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Rojas-Gualdrón DF, Henao MS, Zuluaga CAU, Henao AE, Henck CAG. Global burden of young-onset Alzheimer's disease and other dementias: a secondary analysis of the global burden of disease study, 2019. Dement Neuropsychol 2024; 18:e20240134. [PMID: 39171329 PMCID: PMC11338516 DOI: 10.1590/1980-5764-dn-2024-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/01/2024] [Accepted: 04/16/2024] [Indexed: 08/23/2024] Open
Abstract
The aging of the world population has led to an increase in the epidemiology and burden of Alzheimer's disease and other dementias. Objective To describe the global burden of young-onset Alzheimer's disease and other dementias by world region and income through a secondary analysis of the Global Burden of Disease Study 2019. Methods This is a descriptive cross-sectional ecological study. Data by sex and five-year age groups from 40 to 64 years were extracted from the Global Burden of Disease Study results tool. We performed a descriptive analysis of prevalence, incidence, deaths, disability-adjusted life years, years of life lost, and years lived with disability. Results In 2019, young-onset Alzheimer's disease and other dementias presented a prevalence of 2.67 cases and an incidence of 0.44 per 1,000 inhabitants globally. It carried a significant burden, resulting in 1.16 disability-adjusted life years per 1,000 inhabitants, primarily due to years of life lost, and to a lesser extent due to years lived with disability. East Asia & the Pacific, Latin America & the Caribbean, and North America are the most affected regions. Burden rates are consistently higher among women; no gradient was observed by country income. Smoking was the most relevant risk factor, presenting a broad difference by country income level. Conclusion The global burden of young-onset Alzheimer's disease and other dementias may reshape healthcare requirements and the societal impact of dementias, and its understanding is relevant to inform decisions related to service offerings and research agendas.
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Loi SM, Eratne D, Velakoulis D. Younger people with dementia registered to public mental health services in Victoria, Australia. AUST HEALTH REV 2024; 48:351-357. [PMID: 38569532 DOI: 10.1071/ah23253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/13/2024] [Indexed: 04/05/2024]
Abstract
Objectives Individuals living with young-onset dementia fall through the gaps of adult and geriatric services. Given that non-cognitive symptoms of dementia in younger people are often psychiatric and behavioural in nature, these people may contact mental health services. There is sparse information investigating the frequency of people with young-onset dementia who contact mental health triage in Victoria. Methods Triage data were obtained from the Victorian Agency for Health Information. The data contained demographics for people registered with Victorian mental health services. Consumers who had an International Classification for Diseases code for dementia and were aged less than 65 years were identified as people with young-onset dementia. Using information of the frequency of people with young-onset dementia who were registered with each area-based mental health service, population census statistics were used to make estimates of the frequency of young-onset dementia. Results Of the 6172 people who had a dementia diagnosis, 1020 of them were aged less than 65 years and had young-onset dementia. There were proportionally more men who had young-onset dementia compared to women. There were more people with young-onset dementia registered to rural mental health services compared to metropolitan services. Conclusion Findings provide important information for service planning in Victoria. Recommendations include upskilling and education for the assessment of dementia for those clinicians who work in mental health services, particularly in rural regions.
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Affiliation(s)
- Samantha M Loi
- Neuropsychiatry Centre, Royal Melbourne Hospital, John Cade Level 2, Parkville, Vic. 3050, Australia; and Department of Psychiatry, The University of Melbourne, Grattan Street, Parkville, 3052, Australia
| | - Dhamidhu Eratne
- Neuropsychiatry Centre, Royal Melbourne Hospital, John Cade Level 2, Parkville, Vic. 3050, Australia; and Department of Psychiatry, The University of Melbourne, Grattan Street, Parkville, 3052, Australia; and Florey Institute of Neuroscience and Mental Health, Parkville, 3052, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Centre, Royal Melbourne Hospital, John Cade Level 2, Parkville, Vic. 3050, Australia; and Department of Psychiatry, The University of Melbourne, Grattan Street, Parkville, 3052, Australia
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Olié V, Lailler G, Torres MJ, Regnault N, Carcaillon-Bentata L, Blacher J. Young-Onset Dementia Among Individuals With History of Preeclampsia. JAMA Netw Open 2024; 7:e2412870. [PMID: 38814647 PMCID: PMC11140526 DOI: 10.1001/jamanetworkopen.2024.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 05/31/2024] Open
Abstract
This cohort study assesses the risk of developing early-onset dementia in individuals who had preeclampsia and other hypertensive disorders during pregnancy.
