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Affinito G, Salerno V, Di Gennaro M, Scafa L, Russo A, Fumo MG, Giordana R, Falco F, Della Pia F, Di Cecca A, Migliaccio M, Ilardi CR, Criscuolo C, Spisto M, Triassi M, Brescia Morra V, Palladino R, Salvatore E, Moccia M. Incidence and Prevalence of Dementia: A 2015-2020 Population-Based Study in the Campania Region of Italy. Neuroepidemiology 2024:1-12. [PMID: 38657587 DOI: 10.1159/000539031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/14/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE The aims of this study were to provide population-based estimates of prevalence and incidence of any dementia and Alzheimer's dementia (AD) in the Campania region (South Italy) and to validate towards a clinical registry. METHODS This was a population-based study, using routinely collected healthcare data of individuals living in the Campania region (South Italy) from 2015 to 2020. We included individuals aged ≥65 years alive at the prevalence day (January 1, 2021) who had at least one administrative record for dementia and/or AD from 2015 to 2020. Age-and sex-standardised prevalence rates were calculated using direct standardisation method (European population in 2020 as the reference population). To estimate the incidence, we tested three possible algorithms, which differed for the duration of the time interval between study baseline (January 1, 2015) and index date (first record for dementia and/or AD in administrative databases). We employed a clinical database for the validation of our algorithms towards neuropsychological test results. RESULTS Among individuals aged over 65 years, 80,392 had dementia, of which 35,748 had AD. The age- and sex-standardised prevalence rates per 1,000 individuals for any dementia and AD were 77.64 (95% confidence interval [CI] = 77.57; 77.68) and 34.05 (95% CI = 34.01; 34.09), respectively. There were 82.10 incident cases of any dementia per 100,000 per year (0.79 sensitivity and 0.62 specificity) and 59.89 incident cases of AD per 100,000 per year (0.80 sensitivity and 0.59 specificity). The capture-recapture method showed a very low number of undetected cases (1.7% for any dementia and 3.0% for AD). Our algorithms showed acceptable performance with the area under the curve ranging from 0.59 to 0.72 and a double likelihood ratio of correctly identifying individuals above and below mini-mental status examination (MMSE) standard cut-offs (24 and 26). CONCLUSIONS Prevalence and incidence of any dementia and AD in the Campania region (South Italy) from 2015 to 2020 are in line with previous estimates from other countries. Our algorithm, integrating administrative and clinical data, holds potential for assessing dementia's epidemiological burden, identifying risk factors, planning healthcare access, and developing prevention strategies.
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Affiliation(s)
- Giuseppina Affinito
- Department of Public Health, University of Naples Federico II, Naples, Italy,
| | - Vito Salerno
- Regional Healthcare Society (So.Re.Sa), Naples, Italy
| | - Massimo Di Gennaro
- Innovation and Data Analytics, Regional Healthcare Society (So.Re.Sa), Naples, Italy
| | - Luca Scafa
- Regional Healthcare Society (So.Re.Sa), Naples, Italy
| | | | | | | | - Fabrizia Falco
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Flavio Della Pia
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | | | | | | | - Chiara Criscuolo
- Neurology Unit, Policlinico Federico II University Hospital, Naples, Italy
| | - Myriam Spisto
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University of Naples Federico II, Naples, Italy
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Elena Salvatore
- Cognitive Impairment and Neurorehabilitation Unit, Policlinico Federico II University Hospital, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Marcello Moccia
- Neurology Unit, Policlinico Federico II University Hospital, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
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Mazzola P, Zanetti M, Ferraguzzi G, Villa ML, Sandrini MC, Fumagalli M, Volpi M, Caggiu G, Monzio Compagnoni M, Mecocci P, Bellelli G. Shifting the Paradigm of Nursing Home Care for People with Dementia: The Italian Experience of Il Paese Ritrovato and the Impact of SARS-CoV-2. J Alzheimers Dis 2024; 97:741-752. [PMID: 38143344 DOI: 10.3233/jad-230229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND Il Paese Ritrovato is an Italian nursing home founded in 2018, it is based on the Alzheimer village model and admits people with mild-to-moderate dementia. OBJECTIVE Describe the impact of the SARS-CoV-2 pandemic on people living at Il Paese Ritrovato through a Comprehensive Geriatric Assessment (CGA) regularly administered prior to and during the pandemic. METHODS We explored the effects of a person-centered approach. We assessed 64 subjects (enrolled and followed between June 2018 and December 2020), who underwent at least 18 months of observation prior to the pandemic. Each subject was evaluated using a CGA on admission time (T0) and at defined time-points: T6, T12, T18. One last CGA evaluation was performed during the SARS-CoV-2 pandemic (TCovid-19). Temporal trends during T0-T18, and differences between T18 and TCovid-19 were calculated. RESULTS The mean age was 82 years with a prevalence for females (77.0%) and Alzheimer's disease diagnosis (60%). Psychiatric and behavioral disorders were the most common conditions (80%). We utilized a nonpharmacological approach aimed at promoting the residents' overall wellbeing and observed satisfactory performance during the first 18 months. In comparison with the pre-pandemic period, TCovid-19 enlightened +11.7% use of antidepressants and a decline of Mini-Mental State Examination mean values (not statistically significant), while engagement in activities dropped. CONCLUSIONS The pandemic may have disrupted the existing model of care, but at the same time, it confirmed that the Il Paese Ritrovato approach, which encompasses symptoms improvement and multicomponent support, is in fact beneficial.
