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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.1 no.3 São Paulo July/Sept. 2007 

Original Articles

Systematic review of dementia prevalence - 1994 to 2000

Revisão sistemática de prevalência de demência - 1994 a 2000

Marcos Antonio Lopes 1   2  

Sérgio Ricardo Hototian 2  

Geraldo C. Reis 1  

Hélio Elkis 3  

Cassio Machado de Campos Bottino 2  

1Clinics Hospital, Department of Neurology, Psychiatry and Medical Psychology of Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.

2Old Age Research Group (PROTER), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil.

3Department of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil.


Ageing has occurred in all regions of the world, with impact on neuropsychiatric disorders, particularly dementia. However, previous meta-analysis and reviews have shown high variability in world dementia prevalence rates. Objective: The aim of this study was to perform a wide-ranging review of the dementia prevalence studies published in recent years. Methods: The search was made on Medline, Lilacs and Embase databases for research conducted between 1994 and 2000. The main inclusion criteria were: use of standard diagnostic criteria and investigation of community samples. Results: The final selection included 42 papers, from all continents. The mean prevalence rate of dementia in subjects aged 65 years and older, for continents, ranged from 2.2% in Africa to 8.9% in Europe, and among countries, from 1.3% in India to 14.9% in Spain. However, there was a trend of clustering of the world prevalence rates with the majority of studies reporting rates between 4.2% and 7.2% (³65 years). Age directly influenced the rates, with a mean prevalence rate of 1.2% (95% CI: 0.8-1.5) for the 65-69 years group and 39.9% (95% CI: 34.4-45.3) for the 90-94 year group, but showing less pronounced influence in the very elderly age group. The urban samples had higher rates, where no significant gender difference was evidenced. Conclusion: The age influence over dementia rates apparently leveled off in the very elderly group while a trend toward similar dementia prevalence rates around the world was probably influenced by greater homogeneity in diagnostic criteria.

Key words: epidemiology; prevalence; dementia; Alzheimer disease; review.


A população idosa vem aumentando em todo o mundo, levando a um impacto nos transtornos psiquiátricos, principalmente os quadros de demência. Contudo, revisões e meta-análises prévias têm mostrado alta variabilidade nas taxas mundiais de prevalência de demência. Objetivo: O objetivo deste estudo foi realizar uma ampla revisão de trabalhos recentes de prevalência de demência. Métodos: O levantamento foi feito em três bases de dados, Medline, Lilacs e EMBASE, no período de 1994 a 2000. Os principais critérios de inclusão foram: uso de critérios diagnósticos padronizados e investigação de amostra comunitária. Resultados: A seleção final incluiu 42 artigos, de todos os continentes. A taxa média de prevalência de demência, na idade maior ou igual a 65 anos, entre continentes, variou de 2.2% na África, até 8.9% na Europa, e entre países, de 1.3% na Índia, até 14.9% na Espanha. Contudo, a maioria dos estudos reportou taxas entre 4.2% e 7.2% (³65 anos). A idade exerceu influência direta sobre as taxas de prevalência, com taxas médias de 1.2% na faixa etária 65-69 anos, e 39.9% na faixa etária 90-94 anos, mostrando, no entanto, um efeito menos pronunciado nos idosos muito idosos. A população de procedência urbana teve taxas significativamente maiores, e não houve diferença significativa entre os sexos. Conclusão: A influência da idade sobre as taxas de prevalência de demência diminuiu entre os idosos mais "idosos", e a tendência de resultados similares em todo o mundo provavelmente foi influenciada pela homogeneidade nos critérios diagnósticos.

Palavras-chave: epidemiologia; prevalência; demência; doença de Alzheimer; revisão.

