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.
Texto completo disponível apenas em PDF.
Full text available only in PDF format.
References
-
1Jorm AF, Korten AE, Henderson AS. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand 1987;76:465-479.
-
2Fratiglioni L, Ronchi D, Agüero-Torres H. Worldwide prevalence and incidence of dementia. Drugs Aging 1999;15:365-375
-
3Lobo 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.
-
4Lopes 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.
-
5Ritche 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.
-
6American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed. Washington, DC: American Psychiatric Association; 1980.
-
7American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed (review). Washington, DC, American Psychiatric Association; 1987.
-
8American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC, American Psychiatric Association; 1994.
-
9Hachinski VC, Iliff LD, Zihkla E et al. Cerebral blood flow in dementia. Arch Neurol 1975;32:632-637.
-
10McKhann 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.
-
11Ott 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.
-
12Prencipe 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.
-
13Boersma 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.
-
14Brayne 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.
-
15Andersen 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.
-
16Roelands 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.
-
17Lobo 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.
-
18Pousa SL, Regla JL, Franch V, Pinedo LF. The prevalence of dementia in Girona. Neurologia 1995;10:189-193.
-
19Pi J, Olivé JM, Roca J, Masana L. Prevalence of dementia in a semi-rural population of Catalunya, Spain. Neuroepidemiology 1996;15:33-41
-
20Manubens 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.
-
21Wernicke TF, Reischies FM. Prevalence of dementia in old age: clinical diagnoses in subjects aged 95 years and older. Neurology 1994;44:250-253.
-
22D'Alessandro R, Pandolfo G, Azzimondi G, Feruglio FS. Prevalence of dementia among elderly people in Troina, Sicily. Eur J Epidemiol 1996;12:595-599.
-
23Azzimondi 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.
-
24Strauss 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.
-
25Fichter 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.
-
26Ravaglia G, Forti P, Ronchi D et al. Prevalence and severity of dementia among northern Italian centenarians. Neurology 1999;53:416-418.
-
27Shaji 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.
-
28Yamada 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.
-
29Komahashi T, Ohmori K, Nakano T et al. Epidemiological survey of dementia and depression. Jpn J Psychiatry Neurol 1994;48:517-526.
-
30Kiyohara 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.
-
31Ogura C, Nakamoto H, Uema T et al. COSEOUP GROUP. Prevalence of senile dementia in Okinawa, Japan. Int J Epidemiol 1995;24:373-380.
-
32Shiba M, Shimogaito J, Kose A et al. Prevalence of dementia in the rural village of Hanazono-mura, Japan. Neuroepidemiology 1999;18:32-36.
-
33Chandra 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.
-
34Park J, Ko HJ, Park YN, Jung C. Dementia among the elderly in a Korean community. Br J Psychiatry 1994;164:796-801.
-
35Woo 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.
-
36Liu 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.
-
37Lin 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.
-
38Liu 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.
-
39Chiu HFK, Lam LCW, Chi I et al. Prevalence of dementia in Chinese elderly in Hong Kong. Neurology 1998;50:1002-1009.
-
40Asada 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.
-
41Hendrie 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.
-
42Beard CM, Kokmen E, O'Brien PC, Kurland LT. The prevalence of dementia is changing over time in Rochester, Minnesota. Neurology 1995;45:75-79.
-
43Graves 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.
-
44Fillenbaum 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.
-
45Breitner 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.
-
46McDowel 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.
-
47Ebly 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.
-
48Powell A. Senile dementia of extreme aging: a common disorder of centenarians. Dementia 1994;5:106-109.
-
49Farrag 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.
-
50Ogunniyi 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.
-
51Herrera 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.
-
52Henderson 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.
-
53World Health Organization. International classification of diseases, 10th ed. Mental and behavioral disorders. Geneva: World Health Organization; 1987.
-
54Roth 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.
-
55Hughes CP, Berg L, Danziger WL. A new clinical scale for the stating of dementia. Br J Psychiatry 1982;140:566-572.
-
56Blessed 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.
-
57Román 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.
-
58Morris 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.
-
59Copeland 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.
-
60Folstein 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.
-
61Hebert 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.
-
62Corrada M, Brookmeyer R, Kawas C. Sources of variability in prevalence rates of Alzheimer's disease. Int J Epidemiol 1995;24:1000-1005.
-
63Hébert R, Brayne C. Epidemiology of vascular dementia. Neuroepidemiology 1995;14:240-257.
-
64Guk-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.
-
65Johanson 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.
-
66McGee 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.
-
67McGee 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.
Publication Dates
-
Publication in this collection
Jul-Sep 2007