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Affiliation(s)
| | - Grégory Lailler
- Santé Publique France, Saint-Maurice, France
- Université Paris Est, Créteil, France
| | | | | | | | - Jacques Blacher
- Centre de Diagnostic et de Thérapeutique, Hôtel Dieu, Assistance Publique–Hôpitaux de Paris, Université Paris Cité, Paris, France
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Wei YJJ, Shrestha N, Chiang C, DeKosky ST. Prevalence and trend of central nervous system-active medication polypharmacy among US commercially insured adults with vs without early-onset dementia: a multi-year cross-sectional study. Alzheimers Res Ther 2024; 16:30. [PMID: 38326897 PMCID: PMC10851564 DOI: 10.1186/s13195-024-01405-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Limited data exist on the prevalence and trend of central nervous system (CNS)-active medication polypharmacy among adults with early-onset dementia (EOD) and whether these estimates differ for adults without EOD but with chronic pain, depression, or epilepsy, conditions managed by CNS-active medications. METHODS A multi-year, cross-sectional study using 2012-2021 MarketScan Commercial Claims data was conducted among adults aged 30 to 64 years with EOD and those without EOD but having a diagnosis of chronic pain, depression, or epilepsy as comparison groups. For each disease cohort, the primary outcome was CNS-active medication polypharmacy defined as concurrent use of ≥ 3 CNS-active medications on the US Beers Criteria list that overlapped for > 30 consecutive days during 12 months following a randomly selected medical encounter with the disease diagnosis. A separate multivariate modified Poisson regression model was used to estimate time trends in CNS polypharmacy in each disease cohort. Differences in trend estimates between EOD and non-EOD disease cohorts were examined by an interaction between EOD status and yearly time. RESULTS From 2013 to 2020, the annual crude prevalence of CNS polypharmacy was higher among adults with EOD (21.2%-25.0%) than adults with chronic pain (5.1%-5.9%), depression (14.8%-21.7%), or epilepsy (20.0%-22.3%). The adjusted annual prevalence of CNS polypharmacy among patients with EOD did not significantly change between 2013 and 2020 (adjusted prevalence rate ratio [aPRR], 0.94; 95% CI, 0.88-1.01), whereas a significant decreasing trend was observed among non-EOD cohorts with chronic pain (aPRR, 0.66; 95% CI, 0.63-0.69), depression (aPRR, 0.81; 95% CI, 0.77-0.85), and epilepsy (aPRR, 0.86; 95% CI, 0.83-0.89). The interaction analysis indicated that patients with epilepsy and depression (vs with EOD) had a decreasing probability of CNS-active medication polypharmacy over time (aPRR, 0.98 [95% CI, 0.98-0.99]; P < .001 for interaction for both conditions). CONCLUSIONS The prevalence of CNS polypharmacy among US commercially insured adults with EOD (vs without) was higher and remained unchanged from 2013 to 2021. Medication reviews of adults with EOD and CNS polypharmacy are needed to ensure that benefits outweigh risks associated with combined use of these treatments.
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Affiliation(s)
- Yu-Jung Jenny Wei
- Division of Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, 500 West 12Th Avenue, Columbus, OH, 43210-1291, USA.