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1. Jorm AF, Korten AE, Henderson AS. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand 1987;76:465-479. [ Links ]

2. Fratiglioni L, Ronchi D, Agüero-Torres H. Worldwide prevalence and incidence of dementia. Drugs Aging 1999;15:365-375 [ Links ]

3. Lobo A, Launer LJ, Fratiglioni L et al. Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurology 2000;54(Suppl 5):S4-S9. [ Links ]

4. Lopes MA, Bottino CMC. Prevalence of dementia in several regions of the world: analysis of epidemiologic studies from 1994 to 2000. Arq Neuropsiquiatr 2002;60:61-69. [ Links ]

5. Ritche K, Kildea D. Is senile dementia "age-related" or "ageing-related"? evidence from meta-analysis of dementia prevalence in the oldest old. Lancet 1995; 346:931-934. [ Links ]

6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed. Washington, DC: American Psychiatric Association; 1980. [ Links ]

7. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed (review). Washington, DC, American Psychiatric Association; 1987. [ Links ]

8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC, American Psychiatric Association; 1994. [ Links ]

9. Hachinski VC, Iliff LD, Zihkla E et al. Cerebral blood flow in dementia. Arch Neurol 1975;32:632-637. [ Links ]

10. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspice of the department of health and human services task force on Alzheimer's disease. Neurology 1984;34:939-944. [ Links ]

11. Ott A, Breteler MMB, Harskamp F et al. Prevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam Study. BMJ 1995; 310:970-973. [ Links ]

12. Prencipe M, Casini AR, Ferretti C, Lattanzio MT, Fiorelli M, Culasso F. Prevalence of dementia in a elderly rural population: effects of age, sex, and education. J Neurol Neurosurg Psychiatry 1996;60:628-633. [ Links ]

13. Boersma F, Eefsting JA, van den Brink W, Koeter M, van Tilburg W. Prevalence of dementia in a rural netherlands population and the influence of DSM-III-R and CAMDEX criteria for the prevalence of mild and more severe forms. J Clin Epidemiol 1998;51:189-197. [ Links ]

14. Brayne C, Nickson J, McCraken C, Gill C, Johnson AL. Cognitive function and dementia in six areas of England and Wales: distribution of MMSE and prevalence of GMS organicity level in the MRC CFA Study. Psychol Med 1998;28:319-335. [ Links ]

15. Andersen K, Lolk A, Nielsen H, Andersen J, Olsen C, Kragh-Sorensen P. Prevalence of very mild to severe dementia in Denmark. Acta Neurol Scand 1997; 96:82-87. [ Links ]

16. Roelands M, Wostyn P, Dom H, Baro F. The Prevalence of Dementia in Belgium: A population-based door-to-door survey in a rural community. Neuroepidemiology 1994;13:155-161. [ Links ]

17. Lobo A, Saz P, Marcos G, Dia JL, de la Camara C. The prevalence of dementia and depression in the elderly community in a southern european population. The Zaragoza Study. Arch Gen Psychiatry 1995;52:497-506. [ Links ]

18. Pousa SL, Regla JL, Franch V, Pinedo LF. The prevalence of dementia in Girona. Neurologia 1995;10:189-193. [ Links ]

19. Pi J, Olivé JM, Roca J, Masana L. Prevalence of dementia in a semi-rural population of Catalunya, Spain. Neuroepidemiology 1996;15:33-41 [ Links ]

20. Manubens JM, Martinez-Lage JM, Lacruz F et al. Prevalence of Alzheimer's disease and other dementia disorders in Pamplona, Spain. Neuroepidemiology 1995;14:155-164. [ Links ]

21. Wernicke TF, Reischies FM. Prevalence of dementia in old age: clinical diagnoses in subjects aged 95 years and older. Neurology 1994;44:250-253. [ Links ]

22. D'Alessandro R, Pandolfo G, Azzimondi G, Feruglio FS. Prevalence of dementia among elderly people in Troina, Sicily. Eur J Epidemiol 1996;12:595-599. [ Links ]

23. Azzimondi G , D'Alessandro R, Pandolfo G , Feruglio FS . Comparative study of the prevalence of dementia in two Sicilian communities with different psychosocial backgrounds. Neuroepidemiology 1998;17:199-209. [ Links ]

24. Strauss E, Viitanen M, Ronchi D, Winblad B, Fratiglioni L. Aging and the occurrence of dementia. Findings from a population-based cohort with a large sample of nonagenarians. Arch Neurol 1999;56:587-592. [ Links ]

25. Fichter MM, Meller I, Schröppel H, Steinkirchner R. Dementia and cognitive impairment in the oldest old in the community. Prevalence and comorbidity. Br J Psychiatry 1995;166:621-629. [ Links ]