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Affiliation(s)
- Paolo Mazzola
- School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy
- Fondazione IRCCS San Gerardo dei Tintori, Acute Geriatrics Unit, Monza, Italy
- NeuroMI - Milan Center for Neuroscience, Clinical Neurosciences research area, Milano, Italy
| | | | - Gaia Ferraguzzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | | | | | | | - Giulia Caggiu
- Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Matteo Monzio Compagnoni
- Department of Statistics and Quantitative Methods, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Patrizia Mecocci
- Department of Biomedical Sciences for Health, Università di Perugia, Perugia, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy
- Fondazione IRCCS San Gerardo dei Tintori, Acute Geriatrics Unit, Monza, Italy
- NeuroMI - Milan Center for Neuroscience, Clinical Neurosciences research area, Milano, Italy
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3
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Diagnostic properties of the Frontal Assessment Battery (FAB) in Italian healthy adults. Aging Clin Exp Res 2022; 34:1021-1026. [PMID: 34981429 DOI: 10.1007/s40520-021-02035-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/16/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Sub-clinical cognitive efficiency deficits of a dysexecutive nature are moderately prevalent in healthy older adults and negatively affect their functional outcomes. To screen for such dysfunctions, the Frontal Assessment Battery (FAB) provided promising evidence, although its diagnostic properties have not been tested to date. This study thus aimed at exploring the performance on the FAB of a large sample of Italian healthy adults and comparing it in individuals aged < 75 years vs. ≥ 75 years. METHODS Four hundred and seventy-five healthy adults (169 males, 306 females, age: 61.1 ± 15.1; education 11.7 ± 4.6) were administered the FAB and the Montreal Cognitive Assessment (MoCA). Sensitivity, specificity, positive and negative predictive values and likelihood ratios were computed through receiver-operating characteristics analyses by addressing an above- vs. below-cutoff performance on the MoCA as the state variable (as including measures of executive functioning). RESULTS The FAB overall showed good accuracy (AUC = 0.71-0.76), although higher for healthy older adults. A trend towards higher specificity (64.4-80.3%) than sensitivity (61.1-77.8%) was found, despite these metrics being comparable in healthy older adults. Negative predictive values (0.98-0.99) were systematically higher than positive predictive values (0.05-0.24), whereas consistent post-test probabilities were detected (positive likelihood ratios: 2.19-3.35; negative likelihood ratios: 0.28-0.48). DISCUSSION The FAB is an accurate test for the first-level assessment of dysexecutive-related global cognitive inefficiency in the general population, despite being moderately conservative as far as both its pre- and post-test features are concerned. Its diagnostic value is more informative for individuals aged ≥ 75 years.