| | - Nistha Shrestha
- Division of Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, 500 West 12Th Avenue, Columbus, OH, 43210-1291, USA
| | - ChienWei Chiang
- Department of Biomedical Informatics, College of Medicine and Wexner Medical Center, The Ohio State University, Ohio, 43210, USA
| | - Steven T DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, 32610, USA
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Coste J, Mandereau-Bruno L, Carcaillon-Bentata L, Mikaeloff Y, Bouilleret V. Prevalence, demographic and spatial distribution of treated epilepsy in France in 2020: a study based on the French national health data system. J Neurol 2024; 271:519-525. [PMID: 37787813 PMCID: PMC10770219 DOI: 10.1007/s00415-023-11953-2] [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] [Received: 07/12/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Although still incomplete, the epidemiology of epilepsy shows substantial variations in the burden of the condition according to demographic, social and territorial characteristics. This study aimed to estimate the prevalence of treated epilepsy and to investigate its demographic and spatial distribution in 2020 in France, a country where the nationwide epidemiological situation of the condition remains largely unknown. METHODS We used the French national health data system, which covers nearly the entire population residing in France (over 67 million of inhabitants in metropolitan and overseas departments). Prevalent cases were identified using long-term disease status, hospitalisation for epilepsy (ICD-10 codes G40 or G41), and reimbursements for antiseizure medications and electroencephalograms. RESULTS In 2020, we identified 685,122 epilepsy cases, corresponding to an overall prevalence of 10.2 per 1000 inhabitants [95% confidence interval 10.1-10.2], with similar rates in men and women. Estimates were found to increase with age, with an accelerated rise in the second half of the life, which occurred earlier in men than in women. We observed a monotonic gradient of variation with socio-economic deprivation (in non-military metropolitan subjects aged 18-54 years) as well as territorial heterogeneity, with the mountainous centre of France as well as some French overseas departments having the highest prevalence. CONCLUSIONS Our results revise upwards the estimation of epilepsy prevalence in France, showing that it now ranks among the highest in developed countries. Our study also confirms the important socio-territorial heterogeneity of the condition that reflects health inequalities in this country.
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Affiliation(s)
- Joël Coste
- Santé Publique France (French National Public Health Agency), Saint-Maurice, France.
| | | | | | - Yann Mikaeloff
- CPEA, Assistance Publique-Hôpitaux de Paris, Groupement Hospitalo-Universitaire Paris-Saclay, Paris-Saclay University, Paris, France
- CESP-INSERM, Le Kremlin-Bicêtre, France
| | - Viviane Bouilleret
- Neurophysiology and Epileptology Department, Hôpital Bicêtre, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France
- Laboratoire d'Imagerie Biomédicale Multimodale (BioMaps), Service Hospitalier Frédéric Joliot, CEA, CNRS, Inserm, Université Paris-Saclay, Orsay, France
- School of Medicine, Université Paris Saclay, Le Kremlin Bicêtre, France
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Li H, Zhao H. Stability and bifurcation analysis of Alzheimer's disease model with diffusion and three delays. CHAOS (WOODBURY, N.Y.) 2023; 33:083121. [PMID: 37549120 DOI: 10.1063/5.0152605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Abstract
A reaction-diffusion Alzheimer's disease model with three delays, which describes the interaction of β-amyloid deposition, pathologic tau, and neurodegeneration biomarkers, is investigated. The existence of delays promotes the model to display rich dynamics. Specifically, the conditions for stability of equilibrium and periodic oscillation behaviors generated by Hopf bifurcations can be deduced when delay σ (σ=σ1+σ2) or σ3 is selected as a bifurcation parameter. In addition, when delay σ and σ3 are selected as bifurcation parameters, the stability switching curves and the stable region are obtained by using an algebraic method, and the conditions for the existence of Hopf bifurcations can also be derived. The effects of time delays, diffusion, and treatment on biomarkers are discussed via numerical simulations. Furthermore, sensitivity analysis at multiple time points is drawn, indicating that different targeted therapies should be taken at different stages of development, which has certain guiding significance for the treatment of Alzheimer's disease.
