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Dementia & Neuropsychologia

Print version ISSN 1980-5764

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

https://doi.org/10.1590/S1980-57642008DN10300003 

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.


Abstract

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.

Resumo

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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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: lopes@netsite.com.br

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