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GjØra L, Strand BH, Bergh S, Borza T, Brækhus A, Engedal K, Johannessen A, Kvello-Alme M, Krokstad S, Livingston G, Matthews FE, Myrstad C, Skjellegrind H, Thingstad P, Aakhus E, Aam S, Selbæk G. Current and Future Prevalence Estimates of Mild Cognitive Impairment, Dementia, and Its Subtypes in a Population-Based Sample of People 70 Years and Older in Norway: The HUNT Study. J Alzheimers Dis 2021; 79:1213-1226. [PMID: 33427745 PMCID: PMC7990439 DOI: 10.3233/jad-201275] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Having accurate, up-to-date information on the epidemiology of mild cognitive impairment (MCI) and dementia is imperative. Objective: To determine the prevalence of MCI and dementia in Norway using data from a large population-based study. Methods: All people 70 + years of age, n = 19,403, in the fourth wave of the Trøndelag Health Study (HUNT4) were invited to participate in the study HUNT4 70 + . Trained health personnel assessed participants using cognitive tests at a field station, at homes, or at their nursing home. Interviewers also completed a structured carer questionnaire in regard to participants suspected of having dementia. Clinical experts made diagnoses according to DSM-5 criteria. We calculated prevalence weighing the data to ensure population representativeness. Results: A total of 9,930 (51.2%) of the possible 19,403 people participated, and 9,663 of these had sufficient information for analysis. Standardized prevalence of dementia and MCI was 14.6% (95% confidence interval (CI) 13.9–15.4) and 35.3% (95% CI 34.3–36.4), respectively. Dementia was more prevalent in women and MCI more prevalent in men. The most prevalent dementia subtype was Alzheimer’s disease (57%). By adding data collected from a study of persons < 70 years in the same region, we estimate that there are 101,118 persons with dementia in Norway in 2020, and this is projected to increase to 236,789 and 380,134 in 2050 and 2100, respectively. Conclusion: We found a higher prevalence of dementia and MCI than most previous studies. The present prevalence and future projections are vital for preparing for future challenges to the healthcare system and the entire society.
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Affiliation(s)
- Linda GjØra
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - BjØrn Heine Strand
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Tom Borza
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne Brækhus
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Aud Johannessen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Marte Kvello-Alme
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Steinar Krokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Gill Livingston
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Fiona E Matthews
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Christian Myrstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Håvard Skjellegrind
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Pernille Thingstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Eivind Aakhus
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Stina Aam
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Ibnidris A, Piumatti G, Carlevaro F, Fadda M, Magno F, Magistro D, Albanese E. Italian version of the short 10/66 dementia diagnostic schedule: a validation study. BMJ Open 2021; 11:e045867. [PMID: 34193490 PMCID: PMC8246379 DOI: 10.1136/bmjopen-2020-045867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To determine the criterion and concurrent validity of the Italian version of the short 10/66 Dementia Diagnostic Schedule and algorithm in a sample of Italian native speakers, older adults. DESIGN A cross-sectional, validation study. SETTING The study was conducted with older adults living in the community and in nursing homes in the Canton of Ticino, Switzerland, and the Piedmont region in Italy between March and August 2019. PARTICIPANTS A convenience sample of 229 participants (69% females) were recruited. The eligibility criteria were being ≥60 years old and having an informant. The final sample included 74 participants (32%) with a previous clinical diagnosis of dementia and 155 (68%) cognitively healthy older adults. PRIMARY AND SECONDARY OUTCOME MEASURES The short version of 10/66 Dementia Diagnostic Schedule consists of the Community Screening Instrument for Dementia, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) 10-word list learning task with delayed recall and the depression scale, Euro-Depression (EURO-D) scale. Disability was measured using the WHO Disability Assessment Schedule (WHO-DAS II). RESULTS The Italian version of the short 10/66 Dementia Diagnostic Schedule showed fair sensitivity (87%), specificity (61%) and agreement with the clinical diagnosis of dementia (kappa=0.40, area under the receiver operating characteristics curve=0.74). Older adults with dementia living in nursing homes had higher disability scores (WHO-DAS II mean=23.14, SE=1.29) than those living in the community (WHO-DAS II mean=7.08, SE=0.66). WHO-DAS II was positively correlated with the short version of the 10/66 dementia diagnosis (β=5.23, 95% CI 2.05 to 8.41). CONCLUSIONS In settings where lengthy diagnostic procedures are not feasible, the short 10/66 is a practical tool to identify dementia in older adults. Our findings extend evidence on the validity of the 10/66 dementia diagnostic algorithm to high-income countries, where epidemiological evidence on dementia and its impact is outdated.
