Incidence of Dementia and Associated Factors in the EPIC-Spain Dementia Cohort.


Journal

Journal of Alzheimer's disease : JAD
ISSN: 1875-8908
Titre abrégé: J Alzheimers Dis
Pays: Netherlands
ID NLM: 9814863

Informations de publication

Date de publication:
2020
Historique:
pubmed: 6 10 2020
medline: 8 5 2021
entrez: 5 10 2020
Statut: ppublish

Résumé

Dementia has become a public health priority as the number of cases continues to grow worldwide. To assess dementia incidence and determinants in the EPIC-Spain Dementia Cohort. 25,015 participants (57% women) were recruited from three Spanish regions between 1992-1996 and followed-up for over 20 years. Incident cases were ascertained through individual revision of medical records of potential cases. Crude and age-adjusted incidence rates (IR) of dementia and sub-types (Alzheimer's disease (AD), and non-AD) were calculated by sex. Neelson-Aalen cumulative incidence estimates at 10, 15, and 20 years were obtained for each sex and age group. Multivariate Royston-Parmar models were used to assess independent determinants. Global IR were higher in women for dementia and AD, and similar by sex for non-AD. IR ranged from 0.09 cases of dementia (95% confidence interval: 0.06-0.13) and 0.05 (0.03-0.09) of AD per 1000 person-years (py) in participants below 60 years, to 23.2 (15.9-33.8) cases of dementia and 14.6 (9.1-33.5) of AD (per 1000 py) in those ≥85 years. Adjusted IR were consistently higher in women than men for overall dementia and AD. Up to 12.5% of women and 9.1% of men 60-65 years-old developed dementia within 20 years. Low education, diabetes, and hyperlipidemia were the main independent predictors of dementia risk, whereas alcohol showed an inverse association. Dementia incidence increased with age and was higher among women, but showed no geographical pattern. Dementia risk was higher among subjects with lower education, not drinking alcohol, and presenting cardiovascular risk factors.

Sections du résumé

BACKGROUND
Dementia has become a public health priority as the number of cases continues to grow worldwide.
OBJECTIVE
To assess dementia incidence and determinants in the EPIC-Spain Dementia Cohort.
METHODS
25,015 participants (57% women) were recruited from three Spanish regions between 1992-1996 and followed-up for over 20 years. Incident cases were ascertained through individual revision of medical records of potential cases. Crude and age-adjusted incidence rates (IR) of dementia and sub-types (Alzheimer's disease (AD), and non-AD) were calculated by sex. Neelson-Aalen cumulative incidence estimates at 10, 15, and 20 years were obtained for each sex and age group. Multivariate Royston-Parmar models were used to assess independent determinants.
RESULTS
Global IR were higher in women for dementia and AD, and similar by sex for non-AD. IR ranged from 0.09 cases of dementia (95% confidence interval: 0.06-0.13) and 0.05 (0.03-0.09) of AD per 1000 person-years (py) in participants below 60 years, to 23.2 (15.9-33.8) cases of dementia and 14.6 (9.1-33.5) of AD (per 1000 py) in those ≥85 years. Adjusted IR were consistently higher in women than men for overall dementia and AD. Up to 12.5% of women and 9.1% of men 60-65 years-old developed dementia within 20 years. Low education, diabetes, and hyperlipidemia were the main independent predictors of dementia risk, whereas alcohol showed an inverse association.
CONCLUSION
Dementia incidence increased with age and was higher among women, but showed no geographical pattern. Dementia risk was higher among subjects with lower education, not drinking alcohol, and presenting cardiovascular risk factors.

Identifiants

pubmed: 33016917
pii: JAD200774
doi: 10.3233/JAD-200774
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

543-555

Auteurs

María Encarnación Andreu-Reinón (ME)

Section of Neurology, Department of Internal Medicine, Rafael Méndez Hospital, Murcia Health Service, Lorca, Murcia, Spain.
Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.

José María Huerta (JM)

Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.
Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

Diana Gavrila (D)

Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

Pilar Amiano (P)

CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Public Health Division of Gipuzkoa, Basque Government, Donostia-San Sebastián, Spain.
Biodonostia Health Research Institute, San Sebastián, Spain.

Javier Mar (J)

Biodonostia Health Research Institute, San Sebastián, Spain.
Clinical Management Unit, OSI Alto Deba, Arrasate-Mondragón, Spain.
AP-OSIs Gipuzkoa Research Unit, OSI Alto Deba, Arrasate-Mondragón, Spain.
Health Services Research Network on Chronic Patients (REDISSEC), Bilbao, Spain.

Mikel Tainta (M)

CITA Alzheimer Foundation, Donostia-San Sebastián, Spain.
Neurology Service, OSI Goierri-Alto Urola, Zumárraga, Spain.

Eva Ardanaz (E)

CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Public Health Institute of Navarra, IdiSNA, Pamplona, Spain.

Rosa Larumbe (R)

Public Health Institute of Navarra, IdiSNA, Pamplona, Spain.
Neuroepigenetics Laboratory, Navarrabiomed, Public University of Navarre (UPNA), Pamplona, Spain.
Department of Neurology, Complejo Hospitalario de Navarra, Pamplona, Spain.

Carmen Navarro (C)

Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.
Department of Health and Social Sciences, University of Murcia, Murcia, Spain.

Sandra M Colorado-Yohar (SM)

Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.
Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia.

Fernando Navarro-Mateu (F)

Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM). Servicio Murciano de Salud, Murcia, Spain.

María Dolores Chirlaque (MD)

Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.
Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Department of Health and Social Sciences, University of Murcia, Murcia, Spain.

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