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Research paper
Incidence and survival of dementia in a general population of Japanese elderly: the Hisayama study
  1. Y Matsui1,2,
  2. Y Tanizaki1,
  3. H Arima1,
  4. K Yonemoto1,
  5. Y Doi3,
  6. T Ninomiya1,
  7. K Sasaki4,
  8. M Iida3,
  9. T Iwaki4,
  10. S Kanba2,
  11. Y Kiyohara1
  1. 1
    Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  2. 2
    Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  3. 3
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  4. 4
    Department of Neuropathology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  1. Dr H Arima, Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City 812-8582, Japan; harima{at}envmed.med.kyushu-u.ac.jp

Abstract

Objective: To estimate the incidence and survival rates of total and cause specific dementia in a general Japanese population.

Methods: A total of 828 subjects without dementia, aged 65 years or over, were followed-up prospectively for 17 years. Dementia was subdivided into cause specific subtypes: namely, Alzheimer’s disease (AD), vascular dementia (VD), dementia with Lewy bodies (DLB), combined dementia and other types of dementia. During the follow-up, 275 subjects developed dementia; of these, 251 (91.2%) were evaluated morphologically, with 164 subjected to brain autopsy examination and the remaining 87 to neuroimaging.

Results: The incidences of total dementia, AD, VD, DLB, combined dementia and other types of dementia were 32.3 (n = 275), 14.6 (124), 9.5 (81), 1.4 (12), 3.8 (33), and 3.1 (16) per 1000 person years, respectively. The incidences of AD, combined dementia and other types of dementia rose with increasing age, particularly after the age of 85 years, but this tendency was not observed for VD or DLB. The survival curve of dementia cases aged 65–89 years was significantly lower than that of age and sex matched controls (10 year survival rate, 13.6% vs 29.3%; hazard ratio 1.67; 95% confidence interval 1.31 to 2.13). The 10 year survival rates were not significantly different among dementia subtypes.

Conclusions: Our findings suggest that the Japanese elderly population has a high risk for the development of dementia, specifically AD and VD, and once dementia is established, the risk of death is considerable.

https://doi.org/10.1136/jnnp.2008.155481

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    Footnotes

    • Competing interests: None.

    • Funding: This study was supported in part by a Grant-in-Aid for the 21st Century COE programme, a Grant-in-Aid for Scientists (No 19300125) and a Grant-in-Aid for Scientific Research A (No 18209024) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, and a Health and Labour Sciences Research Grant of the Ministry of Health, Labour and Welfare (Comprehensive Research on Aging and Health: H20-Chouju-004).

    • Ethics approval: The ethics committee of Kyushu University approved this study.