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Determinants of incident dementia in different old age groups: results of the prospective AgeCoDe/AgeQualiDe study

Published online by Cambridge University Press:  23 December 2019

Tobias Luck ,
Alexander Pabst ,
Susanne Roehr Open the ORCID record for Susanne Roehr [Opens in a new window] ,
Birgitt Wiese ,
Marion Eisele ,
Kathrin Heser ,
Dagmar Weeg ,
Angela Fuchs ,
Christian Brettschneider  and
Jochen Werle
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Tobias Luck*
Affiliation:
Department of Economic and Social Sciences & Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), University of Applied Sciences Nordhausen, Nordhausen, Germany
Alexander Pabst
Affiliation:
Faculty of Medicine, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
Susanne Roehr
Affiliation:
Faculty of Medicine, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
Birgitt Wiese
Affiliation:
Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
Marion Eisele
Affiliation:
Center for Psychosocial Medicine, Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Kathrin Heser
Affiliation:
Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
Dagmar Weeg
Affiliation:
Klinikum rechts der Isar, Department of Psychiatry, Technical University of Munich, Munich, Germany
Angela Fuchs
Affiliation:
Medical Faculty, Institute of General Practice, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Christian Brettschneider
Affiliation:
Hamburg Center for Health Economics, Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Jochen Werle
Affiliation:
Medical Faculty Mannheim, Heidelberg University Central Institute of Mental Health, Mannheim, Germany
Silke Mamone
Affiliation:
Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
Hendrik van den Bussche
Affiliation:
Center for Psychosocial Medicine, Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Horst Bickel
Affiliation:
Klinikum rechts der Isar, Department of Psychiatry, Technical University of Munich, Munich, Germany
Michael Pentzek
Affiliation:
Medical Faculty, Institute of General Practice, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Hans-Helmut Koenig
Affiliation:
Hamburg Center for Health Economics, Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Siegfried Weyerer
Affiliation:
Medical Faculty Mannheim, Heidelberg University Central Institute of Mental Health, Mannheim, Germany
Wolfgang Maier
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany Department of Psychiatry, University of Bonn, Bonn, Germany
Martin Scherer
Affiliation:
Center for Psychosocial Medicine, Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Michael Wagner
Affiliation:
Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Steffi G. Riedel-Heller
Affiliation:
Faculty of Medicine, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
*
Correspondence should be addressed to: Tobias Luck, Department of Economic and Social Sciences & Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), University of Applied Sciences Nordhausen, Weinberghof 4, 99734 Nordhausen, Germany. Phone: +49 3631 420 535; Fax: +49 3631 420 817. Email: [email protected].
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Abstract

Objectives:

To examine the impact of determinants of incident dementia in three different old age groups (75–79, 80–84, 85+years) in Germany.

Design:

Multicenter prospective AgeCoDe/AgeQualiDe cohort study with baseline and nine follow-up assessments at 1.5-year intervals.

Setting:

Primary care medical record registry sample.

Participants:

General practitioners’ (GPs) patients aged 75+years at baseline.

Measurements:

Conduction of standardized interviews including neuropsychological assessment and collection of GP information at each assessment wave. We used age-stratified competing risk regression models (accounting for the competing event of mortality) to assess determinants of incident dementia and age-stratified ordinary least square regressions to quantify the impact of identified determinants on the age at dementia onset.

Results:

Among 3027 dementia-free GP patients, n = 704 (23.3%) developed dementia during the 13-year study period. Worse cognitive performance and subjective memory decline with related worries at baseline, and the APOE ε4 allele were associated independently with increased dementia risk in all three old age groups. Worse cognitive performance at baseline was also associated with younger age at dementia onset in all three age groups. Other well-known determinants were associated with dementia risk and age at dementia onset only in some or in none of the three old age groups.

Conclusions:

This study provides further evidence for the age-specific importance of determinants of incident dementia in old age. Such specifics have to be considered more strongly particularly with regard to potential approaches of early detection and prevention of dementia.

