incident dementia definition

Sensitivity Analysis for the Development of Dementia After Exclusion of Underweight Subjects. Incident dementia was identified through linked data to primary care or hospital admission records and death registries. visit 5 through to the end of visit 6 (December 31, 2017). In this longitudinal nationwide study, we analyzed the risk of incident dementia according to late-life metabolic health and obesity status. However, risk was also nonsignificantly increased for exhaustion and low grip strength. The explanation for this finding is unclear. Amnestic mild cognitive impairment and incident dementia and - PubMed We included subjects who underwent health examinations between 1 January 2009 and 31 December 2012. MCI was classified as scoring at least 1.5 SD below the mean of a cognitively normal sample on one or more cognitive tests, and without a current diagnosis of dementia. Second, plasma IGF-1 levels decline in the underweight group (49). For each component, a participant was classified as positive for the component or not. All continuous variables are expressed as a mean (SD), and categorical data are presented as numbers (percentages). Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: the three-city study, Dementia and Alzheimer disease incidence: a prospective cohort study, The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia, Education in cross-cultural dementia screening: applications of a new instrument, Compendium of neuropsychological tests: Administration, norms, and commentary, The Consortium to Establish a Registry for Alzheimers Disease (CERAD). analyzed and interpreted the data. Some have proposed that impaired cognition and physical frailty co-occur because of shared pathophysiology and risk factors. Our findings are consistent with two longitudinal studies (5,11) but not with the other (10). We aimed to investigate the association between common infections and dementia in adults (65 years) in a UK population-based cohort study. The MHO group showed the lowest incidence of overall dementia [hazard ratio (HR) 0.85; 95% CI, 0.84 to 0.86] and AD (HR 0.87; 95% CI, 0.86 to 0.88), but not VaD, compared with the metabolically healthy nonobese group. Our study has several limitations. Address correspondence to Shelly Gray, PharmD, MS, School of Pharmacy, University of Washington, Box 357630, Seattle, WA 98195-7630. Dementia - World Health Organization (WHO) In addition, when underweight subjects were excluded from the analysis, the risk of dementia increased in the MUO group, whereas the risk in the MUNO group decreased, suggesting that being underweight had a great impact on the incidence of dementia. Frailty was defined as having at least 3 of the following criteria: weakness (grip strength), slowness (walking speed), weight loss, low physical activity, and self-reported exhaustion. Incident dementia was ascertained through linkage to health records and with neuropsychological examinations. Definition and Prevalence of Frailty Components (n = 2,619). The overall rate ratio for incident dementia was 1.46 (95% CI: 1.17-1.81; 95% PI: 0.70-3.04; n = 6). Mechanisms underlying these associations remain to be elucidated. sharing sensitive information, make sure youre on a federal Baseline comorbidities were identified as follows: hypertension (ICD-10 codes I10 to I13 or I15 and treatment with antihypertensive medications, or systolic/diastolic BP 140/90 mm Hg), type 2 DM (ICD-10 codes E11 to E14 and antidiabetic drugs, or fasting glucose level 126 mg/dL), hyperlipidemia (ICD-10 code E78 with lipid-lowering agents, or serum total cholesterol 240 mg/dL), CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2), previous myocardial infarction (ICD-10 codes I21 to I22), and ischemic stroke (ICD-10 codes I63 to I64). Results. Missing values: education (2), body mass index (3), smoking status (4), depressive symptoms (3), self-reported health (1), hypertension (11), diabetes (1), myocardial infarction (10), congestive heart failure (11), apolipoprotein E4 allele (253), and CASI (28). ), and an Institute for Information & Communications Technology Promotion grant, funded by the Korean government (no. Risk Factors for Incident Dementia Among Older Cubans Third, because the mean BMI of the MHO group was 27.0 kg/m2, the study results may not be generalizable to a more severely obese group. The sample consisted of 2,619 participants aged 65 and older without dementia at baseline followed from 1994 to 2010. In our