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Risk factors for incident dementia in the very old

Published online by Cambridge University Press:  11 April 2013

Karin Wallin
Affiliation:
Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden Karolinska Institutet Alzheimer Disease Research Center (KI-ADRC), Karolinska Institutet, Stockholm, Sweden Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Gustaf Boström
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Miia Kivipelto
Affiliation:
Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden Karolinska Institutet Alzheimer Disease Research Center (KI-ADRC), Karolinska Institutet, Stockholm, Sweden Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland Department of Neurology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
Yngve Gustafson
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Corresponding
E-mail address:

Abstract

Background: Several risk factors for dementia, Alzheimer's disease, and cognitive impairment have been established; however, knowledge about risk factors in the very old population (≥85 years) is limited. This study describes the association of several baseline factors with dementia in participants aged ≥85 years, and investigates factors associated with a higher risk of incident dementia over five years.

Methods: The participants in this population-based cohort study were aged 85, 90, and ≥95 years at baseline (2000–2002). Data were collected during home visits for interviews and testing, from a review of medical records, and/or interviewing the caregiver or next of kin. After five years 212 participants could be followed up concerning incident dementia. Multivariate logistic regression was used.

Results: At baseline, 100/353 (28%) of participants had a dementia diagnosis. Over five years, 71/212 (33.5%) participants developed dementia. Few participants with dementia at baseline remained alive after five years (12%). Depression at the baseline and follow-up time were associated with a higher risk of dementia, odds ratio (OR) (95% CI, p-value) 2.91 (1.37–6.16, 0.005) and 1.61 (1.26–2.05, <0.001) respectively. More social contact and a higher Mini-Mental State Examination score at baseline were associated with lower risk of incident dementia, OR (95% CI, p-value) 0.87 (0.78–0.97, 0.009) and 0.83 (0.74–0.93, 0.001) respectively.

Conclusions: Prevalence and incidence of dementia are high in very old people and dementia appears to be a fatal disorder. Depression is associated with higher risk of incident dementia over five years whereas more frequent social contacts and a higher MMSE score are associated with lower risk.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

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