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Affiliation(s)
- Aliaa Ibnidris
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Giovanni Piumatti
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Division of Primary Care, Geneva University Hospitals, Geneve, Switzerland
| | - Fabio Carlevaro
- Polo Universitario Asti Studi Superiori (Uni-Astiss), University of Turin, Torino, Italy
| | - Marta Fadda
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Francesca Magno
- Polo Universitario Asti Studi Superiori (Uni-Astiss), University of Turin, Torino, Italy
| | - Daniele Magistro
- Department of Sport Science, Nottingham Trent University, Nottingham, UK
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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Lucca U, Tettamanti M, Tiraboschi P, Logroscino G, Landi C, Sacco L, Garrì M, Ammesso S, Biotti A, Gargantini E, Piedicorcia A, Mandelli S, Riva E, Galbussera AA, Recchia A. Incidence of dementia in the oldest-old and its relationship with age: The Monzino 80-plus population-based study. Alzheimers Dement 2020; 16:472-481. [PMID: 31786127 DOI: 10.1016/j.jalz.2019.09.083] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Relationship between age and dementia at extreme old ages is still an open question, yet population-based studies in this high-risk age segment are rare. METHODS The Monzino 80-plus is a population-based study among residents 80 years and older in the Varese province, Italy. Of 1371 eligible individuals, 1294 (94.4%), of whom 64 are centenarians, were included in the incidence study. RESULTS Since 2002, 584 new cases of all-cause dementia were identified over 15 years. The overall incidence rate was 7.9 per 100 person-years. Dementia risk rose with age (IRR: 1.06), with the cubic model providing the best fit (R2 = 0.91-0.96). Cumulative incidences of dementia unadjusted and adjusted for competing mortality risk progressively diverged with age. CONCLUSION Dementia incidence also keeps rising in nonagenarians and centenarians. Slowing down in growing risk of developing dementia with age is mainly attributable to increasing competing risk of death and resulting selective survival of individuals at lower risk of dementia.
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Affiliation(s)
- Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Pietro Tiraboschi
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy
| | | | - Cristina Landi
- European Foundation of Biomedical Research (FERB), Division of Neurological Rehabilitation, Cernusco s/N (Milano), Italy
| | - Leonardo Sacco
- Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | - Mariateresa Garrì
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Sonia Ammesso
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Anna Biotti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Elena Gargantini
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Alessandro Piedicorcia
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Sara Mandelli
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Alessia A Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Angela Recchia
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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Kim H, Lee S, Ku BD, Ham SG, Park W. Associated factors for cognitive impairment in the rural highly elderly. Brain Behav 2019; 9:e01203. [PMID: 30932371 PMCID: PMC6520289 DOI: 10.1002/brb3.1203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/06/2018] [Accepted: 12/09/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Among the symptoms commonly faced by an increasingly aged population, dementia, preceded by cognitive impairment, most threatens their quality of life. Dementia is a well-recognized burden, not only for individuals who face the disease and for their families, but also for entire nation. AIMS The purpose of this study was to identify associated factors for cognitive impairment in a very elderly population via a screening study design in Sokcho, a rural area in South Korea. METHODS Trained nurses screened patients from 75-84 years of age for dementia using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) and conducted interviews to determine their socioeconomic status, education level, and living conditions (i.e., with or without family). RESULTS In total, 4,369 subjects (1,646 males, 2,723 females) were enrolled in this study. Reported MMSE-DS scores decreased with increasing age and to a greater degree in less educated subjects (p < 0.001). Subjects requiring medical assistance or living alone exhibited lower MMSE-DS scores compared to those who did not require medical assistance or who lived alone (p < 0.001). CONCLUSION We found that less education, lower socioeconomic status, and living alone were associated factors for cognitive impairment based on this study of an elderly population.
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Affiliation(s)
- Hyeyun Kim
- Department of NeurologyCatholic Kwandong University College of Medicine, International St. Mary’s HospitalIncheonKorea
| | - Sujin Lee
- Department of NeurologyCatholic Kwandong University College of Medicine, International St. Mary’s HospitalIncheonKorea
| | - Bon D. Ku
- Department of NeurologyCatholic Kwandong University College of Medicine, International St. Mary’s HospitalIncheonKorea
| | | | - Woong‐Sub Park
- Department of Preventive Medicine & Public HealthCatholic Kwandong University College of MedicineGangneungKorea
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8
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Zaganas IV, Simos P, Basta M, Kapetanaki S, Panagiotakis S, Koutentaki I, Fountoulakis N, Bertsias A, Duijker G, Tziraki C, Scarmeas N, Plaitakis A, Boumpas D, Lionis C, Vgontzas AN. The Cretan Aging Cohort: Cohort Description and Burden of Dementia and Mild Cognitive Impairment. Am J Alzheimers Dis Other Demen 2019; 34:23-33. [PMID: 30259758 PMCID: PMC10852504 DOI: 10.1177/1533317518802414] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Our aim was to explore the burden of dementia in the Cretan Aging Cohort, comprised of 3140 persons aged ≥60 years (56.8% women, 5.8 ± 3.3 years formal education, 86.2% living in rural areas) who attended selected primary health-care facilities on the island of Crete, Greece. In the first study phase, a formal diagnosis of dementia had been reached in 4.0% of the participants. However, when selected 505 participants underwent thorough neuropsychiatric evaluation in the second phase of this study (344 with Mini-Mental State Examination [MMSE] <24 and 161 with MMSE ≥24), and results were extrapolated to the entire cohort, the prevalence of dementia and mild cognitive impairment was estimated at 10.8% (9.7%-11.9%) and 32.4% (30.8%-34.0%), respectively. Using both the field diagnostic data and the extrapolated data, the highest dementia prevalence (27.2%) was found in the 80- to 84-year-old group, who also showed the lowest educational level, apparently due to lack of schooling during World War II.