Keywords

incidenceneurodegenerative diseasesdeterminantsrisk factorsmodifiable factorsage-specificadvanced ageAPOE ε4
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 5: Issue Theme: Challenges and Facilitators for Diagnosis and Treatment of Dementia , May 2020 , pp. 645 - 659
Copyright
© International Psychogeriatric Association 2019

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Footnotes

*

These authors contributed equally to this work.

References

Allison, P.D. (2010). Survival analysis. In: Hancock, G.R. and Mueller, R.O. (Eds.), The Reviewer’s Guide to Quantitative Methods in the Social Sciences (pp. 413–425). New York: Routledge.Google Scholar
Alzheimer’s Disease International (2015). World Alzheimer Report 2015. The Global Impact of Dementia. An analysis of prevalence, incidence, cost and trends. https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf; accessed 15 February 2019.Google Scholar
Alzheimer’s Society (2016). Factsheet 450 LP April 2016: Risk factors for dementia. https://www.alzheimers.org.uk/sites/default/files/pdf/factsheet_risk_factors_for_dementia.pdf; accessed 4 April 2019.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th ed., text revision. Washington, DC: American Psychiatric Association.Google Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association.Google Scholar
Beam, C.R., Kaneshiro, C., Jang, J.Y., Reynolds, C.A., Pedersen, N.L. and Gatz, M. (2018). Differences between women and men in incidence rates of dementia and Alzheimer’s disease. Journal of Alzheimer’s Disease, 64, 1077–1083. doi: 10.3233/JAD-180141.CrossRefGoogle ScholarPubMed
Blessed, G., Tomlinson, B.E. and Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797–811. doi: 10.1192/bjp.114.512.797.CrossRefGoogle ScholarPubMed
Brauns, H. and Steinmann, S. (1999). Educational reform in France, West-Germany and the United Kingdom. Updating the CASMIN Educational Classification. ZUMA-Nachrichten, 44, 7–44.Google Scholar
Bullain, S.S. and Corrada, M.M. (2013). Dementia in the oldest old. Continuum (Minneapolis, Minn.), 19, 457–469. doi: 10.1212/01.CON.0000429172.27815.3f.Google ScholarPubMed
Chêne, G.et al. (2015). Gender and incidence of dementia in the Framingham Heart Study from mid-adult life. Alzheimer’s & Dementia, 11, 310–320. doi: 10.1016/j.jalz.2013.10.005.CrossRefGoogle ScholarPubMed
Cleves, M.A., Gould, W.W. and Marchenko, Y.V. (2016). An Introduction to Survival Analysis Using Stata. Rev. 3rd ed. College Station, TX: Stata Press.Google Scholar
Corrada, M.M., Berlau, D.J. and Kawas, C.H. (2012). A population-based clinicopathological study in the oldest-old: the 90+ study. Current Alzheimer Research, 9, 709–717. doi: 10.2174/156720512801322537.CrossRefGoogle ScholarPubMed
Corrada, M.M.et al. (2017). Age of onset of hypertension and risk of dementia in the oldest-old: the 90+ Study. Alzheimer’s & Dementia, 13, 103–110. doi: 10.1016/j.jalz.2016.09.007.CrossRefGoogle ScholarPubMed
Corrada, M.M., Paganini-Hill, A., Berlau, D.J. and Kawas, C.H. (2013). Apolipoprotein E genotype, dementia, and mortality in the oldest old: the 90+ Study. Alzheimer’s & Dementia, 9, 12–18. doi: 10.1016/j.jalz.2011.12.004.CrossRefGoogle ScholarPubMed
Corrada, M.M., Sonnen, J.A., Kim, R.C. and Kawas, C.H. (2016). Microinfarcts are common and strongly related to dementia in the oldest-old: the 90+ study. Alzheimer’s & Dementia, 12, 900–908. doi: 10.1016/j.jalz.2016.04.006.CrossRefGoogle ScholarPubMed
