Are Trends in Dementia Incidence Associated With Compression in Morbidity? Evidence From The Framingham Heart Study

Carole DufouilPhD, Alexa BeiserPhD, Geneviève ChêneMD, PhD and Sudha SeshadriMD

The Journals of Gerontology: Series B, 2018, vol. 73, issue suppl_1, S65-S72

Abstract: ObjectivesSeveral epidemiological studies suggest declining trends in dementia over the last three decades with both decreasing age-specific prevalence and incidence. There is limited data on whether this delayed clinical onset is accompanied by a shorter postdiagnosis survival.MethodsA total of 5,205 participants from the Framingham Original and Offspring cohorts were studied. Four epochs were considered from 1977–1984 to 2004–2008. Gender and education adjusted 5-year mortality risks were estimated using delayed entry Cox models with the earliest epoch as reference category. Stratified analyses by sex, education, and age were undertaken. A nested case control study of 317 dementia cases and 317 controls matched on age, gender and epoch was initiated.ResultsIn the whole sample, 5-year mortality risk has decreased with time, it was 33% lower in the last epoch compared to the earliest. In the 317 persons who developed dementia, age at onset increased (1.5 years/epoch), and years alive with dementia decreased (1 year/epoch) over time. We observed however, a decreased adjusted relative mortality risk (by 18%) in persons with dementia in 1986–1991 compared to 1977–1983 and no significant change from then to the latest epoch. The nested case control study suggested in matched controls that 5-year mortality relative risk had increased by 60% in the last epoch compared to Epoch 1.DiscussionIn the FHS, in the last 30 years, disease duration in persons with dementia has decreased. However, age-adjusted mortality risk has slightly decreased after 1977–1983. Consequences of such trends on dementia prevalence should be investigated.

Keywords: Alzheimer’s disease; Dementia; morbidity; prevention; secular trends; survival (search for similar items in EconPapers)
Date: 2018
References: Add references at CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
http://hdl.handle.net/10.1093/geronb/gby001 (application/pdf)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:oup:geronb:v:73:y:2018:i:suppl_1:p:s65-s72.

Ordering information: This journal article can be ordered from
https://academic.oup.com/journals

Access Statistics for this article

The Journals of Gerontology: Series B is currently edited by Psychological Sciences - S. Duke Han, PhD and Social Sciences - Jessica A Kelley, PhD, FGSA

More articles in The Journals of Gerontology: Series B from The Gerontological Society of America Oxford University Press, Great Clarendon Street, Oxford OX2 6DP, UK.
Bibliographic data for series maintained by Oxford University Press ().