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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.

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