Deckers, K., Köhler, S., van Boxtel, M., Verhey, F., Brayne, C. and Fleming, J. (2018). Lack of associations between modifiable risk factors and dementia in the very old: findings from the Cambridge City over-75s cohort study. Aging & Mental Health, 22, 1272–1278. doi: 10.1080/13607863.2017.1280767.CrossRefGoogle ScholarPubMed
Folstein, M.F., Folstein, S.E. and McHugh, P.R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. doi: 10.1016/0022-3956(75)90026-6.CrossRefGoogle ScholarPubMed
Fratiglioni, L., Viitanen, M., von Strauss, E., Tontodonati, V., Herlitz, A. and Winblad, B. (1997). Very old women at highest risk of dementia and Alzheimer’s disease: incidence data from the Kungsholmen Project, Stockholm. Neurology, 48, 132–138. doi: 10.1212/wnl.48.1.132.CrossRefGoogle ScholarPubMed
Ganguli, M., Lee, C.W., Snitz, B.E., Hughes, T.F., McDade, E. and Chang, C.C. (2015). Rates and risk factors for progression to incident dementia vary by age in a population cohort. Neurology, 84, 72–80. doi: 10.1212/WNL.0000000000001113.CrossRefGoogle Scholar
Hall, A.et al. (2019). Prediction models for dementia and neuropathology in the oldest old: the Vantaa 85+ cohort study. Alzheimer’s Research & Therapy, 11, 11. doi: 10.1186/s13195-018-0450-3.CrossRefGoogle ScholarPubMed
Hixson, J.E. and Vernier, D.T. (1990). Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. Journal of Lipid Research, 31, 545–548.Google ScholarPubMed
Jessen, F.et al. (2010). Prediction of dementia by subjective memory impairment: effects of severity and temporal association with cognitive impairment. Archives of General Psychiatry, 67, 414–422. doi: 10.1001/archgenpsychiatry.2010.30.CrossRefGoogle ScholarPubMed
Juva, K.et al. (2000). APOE epsilon4 does not predict mortality, cognitive decline, or dementia in the oldest old. Neurology, 54, 412–415. doi: 10.1212/wnl.54.2.412.CrossRefGoogle ScholarPubMed
Kawas, C.H., Kim, R.C., Sonnen, J.A., Bullain, S.S., Trieu, T. and Corrada, M.M. (2015). Multiple pathologies are common and related to dementia in the oldest-old: the 90+ Study. Neurology, 85, 535–542. doi: 10.1212/WNL.0000000000001831.CrossRefGoogle ScholarPubMed
Lawton, M.P. and Brody, E.M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.10.1093/geront/9.3_Part_1.179CrossRefGoogle ScholarPubMed
Linden, M., Gilberg, R., Horgas, A.L. and Steinhagen-Thiessen, E. (1996) Die Inanspruchnahme medizinischer und pflegerischer Hilfe im hohen Alter. In: Baltes, P.B. and Mayer, K.U. (Eds.), Die Berliner Altersstudie (pp. 475–495). Berlin: Akademie Verlag.Google Scholar
Luck, T., Luppa, M., Angermeyer, M.C., Villringer, A., König, H.-H. and Riedel-Heller, S.G. (2011). Impact of impairment in instrumental activities of daily living and mild cognitive impairment on time to incident dementia: results of the Leipzig Longitudinal Study of the Aged. Psychological Medicine, 41, 1087–1097. doi: 10.1017/S003329171000142X.CrossRefGoogle ScholarPubMed
Luck, T.et al. (2007). Mild cognitive impairment in general practice: age-specific prevalence and correlate results from the German study on ageing, cognition and dementia in primary care patients (AgeCoDe). Dementia and Geriatric Cognitive Disorders, 24, 307–316. doi: 10.1159/000108099.CrossRefGoogle Scholar