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Affiliation(s)
- Ioannis V. Zaganas
- Neurology Department, Medical School, Heraklion, University of Crete, Crete, Greece
| | - Panagiotis Simos
- Psychiatry Department, University of Crete, Medical School, Heraklion, Crete, Greece
- Foundation of Research and Technology, Institute of Computer Science, Heraklion, Greece
| | - Maria Basta
- Psychiatry Department, University of Crete, Medical School, Heraklion, Crete, Greece
| | - Stefania Kapetanaki
- Neurology Department, Medical School, Heraklion, University of Crete, Crete, Greece
| | - Symeon Panagiotakis
- Internal Medicine Department, Medical School, University of Crete, Heraklion, Crete, Greece
| | - Irini Koutentaki
- Psychiatry Department, University of Crete, Medical School, Heraklion, Crete, Greece
| | - Nikolaos Fountoulakis
- Internal Medicine Department, Medical School, University of Crete, Heraklion, Crete, Greece
| | - Antonios Bertsias
- Clinic of Social and Family Medicine, Medical School, University of Crete, Heraklion, Crete, Greece
| | - George Duijker
- Clinic of Social and Family Medicine, Medical School, University of Crete, Heraklion, Crete, Greece
| | - Chariklia Tziraki
- Research Department, Community Elders Club, Melabev, Jerusalem, Israel
| | - Nikolaos Scarmeas
- Department of Social Medicine, Psychiatry and Neurology, 1st Neurology Clinic, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Plaitakis
- Neurology Department, Mount Sinai School of Medicine, New York, NY, USA
| | - Dimitrios Boumpas
- Internal Medicine Department, Medical School, University of Athens, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, Medical School, University of Crete, Heraklion, Crete, Greece
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Bacigalupo I, Mayer F, Lacorte E, Di Pucchio A, Marzolini F, Canevelli M, Di Fiandra T, Vanacore N. A Systematic Review and Meta-Analysis on the Prevalence of Dementia in Europe: Estimates from the Highest-Quality Studies Adopting the DSM IV Diagnostic Criteria. J Alzheimers Dis 2018; 66:1471-1481. [PMID: 30412486 PMCID: PMC6294583 DOI: 10.3233/jad-180416] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Dementia, including Alzheimer's disease (AD), is one of the most burdensome medical conditions. Usually, the reviews that aim at calculating the prevalence of dementia include estimates from studies without assessing their methodological quality. Alzheimer's Disease International (ADI) proposed a score to assess the methodological quality of population-based studies aimed at estimating the prevalence of dementia. During the last three years, the European Commission has funded three projects (Eurodem, EuroCoDe, and ALCOVE) in order to estimate the prevalence of dementia in Europe. OBJECTIVE The aim of this study was to perform a systematic review and meta-analysis of data on the prevalence of dementia in Europe derived from studies that included only subjects with a diagnosis of dementia according to the DSM IV criteria, and that had a high quality score according to ADI criteria. METHODS We considered the studies selected by the two projects EuroCoDe (1993-2007) and Alcove (2008-2011), and we performed a new bibliographic search. For the systematic review, we only selected the subset of articles that included subjects with a diagnosis of dementia according to the DSM IV criteria. The studies were qualitatively assessed using the ADI tool. RESULTS The meta-analysis considered 9 studies that were carried out in Europe between 1993 and 2018 including a total of 18,263 participants, of which 2,137 were diagnosed with dementia. The prevalence rate standardized for age and sex resulted 7.1%. DISCUSSION This is the first systematic review on the prevalence of dementia in Europe considering only high-quality studies adopting the same diagnostic criteria (i.e., DSM IV).
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Affiliation(s)
- Ilaria Bacigalupo
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Flavia Mayer
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Eleonora Lacorte
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Alessandra Di Pucchio
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Fabrizio Marzolini
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Marco Canevelli
- Department of Human Neuroscience “Sapienza” University of Rome, Rome, Italy
| | - Teresa Di Fiandra
- General Directorate for Health Prevention, Ministry of Health, Rome, Italy
| | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
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