26. Ravaglia G, Forti P, Ronchi D et al. Prevalence and severity of dementia among northern Italian centenarians. Neurology 1999;53:416-418. [ Links ]

27. Shaji S, Promodu K, Abraham T, Roy KJ, Verghese A. An epidemiological study of dementia in a rural community in Kerala, Índia. Br J Psychiatry 1996;168:745-749. [ Links ]

28. Yamada M, Sasaki H, Mimori Y et al. Prevalence and risks of dementia in the Japanese population: RERF'S adult health study Hiroshima subjects. J Am Geriatr Soc 1999;47:189-195. [ Links ]

29. Komahashi T, Ohmori K, Nakano T et al. Epidemiological survey of dementia and depression. Jpn J Psychiatry Neurol 1994;48:517-526. [ Links ]

30. Kiyohara Y, Yoshitake T, Kato I et al. Changing patterns in the prevalence of dementia in a Japanese community: The Hisayama study. Gerontology 1994; 40(suppl 2):229-235. [ Links ]

31. Ogura C, Nakamoto H, Uema T et al. COSEOUP GROUP. Prevalence of senile dementia in Okinawa, Japan. Int J Epidemiol 1995;24:373-380. [ Links ]

32. Shiba M, Shimogaito J, Kose A et al. Prevalence of dementia in the rural village of Hanazono-mura, Japan. Neuroepidemiology 1999;18:32-36. [ Links ]

33. Chandra V, Ganguli M, Pandav R, Johnston J, Belle S, De Kosky ST. Prevalence of Alzheimer's disease and other dementias in rural India. The Indo-US study. Neurology 1998;51:1000-1008. [ Links ]

34. Park J, Ko HJ, Park YN, Jung C. Dementia among the elderly in a Korean community. Br J Psychiatry 1994;164:796-801. [ Links ]

35. Woo JI, Lee JH, Yoo K, Kim C, Kim Y, Shin YS. Prevalence estimation of dementia in a rural area of Korea. J Am Geriatr Soc 1998;46:983-987. [ Links ]

36. Liu C, Lin R, Chen Y, Tai C, Yen Y, Howng S. Prevalence of dementia in a urban area in Taiwan. J Formos Assoc 1996;95:762-768. [ Links ]

37. Lin R, Lai C, Tai C, Liu C, Yen Y, Howng S. Prevalence and subtypes of dementia in southern Taiwan: impact of age, sex, education, and urbanization. J Neurol Sci 1998;160:67-75. [ Links ]

38. Liu H, Lin K, Teng EL et al. Prevalence and subtypes of dementia in Taiwan: a commmunity survey of 5297 individuals. J Am Geriatr Soc 1995;43:144-149. [ Links ]

39. Chiu HFK, Lam LCW, Chi I et al. Prevalence of dementia in Chinese elderly in Hong Kong. Neurology 1998;50:1002-1009. [ Links ]

40. Asada T, Yamagata Z, Kinoshita T et al. Prevalence of dementia and distribution of apoE alelles in Japanese centenarians: an almost-complete survey in Yamanashi Prefecture, Japan. J Am Geriatr Soc 1996;44:151-156. [ Links ]

41. Hendrie HC, Osuntokun B, Hall K et al. Prevalence of Alzheimer's disease and dementia in two communities: Nigerian Africans and African Americans. Am J Psychiatry 1995;152:1485-1492. [ Links ]

42. Beard CM, Kokmen E, O'Brien PC, Kurland LT. The prevalence of dementia is changing over time in Rochester, Minnesota. Neurology 1995;45:75-79. [ Links ]

43. Graves AB, Larson EB, Edland SD et al. Prevalence of dementia and its subtypes in the Japanese American population of King County, Washington State. The Kame Project. Am J Epidemiol 1996;144:760-771. [ Links ]

44. Fillenbaum GG, Heyman A, Huber MS et al. The prevalence and 3-year incidence of dementia in older black and white community residents. J Clin Epidemiol 1998;51:587-595. [ Links ]

45. Breitner JCS, Wyse BW, Anthony JC et al. APOE-e4 count predicts age when prevalence of AD increases, then declines. The Cache County Study. Neurology 1999;53:321-331. [ Links ]

46. McDowel I, Hill G, Lindsay J et al. Canadian Study of Health and Aging: study methods and prevalence of dementia. Can Med Assoc J 1994;150:899-913. [ Links ]