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Affiliation(s)
- Huixia Li
- School of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing 211106, China
- Key Laboratory of Mathematical Modelling and High Performance Computing of Air Vehicles (NUAA), MIIT, Nanjing 211106, China
| | - Hongyong Zhao
- School of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing 211106, China
- Key Laboratory of Mathematical Modelling and High Performance Computing of Air Vehicles (NUAA), MIIT, Nanjing 211106, China
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Grangeon L, Charbonnier C, Zarea A, Rousseau S, Rovelet-Lecrux A, Bendetowicz D, Lemaitre M, Malrain C, Quillard-Muraine M, Cassinari K, Maltete D, Pariente J, Moreaud O, Magnin E, Cretin B, Mackowiak MA, Sillaire AR, Vercelletto M, Dionet E, Felician O, Rod-Olivieri P, Thomas-Antérion C, Godeneche G, Sauvée M, Cartz-Piver L, Le Ber I, Chauvire V, Jonveaux T, Balageas AC, Laquerriere A, Duyckaerts C, Vital A, de Paula AM, Meyronet D, Guyant-Marechal L, Hannequin D, Tournier-Lasserve E, Campion D, Nicolas G, Wallon D. Phenotype and imaging features associated with APP duplications. Alzheimers Res Ther 2023; 15:93. [PMID: 37170141 PMCID: PMC10173644 DOI: 10.1186/s13195-023-01172-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/18/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND APP duplication is a rare genetic cause of Alzheimer disease and cerebral amyloid angiopathy (CAA). We aimed to evaluate the phenotypes of APP duplications carriers. METHODS Clinical, radiological, and neuropathological features of 43 APP duplication carriers from 24 French families were retrospectively analyzed, and MRI features and cerebrospinal fluid (CSF) biomarkers were compared to 40 APP-negative CAA controls. RESULTS Major neurocognitive disorders were found in 90.2% symptomatic APP duplication carriers, with prominent behavioral impairment in 9.7%. Symptomatic intracerebral hemorrhages were reported in 29.2% and seizures in 51.2%. CSF Aβ42 levels were abnormal in 18/19 patients and 14/19 patients fulfilled MRI radiological criteria for CAA, while only 5 displayed no hemorrhagic features. We found no correlation between CAA radiological signs and duplication size. Compared to CAA controls, APP duplication carriers showed less disseminated cortical superficial siderosis (0% vs 37.5%, p = 0.004 adjusted for the delay between symptoms onset and MRI). Deep microbleeds were found in two APP duplication carriers. In addition to neurofibrillary tangles and senile plaques, CAA was diffuse and severe with thickening of leptomeningeal vessels in all 9 autopsies. Lewy bodies were found in substantia nigra, locus coeruleus, and cortical structures of 2/9 patients, and one presented vascular amyloid deposits in basal ganglia. DISCUSSION Phenotypes associated with APP duplications were heterogeneous with different clinical presentations including dementia, hemorrhage, and seizure and different radiological presentations, even within families. No apparent correlation with duplication size was found. Amyloid burden was severe and widely extended to cerebral vessels as suggested by hemorrhagic features on MRI and neuropathological data, making APP duplication an interesting model of CAA.
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Affiliation(s)
- Lou Grangeon
- Department of Neurology and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France.
- Department of Neurology, Rouen University Hospital, Rouen Cedex, 76031, France.
| | - Camille Charbonnier
- Department of Genetics and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - Aline Zarea
- Department of Neurology and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - Stephane Rousseau
- Department of Genetics and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - Anne Rovelet-Lecrux
- Department of Genetics and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - David Bendetowicz
- Neurology Department, Sorbonne Université, Paris Brain Institute - ICM, Inserm, CNRS and APHP, Hôpital de la Pitié-Salpétrière APHP, Paris, France
| | - Marion Lemaitre
- Geriatric department, Seclin-Carvin Hospital, Seclin, France
| | - Cécile Malrain
- Department of Neurology, Rennes Hospital, Rennes, France
| | | | - Kevin Cassinari
- Department of Genetics and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - David Maltete
- Department of Neurology and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - Jeremie Pariente