Luck, T.et al. (2012). Prediction of incident dementia: impact of impairment in instrumental activities of daily living and mild cognitive impairment-results from the German study on ageing, cognition, and dementia in primary care patients. The American Journal of Geriatric Psychiatry, 20, 943–954. doi: 10.1097/JGP.0b013e31825c09bc.CrossRefGoogle Scholar
Luck, T.et al. (2014). A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study. Acta Psychiatrica Scandinavica, 129, 63–72. doi: 10.1111/acps.12129.CrossRefGoogle ScholarPubMed
Luck, T.et al. (2017). Advance directives and power of attorney for health care in the oldest-old – results of the AgeQualiDe study. BMC Geriatrics, 17, 85. doi: 10.1186/s12877-017-0482-8.CrossRefGoogle ScholarPubMed
Mendonça, M.D., Alves, L. and Bugalho, P. (2016). From subjective cognitive complaints to dementia: who is at risk?: a systematic review. American Journal of Alzheimer’s Disease & Other Dementias, 31, 105–114. doi: 10.1177/1533317515592331.CrossRefGoogle ScholarPubMed
Mielke, M.M., Vemuri, P. and Rocca, W.A. (2014). Clinical epidemiology of Alzheimer’s disease: assessing sex and gender differences. Clinical Epidemiology, 6, 37–48. doi: 10.2147/CLEP.S37929.CrossRefGoogle ScholarPubMed
Nelson, P.T.et al. (2013). Hippocampal sclerosis of aging, a prevalent and high-morbidity brain disease. Acta Neuropathologica, 126, 161–177. doi: 10.1007/s00401-013-1154-1.CrossRefGoogle ScholarPubMed
Peltz, C.B., Corrada, M.M., Berlau, D.J. and Kawas, C.H. (2011). Incidence of dementia in oldest-old with amnestic MCI and other cognitive impairments. Neurology, 77, 1906–1912. doi: 10.1212/WNL.0b013e318238ee89.CrossRefGoogle ScholarPubMed
Pierce, A.L. and Kawas, C.H. (2017). Dementia in the oldest old: beyond Alzheimer disease. PLoS Medicine, 14, e1002263. doi: 10.1371/journal.pmed.1002263.CrossRefGoogle ScholarPubMed
Reisberg, B., Ferris, S.H., de Leon, M.J. and Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. The American Journal of Psychiatry, 139, 1136–1139. doi: 10.1176/ajp.139.9.1136.Google ScholarPubMed
Seitz, H.K., Bühringer, G. and Mann, K. (2008). Grenzwerte für den Konsum alkoholischer Getränke. In: Deutsche Hauptstelle für Suchtfragen (Ed.), Jahrbuch Sucht 2008 (pp. 205–208) [article in German]. Geesthacht: Neuland.Google Scholar
Sheikh, J.I. and Yesavage, J.A. (1986). Geriatric depression scale (GDS): Recent evidence and development of a shorter version. In: Bring, T.L. (Ed.), Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165–173). New York: Haworth.Google Scholar
Sommerlad, A., Ruegger, J., Singh-Manoux, A., Lewis, G. and Livingston, G. (2018). Marriage and risk of dementia: systematic review and meta-analysis of observational studies. Journal of Neurology, Neurosurgery, and Psychiatry, 89, 231–238. doi: 10.1136/jnnp-2017-316274.CrossRefGoogle ScholarPubMed
World Health Organization (2019). Global Health Observatory (GHO) data. Life Expectency. https://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/; accessed 15 February 2019.Google Scholar
Yang, Z., Slavin, M.J. and Sachdev, P.S. (2013). Dementia in the oldest old. Nature Reviews. Neurology, 9, 382–393. doi: 10.1038/nrneurol.2013.105.CrossRefGoogle ScholarPubMed
Zaudig, M.et al. (1991). SIDAM--A structured interview for the diagnosis of dementia of the Alzheimer type, multi-infarct dementia and dementias of other aetiology according to ICD-10 and DSM-III-R. Psychological Medicine, 21, 225–236. doi: 10.1017/s0033291700014811.CrossRefGoogle Scholar