study, hyperglycemia increased the risk of overall dementia and AD 1.2-fold and raised the risk of VaD 1.3-fold. Over a mean follow-up of 6.5 years, 521 participants developed dementia (of which 448 developed AD). Thus, results of prior observational studies are inconsistent. In the current study, we used NHIS data, a well-established cohort representing the entire Korean population, which is >50 million. Further adjusted for tobacco and alcohol use, exercise, socioeconomic status, and LDL-C. ACT study methods have been described in detail elsewhere (12). Covariates came from self-report and study measures. An unexpected finding of this study was that the association between frailty and dementia varied according to baseline cognitive scores. Atti AR, Palmer K, Volpato S, Winblad B, De Ronchi D, Fratiglioni L. Stefan N, Kantartzis K, Machann J, Schick F, Thamer C, Rittig K, Balletshofer B, Machicao F, Fritsche A, Hring HU. Neuropsychological Criteria for Mild Cognitive Impairment and Dementia Weakness was defined using cut-points stratified by sex and body mass index. In addition, for the outcome of AD, individuals were censored at the time of non-AD dementia diagnosis. HRs for the Development of Dementia According to Metabolic Health and Obesity Status. Because non-AD dementia includes several dementia types and the overall event rate is low, this finding requires confirmation in a larger sample where vascular dementia events could be examined separately. Age-adjusted incidence rates of dementia, AD, and non-AD dementia per 1,000 person-years were calculated according to frailty status by the direct method of standardization, using the age distribution of the full cohort as the standard population. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. The HR for the association between frailty and non-AD dementia was greater than that between walking speed and non-AD dementia, suggesting that the frailty and non-AD dementia relationship was not determined solely by walking speed but that multiple elements of the frailty phenotype contributed to this relationship. Quality of Life in children and young people with Congenital Adrenal Hyperplasia UK nationwide multicentre assessment, The Impact of Gender Affirming Hormone Therapy on Physical Performance, The Journal of Clinical Endocrinology & Metabolism, About The Journal of Clinical Endocrinology & Metabolism, Receive exclusive offers and updates from Oxford Academic. Slow walking speed as defined for the frailty phenotype was not related to overall dementia or AD. Abstract. On average, frail participants were older, more likely to be female, to be obese, to have depressive symptoms, to rate their health as fair or poor, and to report several chronic health conditions. Of these, the most common ATP-III criterion for metabolic syndrome was high BP (69.3%), followed by hyperglycemia (54.8%), hypertriglyceridemia (49.2%), and low HDL-C (43.6%). The rate of dementia per 1000 person-years was higher in participants with cognitive impairment than in those without cognitive impairment (table 3). Physical frailty in older persons is associated with Alzheimers disease pathology. Cognitive status and future risk of frailty in older Mexican Americans. There are many different causes of dementia, and many different types. Frailty was associated with increased risk for dementia only for those in . To identify a subject as metabolically healthy, we used the Adult Treatment Panel III (ATP-III) definition (26). Actually, many studies have demonstrated that weight loss precedes the diagnosis of dementia by 10 years (47, 48). Abstract. Incident dementia was considered to be a diagnosis of dementia (ICD-10 codes F00, G30, F01, F02, F03, G23.1, G31.0, G31.1, G31.82, G31.83, G31.88, and F10.7) and prescription . This study had several strengths, including a large, representative sample of community-dwelling older adults with extended follow-up and a large number of incident dementia cases. Study selection: Inclusion criteria were (1) prospective cohort studies, (2) in general populations or memory clinic patients without dementia, (3) with clear definitions of apathy and dementia, and (4) reporting on the association between apathy and incident dementia. (B) AD. Our findings indicate that high BP is associated with VaD (HR 1.44; 95% CI, 1.41 to 1.48). During the 17,075 person-years of follow-up (mean 6.5, SD 3.9 years), 521 cases of dementia were diagnosed, of which 448 were cases of probable or possible AD and 73 were cases of non-AD