"The number of people affected by Alzheimer's and dementia is growing at an epidemic pace, and the skyrocketing financial and personal costs will devastate the world's economies and healthcare systems, and far too many families," said William Thies, Ph.D., Chief Medical & Scientific Officer at the Alzheimer's Association. "We must make the fight against Alzheimer's a priority before it's too late."
"However there is hope. There are many drugs in late stage clinical trials for Alzheimer's that show promise to slow or stop the progression of the disease. This, combined with advancements in early detection, has the potential to change the landscape of Alzheimer's in our lifetimes. But we need more funding for research to see these possibilities through to completion," Thies said.
The research reported at ICAD 2009 includes a study of more than 2,100 individuals age 80 years or older in eight municipalities of Varese province, Italy, and a systematic review and collaborative analysis of studies reporting the prevalence of dementia in Europe.
The Monzino 80-plus Study – Dementia Risk Continues to Rise in the "Oldest Old"
Ugo Lucca, head of the Laboratory of Geriatric Neuropsychiatry at the Mario Negri Institute for Pharmacological Research in Milano, Italy, and colleagues conducted a prospective, door-to-door, population-based study of all people age 80 years or older in eight municipalities of Varese province, Italy, roughly 30 kilometers (20 miles) north of Milan (known as the Monzino 80-plus Study). Their goal was to estimate the prevalence (total number with the disease) and incidence (new cases of the disease) of dementia in this population.
The researchers were able to gather information and an initial dementia evaluation for 2,138 individuals. The mean age of the population at that first evaluation was 87.5 years; 74.1% were women. Mean education was 5.1 years, and mean MMSE score was 21.4. After an average follow-up period of three years, of the 1,085 survivors non-demented at baseline, 995 were re-evaluated for dementia.
Prevalence of dementia standardized on the 2008 Italian population was 22.9% and was higher in women (25.8%) than in men (17.1%). Prevalence increased with advancing age:
- 13.5% at 80-84 years
- 30.8% at 85-89
- 39.5% at 90-94
- 52.8% over 94
The estimated annual incidence of dementia standardized on the 2008 Italian population was 8.6% and was higher in women (9.2%) than in men (7.2%). Incidence also rose with increasing age:
- 6.0% at 80-84 years
- 12.4% at 85-89
- 13.1% at 90-94
- 20.7% over 94
"Gathering reliable information on such a large number of the 'oldest old' makes this one of the largest studies investigating dementia in this age segment of the population," Lucca said. "This study's results confirm that Alzheimer's and dementia are very common among the oldest people in society. We believe this strengthens the need to shift more of the focus of clinical research to this segment of the elderly population."
According to the researchers, though the rate of women who developed dementia during the follow-up period was higher than in men in this study, no definite conclusion can be drawn about this difference because the number of men in the oldest ages became very small.
Systematic Review of Dementia in Europe – Higher Prevalence in Female "Oldest Old"
The goal of Dr. Emma Reynish, a consultant geriatrician and coordinator of the European Alzheimer's Disease Consortium from the Victoria Hospital, Kirkcaldy, Scotland, UK, and colleagues at the EuroCoDe (European Collaboration on Dementia) project, was to determine the prevalence of dementia in Europe based on up to date research findings and including data from Eastern Europe. They conducted an extensive literature search using Cochrane review methodologies and compiled a database of all European epidemiological studies in the field up to the present date. 194 articles were identified by the review and 26 studies met inclusion criteria to participate with raw data in the collaborative analysis.
According to the researchers, while dementia prevalence rates for all men and for women up to age 85 confirmed previous findings, age-specific prevalence rates were higher than previously documented in the female "oldest old" age groups, rising to over 50% in those over 95 years.
"Our key findings confirmed that age remains as the single most important risk factor for dementia," Reynish said. "Nevertheless, due to the lack of data in the oldest old in previous prevalence studies, the prevalence of dementia of women over the age of 85 had been underreported."
Ugo Lucca, Mariateresa Garrì, Alessandro Nobili, Luca Pasina, Francesca Gandini, Emma Riva, Mauro Tettamanti
Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
Contact e-mail: lucca@marionegri.it
About ICAD 2009
The 2009 Alzheimer's Association International Conference on Alzheimer's Disease (ICAD 2009) brings together more than 5,000 researchers from 60 countries to share groundbreaking research and information on the cause, diagnosis, treatment and prevention of Alzheimer's disease and related disorders. As a part of the Association's research program, ICAD 2009 serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community. ICAD 2009 will be held in Vienna, Austria at Messe Wien Exhibition and Congress Center from July 11–16.
About the Alzheimer's Association
The Alzheimer's Association is the leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. For more information, visit www.alz.org.
Ugo Lucca, et al – Risk of dementia continues to rise in the oldest old: The Monzino 80-plus Study (Funder: Fondazione Italo Monzino (Milano, Italy))
Emma Reynish, et al – Systematic Review and Collaborative Analysis of the Prevalence of Dementia in Europe (Funder: European Commission, coordinated by Alzheimer Europe)
Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for advice and insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 700 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.
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