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Trends in dementia incidence: Evolution over a 10‐year period in France
Author(s) -
Grasset Leslie,
Brayne Carol,
Joly Pierre,
JacqminGadda Hélène,
Peres Karine,
FoubertSamier Alexandra,
Dartigues JeanFrançois,
Helmer Catherine
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2015.11.001
Subject(s) - dementia , incidence (geometry) , hazard ratio , confidence interval , demography , medicine , depression (economics) , vascular dementia , pediatrics , gerontology , disease , physics , sociology , optics , economics , macroeconomics
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. Discussion Our study provides further support for a decrease in dementia incidence in women using algorithmic diagnosis. Changes in diagnostic boundaries mask this reduction.