dementia. There is information to support the notion that frailty may precede dementia (8) and for the notion that impaired cognition (mild) may precede the development of frailty (30). The original cohort of 2,581 participants without dementia was enrolled between 1994 and 1996. Early identification and timely intervention of modifiable risk factors is of great clinical importance in slowing or preventing dementia onset (Livingston et al., 2017).While meta-analyses show that depression is associated with a two-fold increase in risk of dementia (Diniz et al., 2013; Ownby et al., 2006), several key questions . In our cohort, 42% (31 of 73) of those with non-AD dementia had vascular dementia. Metabolically healthy was defined as meeting no more than one of the following four criteria: a systolic BP 130 mm Hg, diastolic BP 85 mm Hg, or on antihypertensive treatment; TG 150 mg/dL; fasting plasma glucose 100 mg/dL or on antidiabetic treatment; or HDL-C <40 mg/dL in men and <50 mg/dL in women. Similarly, for the outcome of non-AD dementia, individuals were censored at the time of AD diagnosis. The five MetS components measured before 70 years of age, considered on a continuous scale, showed the risk of dementia to increase with each additional component. Furthermore, we conducted subgroup analyses by dividing the subjects according to smoking, drinking, and exercise status: subjects without modifiable risk factors (noncurrent smoker, no heavy drinker, and physically active; n = 1,978,111) and subjects with modifiable risk factors (current smoker, heavy drinker, and not physically active; n = 60,564). Perhaps those in the lower quartile of cognitive scores, even though considered within the normal range of cognition for this study, may include participants who had mild cognitive impairment or impending dementia that may overshadow any association that frailty might have with incident dementia. Table 2 provides baseline characteristics of the 2,619 eligible ACT participants according to baseline frailty status. We found that frailty was associated with non-AD dementia. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D; Chang Y, Ryu S, Choi Y, Zhang Y, Cho J, Kwon MJ, Hyun YY, Lee KB, Kim H, Jung HS, Yun KE, Ahn J, Rampal S, Zhao D, Suh BS, Chung EC, Shin H, Pastor-Barriuso R, Guallar E. Hbert R, Lindsay J, Verreault R, Rockwood K, Hill G, Dubois MF. Incident myocardial infarction (MI) has no association with a decline in cognition, memory, and executive function immediately following the event. Although frailty was not associated with all-cause dementia in the entire sample, an association did exist in participants with higher cognitive scores. Participants were asked whether a physician had ever told them that they had congestive heart failure, hypertension, diabetes mellitus, or myocardial infarction. #2 I am not a medical professional but my understanding is that incident dementia is caused by an incident such as a stroke or anaesthesia. Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Mark Clarfield A. These subjects exhibited lower insulin resistance and visceral adiposity and were not at higher risk of cardiovascular disease (CVD) and all-cause mortality compared with metabolically healthy nonobese (MHNO) subjects (15, 16). Risk of Incident Dementia, Alzheimer Disease (AD), and Non-AD Dementia Associated With Frailty. Careers, Unable to load your collection due to an error. An additional 811 participants were enrolled between 2000 and 2002, and in 2004 the study began continuous enrollment (n = 1,023 as of September 30, 2010), to replace those who die or drop out from a total of 4,415 study participants. See more. Further adjusted for baseline Cognitive Abilities Screening Instrument (CASI) score. It is also a contributing cause of death, because dementia is usually accompanied by immobility, malnutrition, and weight loss (4). Additional studies in other populations are warranted to elucidate current results and may predict individuals most at risk for developing dementia. 