Cognition, function, and prevalent dementia in centenarians and near‐centenarians: An individual participant data (IPD) meta‐analysis of 18 studies (original) (raw)
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BMC neurology, 2016
Considerable variability exists in international prevalence and incidence estimates of dementia. The accuracy of estimates of dementia in the oldest-old and the controversial question of whether dementia incidence and prevalence decline at very old age will be crucial for better understanding the dynamics between survival to extreme old age and the occurrence and risk for various types of dementia and comorbidities. International Centenarian Consortium - Dementia (ICC-Dementia) seeks to harmonise centenarian and near-centenarian studies internationally to describe the cognitive and functional profiles of exceptionally old individuals, and ascertain the trajectories of decline and thereby the age-standardised prevalence and incidence of dementia in this population. The primary goal of the ICC-Dementia is to establish a large and thorough heterogeneous sample that has the power to answer epidemiological questions that small, separate studies cannot. A secondary aim is to examine cohor...
The 100-plus Study of cognitively healthy centenarians: rationale, design and cohort description
European journal of epidemiology, 2018
Although the incidence of dementia increases exponentially with age, some individuals reach more than 100 years with fully retained cognitive abilities. To identify the characteristics associated with the escape or delay of cognitive decline, we initiated the 100-plus Study ( www.100plus.nl ). The 100-plus Study is an on-going prospective cohort study of Dutch centenarians who self-reported to be cognitively healthy, their first-degree family members and their respective partners. We collect demographics, life history, medical history, genealogy, neuropsychological data and blood samples. Centenarians are followed annually until death. PET-MRI scans and feces donation are optional. Almost 30% of the centenarians agreed to post-mortem brain donation. To date (September 2018), 332 centenarians were included in the study. We analyzed demographic statistics of the first 300 centenarians (25% males) included in the cohort. Centenarians came from higher socio-economic classes and had high...
Cognitive functional status of age-confirmed centenarians in a population-based study
2001
The New England Centenarian Study is a population-based study of all centenarians in 8 towns near Boston, MA. Age was confirmed for 43 centenarians all alive on a designated date. To determine prevalence of dementia in centenarians, the authors analyzed neuropsychological, medical, and functional status data for 34 (79%) of the centenarians. Definition of dementia was based on the Consortium to Establish a Registry for Alzheimer's Disease criteria, and a Clinical Dementia Rating (CDR) score was formulated for each participant. Seven (21%) had no dementia (CDR score 0), and an additional 4 (12%) were assigned a CDR score of 0.5, uncertain or deferred diagnosis. The remaining 22 (64%) had at least some degree of dementia. The authors calculated Barthel Index scores to determine ability to perform activities of daily living. There was a statistically significant correlation between CDR scores and Barthel Index scores (r =-0.73). Correlation was strongest for those with no or severe dementia, with the greatest range of function measured among those with moderate dementia.
The Journals of Gerontology: Series A
Background Recent studies suggest a decline in the age-specific incidence and prevalence of dementia. However, results are mixed regarding trends among octogenarians. We investigated time trends in the prevalence and incidence of dementia in 3 population-based cohorts of 85–90-year olds. We also examined if there were different time trends for men and women. Methods We examined population-based birth cohorts within the Gothenburg H70 Birth Cohort Studies born 1901–02, 1923–24, and 1930, at ages 85 (N = 1481) and 88 (N = 840) years. The first 2 cohorts were also examined at age 90 (N = 450). The incidence was examined in 1 109 individuals free from dementia at baseline using information from the examination at age 88 or register data. All 3 cohorts were examined with identical methods. Results The prevalence of dementia decreased from 29.8% in 1986–87 to 21.5% in 2008–10 and 24.5% in 2015–16 among 85-year olds, and from 41.9% in 1989–90 to 28.0% in 2011–12 to 21.7% in 2018–19 among 8...
A Prospective Study of Cognitive Function and Onset of Dementia in Cognitively Healthy Elders
Archives of Neurology, 1998
To examine the earliest cognitive changes associated with the onset of dementia as well as changes associated with normal aging. Design: Longitudinal evaluation of participants with annual clinical and psychometric examinations for up to 15 1 ⁄2 years. Setting and Participants: Elderly volunteers (n=82) enrolled with a Clinical Dementia Rating of 0 (cognitively intact) in longitudinal studies. Interventions: None. Main Outcome Measures: Clinical Dementia Rating and results of a 1 1 ⁄2-hour psychometric battery. Results: As estimated with survival analysis, 40% of participants had a Clinical Dementia Rating greater than 0 (cognitive decline) within 12 years of enrollment; 59% of these were judged to have dementia of the Alzheimer type or incipient dementia. Participants with poorer performance on psychometric testing at enrollment were at higher risk for cognitive decline subsequently. The rate of change in psychometric performance before clinically detectable cognitive change occurred was not significantly different between those who eventually developed dementia and those who remained stable, except for performance on the Logical Memory subtest of the Wechsler Memory Scale. When subtle cognitive decline was clinically detected, however, an abrupt deterioration in performance on independently administered psychometric tests was observed. Conclusions: Cognitively healthy elderly people maintain stable cognitive performance when measured longitudinally by both careful clinical evaluation and repeated psychometric testing. This stability is maintained unless and until they develop a dementing illness, at which time a sharp decline in performance is observed.