- Neurology Department, Toulouse University Hospital and Toulouse NeuroImaging Center (ToNIC) INSERM-Univeristy of Toulouse Paul Sabatier, Toulouse, France
| | - Olivier Moreaud
- Department of Neurology, Grenoble Hospital, Grenoble, France
| | - Eloi Magnin
- Department of Neurology, Besancon Hospital, Besancon, France
| | - Benjamin Cretin
- Department of Neurology, Hautepierre Hospital, Strasbourg, France
| | | | | | | | - Elsa Dionet
- Department of Neurology, Clermont-Ferrand Hospital, Clermont-Ferrand, France
| | - Olivier Felician
- APHM, Service de Neurologie et Neuropsychologie, CHU Timone, Marseille, France
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | | | | | - Gaelle Godeneche
- Department of Neurology, La Rochelle Hospital, La Rochelle, France
| | - Mathilde Sauvée
- Department of Neurology, Grenoble Hospital, Grenoble, France
| | - Leslie Cartz-Piver
- Centre Mémoire Ressources et Recherche (CMRR), Limoges University Hospital, Limoges, France
| | - Isabelle Le Ber
- Neurology Department, Sorbonne Université, Paris Brain Institute - ICM, Inserm, CNRS and APHP, Hôpital de la Pitié-Salpétrière APHP, Paris, France
| | - Valérie Chauvire
- Department of Neurology, Angers University Hospital, Angers, France
| | - Therèse Jonveaux
- Department of Neurology, Nancy University Hospital, Nancy, France
| | | | - Annie Laquerriere
- Department of Neuropathology, F 76000, Normandy Center for Genomic and Personalized Medicine, Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Rouen, France
| | - Charles Duyckaerts
- Sorbonne Unviersité, INSERM, CNRS U1127, ICM and Laboratoire de Neuropathologie R. Escourolle, Hospital Pitie-Salpêtrière, Paris, France
| | - Anne Vital
- Department of Pathology, University Hospital, Bordeaux, France
| | | | - David Meyronet
- Department of Pathology, Hopital Civil University Hospital, Lyon, France
| | - Lucie Guyant-Marechal
- Department of Genetics and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - Didier Hannequin
- Department of Neurology and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - Elisabeth Tournier-Lasserve
- AP-HP, Groupe Hospitalier Saint-Louis Lariboisière-Fernand-Widal, Service de Génétique Moléculaire Neurovasculaire, INSERM UMR 1141, NeuroDiderot, Université de Paris, Paris, France
| | - Dominique Campion
- Department of Genetics and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - Gaël Nicolas
- Department of Genetics and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
| | - David Wallon
- Department of Neurology and CNR-MAJ, Univ Rouen Normandie, U1245 and CHU Rouen, 76000, Rouen, France
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Vinay R, Biller-Andorno N. A critical analysis of national dementia care guidances. Health Policy 2023; 130:104736. [PMID: 36796180 DOI: 10.1016/j.healthpol.2023.104736] [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] [Received: 07/25/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Adopting an ethics and human rights lens, this paper provides a critical analysis of national dementia care guidance from countries ranked highly in providing quality of care towards the end-of-life, including Australia, Ireland, New Zealand, Switzerland, Taiwan and the United Kingdom. The aim of this paper is to determine areas of consensus and disagreement among guidance and to understand current gaps in research. Overall, studied guidances showed consensus regarding patient empowerment and engagement, promoting independence, autonomy and liberty through; establishing person-centered care plans, providing ongoing care assessment, resources and support to individuals and their family/carers. Consensus was also seen in most end-of-life care issues; re-assessing care plans, rationalizing medication, and most importantly carer support and well-being. Disagreement could be found in criteria relating to decision-making after losing capacity, i.e. through appointment of case managers or a power of attorney, reducing barriers to equitable access of care, stigma and discrimination for minority and disadvantaged groups - including younger people with dementia, medicalized care strategies such as alternatives to hospitalization, covert administration, and assisted hydration and nutrition, and also in identifying an active dying phase. Potential for future development includes a greater emphasis on multidisciplinary collaborations, financial and welfare assistance, exploring the use of artificial intelligence technologies for testing and management, while also providing safeguards against such emerging technologies and therapies.