4Division of General Internal Medicine, and. What Is Dementia? | CDC - Centers for Disease Control and Prevention The assessment of frailty in older adults. Kalyani RR, Varadhan R, Weiss CO, Fried LP, Cappola AR. Orthostatic hypotension and dementia incidence: links and implications The age-adjusted incidence of any dementia was 54.6 per 1,000 person-years for those who were frail at baseline and 29.3 per 1,000 person-years for those who were not frail. Dementia is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning. Meeting two or more criteria for metabolic syndrome was also highly correlated with the development of overall dementia, and the adjusted HR was significantly higher in VaD than in AD (HR 1.37 vs 1.14). After overnight fasting, blood samples were collected. Inclusion in an NLM database does not imply endorsement of, or agreement with, Incident dementia and faster rates of cognitive decline are associated An official website of the United States government. Incident Definition & Meaning - Merriam-Webster Alzheimer's disease first affects the part of the brain associated with learning, so early symptoms often include changes in memory, thinking and reasoning skills. To avoid overestimation and to raise diagnostic accuracy, we defined dementia by using both ICD-10 codes and history of prescription antidementia drugs. Hearing loss is defined by the pure-tone average of thresholds at 0.5, 1, 2, and 4 kHz in the better-hearing ear. Epidemiological Studies of the Effect of Stroke on Incident Dementia Of note, we also found an association between frailty and AD in our minimally adjusted model including similar variables (HR 1.55, 95% CI 1.122.14), which was attenuated considerably in the fully adjusted model with several additional covariates including baseline cognition (HR 1.08, 95% CI 0.741.57). For all-cause dementia, we found an interaction between baseline cognitive score and frailty (p = .02); hazard ratio for frailty was 1.78 for those with higher global cognition (95% CI 1.142.78) and 0.79 for those with lower global cognition (95% CI 0.501.26). Each participant was timed for two walks and the average time was used. 1. The relationship between frailty and dementia is unclear and there are very few population-based studies regarding this issue in China. Frailty was defined as having at least 3 of the following criteria: weakness (grip strength), slowness (walking speed), weight loss, low physical activity, and self-reported exhaustion. The impact on VaD was less than expected, probably because we defined hyperglycemia as including both prediabetes and diabetes (either fasting plasma glucose 100 mg/dL or on antidiabetic treatment), whereas previous studies were conducted only in patients with diabetes. Dementia is a major health problem worldwide. All analyses were performed using Stata version 10 (StataCorp, College Station, TX). Dementia at baseline and at the follow-up waves was diagnosed in a consensus conference (interviewer, . Clinical diagnosis of Alzheimers disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimers Disease, Tutorial in biostatistics methods for interval-censored data, Estimation in the Cox proportional hazards model with left-truncated and interval-censored data, Physical performance measures in the clinical setting, Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older, The CES-D scale: a self-report depression scale for research in the general population, Time-to-event analysis of longitudinal follow-up of a survey: choice of the time-scale. Before While dementia is a general term, Alzheimer's disease is a specific brain disease. Association of Midlife to Late-Life Blood Pressure Patterns With Therefore, we investigated the impact of the MHO phenotype on incident dementia according to body mass index (BMI) and metabolic health status by using a nationwide population-based cohort study. Serum glucose, total cholesterol, triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured. Whitmer RA, Gunderson EP, Barrett-Connor E, Quesenberry CP Jr, Yaffe K. Fitzpatrick AL, Kuller LH, Lopez OL, Diehr P, OMeara ES, Longstreth WT Jr, Luchsinger JA. Is frailty a prodromal stage of vascular dementia? *From Cox proportional hazards regression model with age as the time scale, adjusted for age at baseline, sex, education, and race. At each ACT study visit, cognitive function was evaluated using the Cognitive Abilities Screening Instrument (CASI; 13). Incident dementia in a defined older Chinese population Association of change in cardiovascular risk factors with incident dementia Notes: CI = confidence interval; HR = hazard ratio. obtained the funding and is the guarantor of the study. Values are presented as mean (SD) for continuous variables and n (%) for categorical variables. Age-adjusted incidence rates of these outcomes were considerably higher for those who were frail at baseline (Figure 2). Further adjusted for body mass index, depressive symptoms, antidepressant use, self-reported health, hypertension, diabetes, myocardial infarction, congestive heart failure, and smoking status. 