|Title||A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Langa, KM, Larson, EB, Crimmins, EM, Faul, JD, Levine, DA, Kabeto, MU, Weir, DR|
|Journal||JAMA Intern Med|
|Date Published||2017 01 01|
|Keywords||Aged, Dementia, Female, Humans, Male, Prevalence, Risk Factors, United States|
Importance: The aging of the US population is expected to lead to a large increase in the number of adults with dementia, but some recent studies in the United States and other high-income countries suggest that the age-specific risk of dementia may have declined over the past 25 years. Clarifying current and future population trends in dementia prevalence and risk has important implications for patients, families, and government programs.
Objective: To compare the prevalence of dementia in the United States in 2000 and 2012.
Design, Setting, and Participants: We used data from the Health and Retirement Study (HRS), a nationally representative, population-based longitudinal survey of individuals in the United States 65 years or older from the 2000 (n = 10 546) and 2012 (n = 10 511) waves of the HRS.
Main Outcomes and Measures: Dementia was identified in each year using HRS cognitive measures and validated methods for classifying self-respondents, as well as those represented by a proxy. Logistic regression was used to identify socioeconomic and health variables associated with change in dementia prevalence between 2000 and 2012.
Results: The study cohorts had an average age of 75.0 years (95% CI, 74.8-75.2 years) in 2000 and 74.8 years (95% CI, 74.5-75.1 years) in 2012 (P = .24); 58.4% (95% CI, 57.3%-59.4%) of the 2000 cohort was female compared with 56.3% (95% CI, 55.5%-57.0%) of the 2012 cohort (P < .001). Dementia prevalence among those 65 years or older decreased from 11.6% (95% CI, 10.7%-12.7%) in 2000 to 8.8% (95% CI, 8.2%-9.4%) (8.6% with age- and sex-standardization) in 2012 (P < .001). More years of education was associated with a lower risk for dementia, and average years of education increased significantly (from 11.8 years [95% CI, 11.6-11.9 years] to 12.7 years [95% CI, 12.6-12.9 years]; P < .001) between 2000 and 2012. The decline in dementia prevalence occurred even though there was a significant age- and sex-adjusted increase between years in the cardiovascular risk profile (eg, prevalence of hypertension, diabetes, and obesity) among older US adults.
Conclusions and Relevance: The prevalence of dementia in the United States declined significantly between 2000 and 2012. An increase in educational attainment was associated with some of the decline in dementia prevalence, but the full set of social, behavioral, and medical factors contributing to the decline is still uncertain. Continued monitoring of trends in dementia incidence and prevalence will be important for better gauging the full future societal impact of dementia as the number of older adults increases in the decades ahead.
|User Guide Notes|
|Short Title||JAMA Intern Med|
|Alternate Journal||JAMA Intern Med|
|PubMed Central ID||PMC5195883|
|Grant List||P30 AG053760 / AG / NIA NIH HHS / United States |
U01 AG009740 / AG / NIA NIH HHS / United States
U19 AG010483 / AG / NIA NIH HHS / United States
P30 AG024824 / AG / NIA NIH HHS / United States
P30 AG017265 / AG / NIA NIH HHS / United States
K23 AG040278 / AG / NIA NIH HHS / United States