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Affiliation(s)
- Rasita Vinay
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland.
| | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland
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Hendriks S, Peetoom K, Bakker C, Koopmans R, van der Flier W, Papma J, Verhey F, de Vugt M, Köhler S. Global incidence of young-onset dementia: A systematic review and meta-analysis. Alzheimers Dement 2023; 19:831-843. [PMID: 35715891 DOI: 10.1002/alz.12695] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/19/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Reliable data on the incidence rates for young-onset dementia (YOD) are lacking, but are necessary for research on disease etiology and to raise awareness among health care professionals. METHODS We performed a systematic review and meta-analysis on population-based studies on the incidence of YOD, published between January 1, 1990 and February 1, 2022, according to Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. Data were analyzed using random-effects meta-analyses. Results were age-standardized, and heterogeneity was assessed by subgroup analyses and meta-regression. RESULTS Sixty-one articles were included. Global age-standardized incidence rates increased from 0.17/100,000 in age 30 to 34 years, to 5.14/100,000 in age 60 to 64 years, giving a global total age-standardized incidence rate of 11 per 100,000 in age 30 to 64. This corresponds to 370,000 new YOD cases annually worldwide. Heterogeneity was high and meta-regression showed geographic location significantly influenced this heterogeneity. DISCUSSION This meta-analysis shows the current best estimate of YOD incidence. New prospective cohort studies are needed.
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Affiliation(s)
- Stevie Hendriks
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Kirsten Peetoom
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud UMC Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Raymond Koopmans
- Department of Primary and Community Care, Radboud UMC Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wiesje van der Flier
- Department of Neurology, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Janne Papma
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
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Fonseka L, Wang D, Ryan B, Cheung G, Ma’u E. Incidence of Young Onset Dementia in Waikato, New Zealand: A Population-Based Study. J Alzheimers Dis 2022; 90:1321-1327. [DOI: 10.3233/jad-220802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: There is limited epidemiological research on the incidence of young onset dementia (YOD). Estimates of YOD incidence in New Zealand are extrapolated from international studies that do not reflect New Zealand’s population and ethnic diversity. Objective: To determine the incidence of YOD in the geographical area served by the Waikato District Health Board Methods: All new inpatient and outpatient in the age range 30–64 years with a documented diagnosis of dementia at Waikato Hospital between 1 January 2014 –31 December 2016 were identified. Incidence rates were calculated by 5-year age-band, sex, and ethnicity. Results: 64 incident cases of YOD were included. Incidence rates for all cause YOD were 13.3 (95% CI 10.3–17.0) and 22.7 (95% CI 17.5–29.1) per 100,000 person-years in the age range 30–64 years and 45–64 years respectively. The incidence rate in Māori (20.0, 95% CI 11.4–32.4) was higher compared to non-Māori (12.0, 95% CI 8.9–15.9), but this difference was not statistically significant (p = 0.09). Conclusion: The incidence of YOD in this study is similar to global estimates. Incidence may be higher in Māori compared to non-Māori, highlighting the need for culturally appropriate approaches to dementia prevention, intervention, and care.
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Affiliation(s)
| | - David Wang
- Department of Medicine, University of Otago, DunedinNew Zealand
| | - Brigid Ryan
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Gary Cheung
- Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Etuini Ma’u
- Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Liu CC, Liu CH, Chang KC, Ko MC, Lee PC, Wang JY. Association Between Young-Onset Dementia and Risk of Hospitalization for Motor Vehicle Crash Injury in Taiwan. JAMA Netw Open 2022; 5:e2210474. [PMID: 35511178 PMCID: PMC9073564 DOI: 10.1001/jamanetworkopen.2022.10474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE Several studies have suggested that older-onset dementia is associated with an increased risk of motor vehicle crash injury (MVCI). However, evidence of an association between young-onset dementia and the risk of MVCI is insufficient, particularly in Asia. OBJECTIVE To investigate the association between young-onset dementia and MVCI-related hospitalization in Taiwan. DESIGN, SETTING, AND PARTICIPANTS In this nationwide, population-based cohort study in Taiwan, a cohort of 39 344 patients aged 40 to 64 years with incident dementia