8600 Rockville Pike In the model adjusted for age, sex, education, and race, frailty was associated with an increased risk of dementia (Table 3; Model 1: adjusted HR 1.78, 95% confidence interval [CI] 1.322.40). Neuropsychological Criteria for Mild Cognitive Impairment and Dementia A total of 189 cases of incident dementia were identified through the 5 years of follow-up. Abellan van Kan G, Rolland Y, Gillette-Guyonnet S, et al. 4-2016-0770), and informed consent from study subjects was waived because of the retrospective cohort nature of the study. The purpose of this study is to estimate the association between frailty and incident dementia in China, and to explore different effects of frailty established by three definitions of frailty on dementia incidence. Social connections and risk of incident mild cognitive impairment Risk of Incident Dementia According to Metabolic Health and Obesity Patients with dementia were grouped into AD (ICD-10 codes F00 and G30) or VaD (ICD-10 code F01) by the diagnosis code at the first visit. The first biennial follow-up visit was designated as the baseline year for this analysis so that we could define the weight loss component of frailty. Increased risk of incident dementia following use of - PubMed Demographic factors included age, sex, race, and years of education. The association between frailty and dementia was stronger for those with higher baseline cognitive scores (HR 1.78, 95% CI 1.142.78) than for those with lower cognitive scores (HR 0.79, 95% CI 0.501.26; p value for interaction = .02). official website and that any information you provide is encrypted Model 2 was further adjusted for body mass index, depressive symptoms, antidepressant use (in year prior to baseline), self-rated health, hypertension, diabetes, myocardial infarction, congestive heart failure, and smoking status. A total of 12,296,863 adults >50 years old who underwent health examinations from 2009 to 2012 without baseline history of dementia. Person-years of follow-up were calculated from the date of the health examination to the date of diagnosis of dementia or to 31 December 2016, whichever came first. . The antidementia medications could include an acetylcholinesterase inhibitor (rivastigmine, galantamine, or donepezil) or N-methyl-d-aspartate receptor antagonist (memantine), which are most commonly used to treat dementia (24). Furthermore, all criteria for metabolic syndrome (high BP, hyperglycemia, high TG, and low HDL-C) were associated with a higher risk of incident dementia. Incident Myocardial Infarction Tied to Faster Cognitive Decline Over Time Baseline Characteristics of Study Subjects According to Metabolic Health and Obesity. First, unintentional weight loss in older adults is usually associated with malnutrition and coexisting chronic diseases (46). Meet two or more metabolic syndrome criteria. Background: Memory impairment in geriatric depression is understudied, but may identify individuals at risk for development of dementia and Alzheimer's disease (AD). Relevant laboratory tests and brain CT or MRI studies were performed or results were obtained from Group Health records. Figure 2 shows the Kaplan-Meier curves for overall dementia-free survival for each group. Third, adipokines secreted from adipose tissue may play a role (52). In contrast, with regard to the development of hypertension, type 2 DM, and chronic kidney disease (CKD), MHO subjects were at 1.4- to 1.6-fold higher risk than their nonobese counterparts (1719). Figure 1 shows exclusion criteria for this analysis. Frailty was associated with higher risk of developing non-AD dementia but not AD. However, to our knowledge there are no studies reporting the relationship between the MHO phenotype and the development of dementia. ACTIVE Cognitive Training and Rates of Incident Dementia To investigate the risk of incident dementia according to fasting glucose levels and presence of comorbidities. Subjects were followed for a median of 65 months (IQR 51 to 74 months). conceived and designed the study. 1School of Pharmacy, University of Washington, Seattle. Blood pressure (BP) was measured in the sitting position after 5 minutes of rest. Association of Apathy With Risk of Incident Dementia: A - PubMed When these investigators used a categorical measure of frailty, similar to the frailty definition we used, frailty was associated with a twofold increase risk for AD after adjusting for age, sex, and education. Definition of Cases. Results: Short-term antiherpetic medication is not markedly associated with incident dementia. (A) Overall dementia. 