Prevalence of dementia in the oldest old: The Monzino 80‐plus population based study
Alzheimer's & Dementia, 2015
Background: Epidemiological studies commonly include too few of the oldest old to provide accurate prevalence rates of dementia in older age groups. Estimates of the number of those affected, necessary for healthcare planning, are thus flawed. The objective is to estimate the prevalence of dementia and levels of dementia severity in a very large population of oldest old and to investigate the relation between age and dementia prevalence in the extreme ages. Methods: The Monzino 80-plus is a population-based study among residents 80 years or older in Varese province, Italy. Dementia cases were identified using a one-phase design. The survey was conducted in the participant's place of residence, whether home or institution. Both participants and informants were interviewed. Information was available for 2504 of the 2813 residents (89%). Results: In all, 894 individuals (714 women and 180 men) met the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) criteria for dementia, for a standardized prevalence of 25.3% (95% confidence interval [CI]: 23.4, 27.2%), 28.5% (95% CI: 26.2, 30.9) in women and 18.6% (95% CI: 15.2, 21.9) in men. Age-specific prevalence estimates of dementia increased with age from 15.7% at age 80 to 84 years to 65.9% at age 100 years and higher. For women, prevalence continued to rise after age 100 years, from 64.8% at age 100 to 101 years to 76.1% at age 102 to 107 years. After age 85 years prevalence rates tended to rise linearly, on average 2.6% per year in women and 1.8% in men. About 80% of the cases were moderate or severe. The frequency of mild dementia decreased and that of severe dementia increased with age. Conclusion: One-quarter of 80-plus year olds are affected by dementia, mostly moderate or severe. Prevalence rates of dementia do not level off, but continue to rise gradually even in the extreme ages.
Secular changes in cognitive predictors of dementia and mortality in 70-year-olds
Neurology, 2010
Background: Successive elderly birth cohorts improved in cognitive performance during the 20th century. It is not clear whether this influences cognitive predictors of dementia and mortality. Objective: In 2 longitudinal population studies, representing 2 cohorts of 70-year-olds examined 30 years apart, we investigated the relation between baseline cognitive function and 5-year occurrence of dementia and mortality.
Dementia and Cognitive Impairment in the Oldest Old in the Community Prevalence and Comorbidity
British Journal of Psychiatry, 1995
BackgroundThe study focuses on the prevalence of dementia in the oldest old.MethodA community sample (n = 402) of the oldest old in Munich (≥ 85 years) was assessed with different methods. Four instruments and a clinical examination were used for case identification: (a) the Geriatric Mental State Interview (GMS-A); (b) the Structured Interview for the Diagnosis of Dementia (SIDAM); (c) the Global Deterioration Scale (GDS); and (d) the Mini Mental State Examination (MMSE). The clinical examination was performed by the interviewing physicians, who made their diagnoses according to ICD–10 and DSM–III–R.ResultsThe structured interviews (GMS-A: 25.4%; SIDAM/SISCO: 28.0%; SIDAM/DSM–III–R: 27.8%; SIDAM/ICD–10: 16.1 %) gave lower point prevalence rates of dementia than physicians' clinical diagnoses (43.1 %). The rates were 21.2% based on the MMSE. Depressive syndromes and anxiety syndromes were the most frequent psychiatric disturbances associated with dementia in the very old.Conclus...
Neuropathology and cognitive performance in self-reported cognitively healthy centenarians
Acta neuropathologica communications, 2018
With aging, the incidence of neuropathological hallmarks of neurodegenerative diseases increases in the brains of cognitively healthy individuals. It is currently unclear to what extent these hallmarks associate with symptoms of disease at extreme ages. Forty centenarians from the 100-plus Study cohort donated their brain. Centenarians self-reported to be cognitively healthy at baseline, which was confirmed by a proxy. Objective ante-mortem measurements of cognitive performance were associated with the prevalence, distribution and quantity of age- and AD-related neuropathological hallmarks. Despite self-reported cognitive health, objective neuropsychological testing suggested varying levels of ante-mortem cognitive functioning. Post-mortem, we found that neuropathological hallmarks related to age and neurodegenerative diseases, such as Aβ and Tau pathology, as well as atherosclerosis, were abundantly present in most or all centenarians, whereas Lewy body and pTDP-43 pathology were s...
Prevalence and determinants of cognitive impairment in an elderly population: A hospital based study
Annals of Geriatric Education and Medical Sciences, 2023
Background and Objective: Dementia and cognitive impairment (CI) are some of the common problems associated with ageing. However, a lot of other factors apart from ageing can increase this risk. In this study, prevalence of CI and its correlation with different sociodemographic and clinical factors was assessed among patients attending outpatient department of a geriatric healthcare facility. Materials and Methods: A total of 240 elderly OPD patients (>60 years) having recovered from different acute illnesses or making follow-up visits were enrolled in the study. Critically ill, hospitalized patients and those with history of COVID-19 exposure were excluded from the study. Demographic and social profile of the patients was noted. Mini Mental State Examination (MMSE) was used for assessment of cognition. MMSE score <27> Results: Mean age of patients was 72.58±6.46 years (range 62-91 years), majority of patients were males (55%). Prevalence of CI was 41.2%. There were 59 (24.6%) elderly with mild and 40 (16.7%) with moderate cognitive impairment. On univariate assessment, older age (p=0.003), male sex (p=0.024), living without spouse (p=0.040) and history of hospitalization in last one year (p=0.031) were found to be significantly associated with CI. On logistic regression age (OR=1.072), female sex (OR=0.561), ability to perform routine work (OR=0.461) and hospitalization history (OR=1.823) were identified as independent predictors of CI. Conclusion : Prevalence of CI was 41.2% in our study. Age, sex, ability to perform routine works and hospitalization history were independently associated with CI risk. Keywords: Elderly, Cognitive impairment, Mini Mental State Examination (MMSE), Ageing.