Influence of socio-demographic features and apolipoprotein E epsilon 4 expression on the prevalence of dementia and cognitive impairment in a population of 70–74-year olds: The InveCe.Ab study

https://doi.org/10.1016/j.archger.2014.11.006Get rights and content
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Highlights

  • The InveCe.Ab study estimated the prevalence of dementia and cognitive impairment.

  • It also looked for associations with socio-demographic and genetic risk factors.

  • Dementia prevalence was 3.0%; AD was more frequent in ApoE epsilon-4 carriers.

  • Dementia risk was greater in southern-born Italians, VD risk greater in single people.

  • CIND occurred in 7.8%, with males and those born in the North East at more risk.

Abstract

The age-specific prevalence rates of dementia vary widely. Studies focusing on specific age groups are needed to provide reliable estimates for healthcare providers and policy makers.

We estimated the prevalence of dementia, dementia subtypes and cognitive impairment in “InveCe.Ab” (ClinicalTrials.gov, NCT01345110), a single-step multidimensional population-based study of 70–74-year olds living in Abbiategrasso (Milan, Italy). We also looked for associations with socio-demographic factors and the presence of the apolipoprotein E-ɛ4 allele.

The overall dementia prevalence was 3% (95%CI: 2.1–4.1%) [Alzheimer's disease (AD): 1.2% (95%CI 0.6–1.9%); vascular dementia (VD): 1.4% (95%CI: 0.8–2.2%)]. Being single was found to be a risk factor for vascular dementia; subjects born in southern Italy were shown to be at greater risk both of overall dementia and of vascular dementia. The prevalence of cognitive impairment, with or without subjective cognitive complaints (cognitive impairment, no dementia, CIND) was 7.8% (95%CI: 6.4–9.4%). As regards the CIND subgroups, the prevalence of subjects with subjective cognitive complaints (mild cognitive impairment, MCI) was 5.0% (95%CI 3.9–6.3%), while the prevalence of those without MCI (CIND-other) was 2.8% (95%CI: 1.9–3.8). The males had a higher risk of MCI and CIND-other; the older subjects were more likely to have MCI, and those born in north-eastern Italy to have CIND-other. The prevalence of AD was higher among the apolipoprotein E-ɛ4 carriers.

Our data highlight the importance of dementia and cognitive impairment in the transitional period from adulthood to old age, and reveal the presence of different associations with socio-demographic and genetic factors.

Abbreviations

MCI
mild cognitive impairment
CIND
cognitive impairment, no dementia
ApoE-ɛ4
apolipoprotein E- ɛ4
AD
Alzheimer's disease
VD
vascular dementia
DLB
dementia with Lewy bodies
FTD
frontotemporal dementia
DSM-IV-TR
Italian version of the Diagnostic and Statistical Manual of Mental Disorders IV
NINCDS/ADRDA
National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association
NINDS-AIREN
National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherché et l’Enseignement en Neurosciences
MMSE
mini-mental state examination
ISTAT
Italian National Institute of Statistics
MD
mixed dementia
PDD
Parkinson's disease dementia
Crude Prev.
crude prevalence
Adj. Prev.
adjusted prevalence
95%CI
95% confidence interval
OR
odds ratio

Keywords

Dementia
Alzheimer's disease
Risk factors
Prevalence
Cognitive impairment
ApoE-ɛ4

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