47. Ebly EM, Parhad IM, Hogan DB, Fung TS. Prevalence and types of dementia in the very old: results from the Canadian study of health and aging. Neurology 1994;44:1593-1600. [ Links ]

48. Powell A. Senile dementia of extreme aging: a common disorder of centenarians. Dementia 1994;5:106-109. [ Links ]

49. Farrag AF, Farwiz HM, Khedr EH, Mahfouz RM, Omran SM. Prevalence of Alzheimer's disease and other dementing Disorders: assiut-upper Egypt study. Dement Geriatr Cogn Disord 1998;9:323-328. [ Links ]

50. Ogunniyi A, Gureje O, Baiyewu O et al. Profile of dementia in a Nigerian community: types, pattern of impairment, and severity rating. J Natl Med Assoc 1997;89:392-396. [ Links ]

51. Herrera Jr E, Caramelli P, Nitrini R. Estudo epidemiológico populacional de demência na cidade de Catanduva - Estado de São Paulo - Brasil. Rev Psiq Clín (São Paulo) 1998;25:70-73. [ Links ]

52. Henderson AS, Jorm AF, Mackinnon A et al. A survey of dementia in the Canberra population: experience with ICD-10 and DSM-III-R criteria. Psychol Med 1994; 24:473-482. [ Links ]

53. World Health Organization. International classification of diseases, 10th ed. Mental and behavioral disorders. Geneva: World Health Organization; 1987. [ Links ]

54. Roth M, Tym E, Mountjoy CQ et al. CAMDEX A standardised instrument for the diagnosis of mental disorders in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986;149:698-709. [ Links ]

55. Hughes CP, Berg L, Danziger WL. A new clinical scale for the stating of dementia. Br J Psychiatry 1982;140:566-572. [ Links ]

56. Blessed G, Tomlinson B, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968;114:797-811. [ Links ]

57. Román GC, Tatemichi TK, Erkinjuntti T et al. Vascular dementia: Diagnostic criteria for research studies: report of the NINDS-AIREN International Wokshop. Neurology 1993;43:250-260. [ Links ]

58. Morris JC, Heyman A, Mohs RC et al. The consortium to establish a registry for Alzheimer's disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology 1989;39:1159-1165. [ Links ]

59. Copeland JRM, Dewey ME, Griffiths-Jones HM. Computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychol Med 1986;16:89-99. [ Links ]

60. Folstein MF, Folstein SE, McHugh PR. Mini Mental State: a pratical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198. [ Links ]

61. Hebert LE, Scherr PA, McCann JJ et al. Is the risk of developing Alzheimer's disease greater for women than for men? Am J Epidemiol 2001;153:132-136. [ Links ]

62. Corrada M, Brookmeyer R, Kawas C. Sources of variability in prevalence rates of Alzheimer's disease. Int J Epidemiol 1995;24:1000-1005. [ Links ]

63. Hébert R, Brayne C. Epidemiology of vascular dementia. Neuroepidemiology 1995;14:240-257. [ Links ]

64. Guk-Hee S, Ajit S. A review of the epidemiological transition in dementia: cross-national comparisons of the indices related to Alzheimer's disease and vascular dementia. Acta Psychiatr Scand 2001;104:4-11. [ Links ]

65. Johanson B, Zarit S. Prevalence and incidence of dementia in the oldest old: a longitudinal study of population-based sample of 84-90-year-olds in Sweden. Int J Geriatr Psychiatry 1995;10:359-366. [ Links ]

66. McGee MA, Brayne C. The impact on prevalence of dementia in the oldest age groups of differential mortality patterns: a deterministic approach. Int J Epidemiol 1998;27:87-90. [ Links ]

67. McGee MA, Brayne C. Exploring the impact of prevalence and mortality on incidence of dementia in the oldest old: the sensitivity of a deterministic approach. Neuroepidemiology. 2001;20:221-224. [ Links ]

Marcos Antonio Lopes - Clinics Hospital, Department of Neurology, Psychiatry and Medical Psychology - Bandeirantes Avenue, 3900 / Campus of USP 14049-900 Ribeirão Preto SP - Brazil. E-mail:

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