10.1371/journal.pone.0024817 Abstract Background: We know little about incidence and predictors of dementia in China, where the prevalence is increasing and the patterns of risk factors are different. The assumption was satisfied for all models. Prediction of Incident Dementia: Impact of Impairment - ScienceDirect Boyle PA, Buchman AS, Wilson RS, Leurgans SE, Bennett DA. Incident dementia was defined using a combination of interview- and performance-based methods. Regarding hyperlipidemia and dementia, the published findings are inconsistent (3437). Thus, baseline cognition, even within the range that is considered intact should be considered as an important confounder in future research in this area. Li S, Yan F, Li G, Chen C, Zhang W, Liu J, Jia X, Shen Y. Yamada M, Mimori Y, Kasagi F, Miyachi T, Ohshita T, Sudoh S, Ikeda J, Matsui K, Nakamura S, Matsumoto M, Fujiwara S, Sasaki H. Ott A, Breteler MM, van Harskamp F, Stijnen T, Hofman A. Oxford University Press is a department of the University of Oxford. Incident Dementia, Glycated Hemoglobin (HbA1c) Levels, and - PubMed Comparison of the predictive accuracy of multiple definitions of HRs for Developing Dementia According to Obesity Status and Metabolic Syndrome Criteria. Model 3 was further adjusted for baseline CASI score to examine further potential confounding by global cognitive functioning. Lignell S, Winkvist A, Bertz F, Rasmussen KM, Glynn A, Aune M, Brekke HK. To determine the association between late-life metabolic health and obesity status and risk of incident dementia. Despite these limitations, this study investigated the risk of incident dementia among different metabolic phenotypes in older adults. Adjusted for age, sex, socioeconomic status, and LDL-C. Next, we examined the association between BMI, components of metabolic syndrome, and incident dementia (Table 4). First, dementia and other comorbidities were identified from claim data in the NHIS database. "incident" vs "prevalent" dementia - please explain to non native Multi-domain amnestic and single domain non-amnestic MCI subtypes were significantly associated with incident dementia for both diagnostic approaches (all p . Incident definition, an individual occurrence or event. Exposure to POPs was associated with dose-dependent deterioration of attention, memory, and learning ability (57, 58), which suggests potential links to dementia. Comparison of the predictive accuracy of multiple definitions of cognitive impairment for incident dementia: a 20-year follow-up of the Whitehall II cohort study . Incident dementia was considered to be a diagnosis of dementia (ICD-10 codes F00, G30, F01, F02, F03, G23.1, G31.0, G31.1, G31.82, G31.83, G31.88, and F10.7) and prescription of antidementia medication at the same time. Walking speed was assessed by having participants walk a 10-foot distance at their usual speed using assistive devices if needed. Impaired Lung Function, Lung Disease, and Risk of Incident Dementia Lee YH, Han K, Ko SH, Ko KS, Lee KU; Cheol Seong S, Kim YY, Khang YH, Heon Park J, Kang HJ, Lee H, Do CH, Song JS, Hyon Bang J, Ha S, Lee EJ, Ae Shin S. Song SO, Jung CH, Song YD, Park CY, Kwon HS, Cha BS, Park JY, Lee KU, Ko KS, Lee BW. The Frailty Operative Definition-Consensus Conference Project, Frailty in older adults: evidence for a phenotype, Frailty: emergence and consequences in women aged 65 and older in the Womens Health Initiative Observational Study. A prior study found that frailty was associated with dementia in those with cognitive impairment (11). The MHO phenotype showed a 13% to 15% lower risk of overall dementia and AD, compared with the MHNO phenotype, but no difference in the incidence of VaD. All statistical analyses were performed in SAS version 9.2 (SAS Institute, Cary, NC) and R programming version 3.1.0 (The R Foundation for Statistical Computing, Vienna, Austria, http://www.R-project.org). Avila-Funes JA, Carcaillon L, Helmer C, et al. As a library, NLM provides access to scientific literature. Baseline Characteristics of the Cohort, Overall and by Baseline Frailty Status*,. At baseline, 213 (8.1%) participants were frail. K.H. ACT = Adult Changes in Thought study. Among the components of frailty, only slow walking speed was significantly related to non-AD dementia.
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