diagnosed between 2006 and 2012 was matched 1:1 with a cohort of participants without dementia by age, sex, and index year (initial diagnosis of dementia). Participants were identified from Taiwan's National Health Insurance Research Database (NHIRD). Data were analyzed between March 25 and October 22, 2021. EXPOSURES Dementia, defined by International Classification of Diseases, Ninth Revision, Clinical Modification codes. MAIN OUTCOMES AND MEASURES Hospitalization for MVCI, determined using linked data from Taiwan's Police-Reported Traffic Accident Registry and the NHIRD from January 1, 2003, to December 31, 2015. Hazard ratios (HRs) for MVCI-related hospitalization were estimated using Cox proportional hazards regression models adjusted for sex, age, salary-based insurance premium, urbanization level, and comorbidities. RESULTS Of the 78 688 participants, 47 034 (59.8%) were male; the mean (SD) age was 54.5 (7.4) years. During the 10-year follow-up period, the incidence density of MVCI-related hospitalization was 45.58 per 10 000 person-years (95% CI, 42.77-48.39 per 10 000 person-years) among participants with dementia and 24.10 per 10 000 person-years (95% CI, 22.22-25.99 per 10 000 person-years) among participants without dementia. Compared with participants without dementia, patients with young-onset dementia were at higher risk of MVCI-related hospitalization (adjusted HR [aHR], 1.83; 95% CI, 1.63-2.06), especially those in younger age groups (aged 40-44 years: aHR, 3.54; 95% CI, 2.48-5.07) and within a shorter period (within 1 year of follow-up: aHR, 3.53; 95% CI, 2.50-4.98) after dementia was diagnosed. Patients with young-onset dementia also had a higher risk of being a pedestrian when the crash occurred (aHR, 2.89; 95% CI, 2.04-4.11), having an intracranial or internal injury (aHR, 2.44; 95% CI, 2.02-2.94), and having a severe injury (aHR, 2.90; 95% CI, 2.16-3.89). CONCLUSIONS AND RELEVANCE In this retrospective cohort study, patients in Taiwan with a diagnosis of young-onset dementia had a higher risk of MVCI-related hospitalization than did individuals without dementia and the risk varied by age, disease duration, transport mode, injury type, and injury severity. These findings suggest a need for the planning of strategies to prevent transportation crashes among patients with young-onset dementia.
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Affiliation(s)
- Chih-Ching Liu
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Chien-Hui Liu
- School of Nursing, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Kun-Chia Chang
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
- Department of Natural Biotechnology, NanHua University, Chiayi, Taiwan
| | - Ming-Chung Ko
- Department of Surgery, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
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Vipin A, Satish V, Saffari SE, Koh W, Lim L, Silva E, Nyu MM, Choong TM, Chua E, Lim L, Ng ASL, Chiew HJ, Ng KP, Kandiah N. Dementia in Southeast Asia: influence of onset-type, education, and cerebrovascular disease. Alzheimers Res Ther 2021; 13:195. [PMID: 34847922 PMCID: PMC8630908 DOI: 10.1186/s13195-021-00936-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/16/2021] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Southeast Asia represents 10% of the global population, yet little is known about regional clinical characteristics of dementia and risk factors for dementia progression. This study aims to describe the clinico-demographic profiles of dementia in Southeast Asia and investigate the association of onset-type, education, and cerebrovascular disease (CVD) on dementia progression in a real-world clinic setting.
Methods
In this longitudinal study, participants were consecutive series of 1606 patients with dementia from 2010 to 2019 from a tertiary memory clinic from Singapore. The frequency of dementia subtypes stratified into young-onset (YOD; <65 years age-at-onset) and late-onset dementia (LOD; ≥65 years age-at-onset) was studied. Association of onset-type (YOD or LOD), years of lifespan education, and CVD on the trajectory of cognition was evaluated using linear mixed models. The time to significant cognitive decline was investigated using Kaplan-Meier analysis.
Results
Dementia of the Alzheimer’s type (DAT) was the most common diagnosis (59.8%), followed by vascular dementia (14.9%) and frontotemporal dementia (11.1%). YOD patients accounted for 28.5% of all dementia patients. Patients with higher lifespan education had a steeper decline in global cognition (p<0.001), with this finding being more pronounced in YOD (p=0.0006). Older patients with a moderate-to-severe burden of CVD demonstrated a trend for a faster decline in global cognition compared to those with a mild burden.
Conclusions
There is a high frequency of YOD with DAT being most common in our Southeast Asian memory clinic cohort. YOD patients with higher lifespan education and LOD patients with moderate-to-severe CVD experience a steep decline in cognition.
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