Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-22T18:36:02.424Z Has data issue: false hasContentIssue false
  • English
  • Français

Prospects for delaying the rising tide of worldwide, late-life dementias

Published online by Cambridge University Press:  01 July 2010

Eric B. Larson
Eric B. Larson*
Affiliation:
Group Health Research Institute, Seattle, Washington, U.S.A.
*
Correspondence should be addressed to: Eric B. Larson, MD, MPH, Executive Director, Group Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA 98101-1448, U.S.A. Phone: 206-287-2988; Fax: 206-287-2871. Email: [email protected].
Get access

Abstract

Worldwide, lifespan is lengthening. Concomitantly, late-life dementias are increasingly common, challenging both personal and public health internationally. After age 65, rates of dementia tend to double every five years in developed countries and every seven in developing ones. The late-life dementias, particularly Alzheimer's disease, have profound effects on aging individuals and their caregivers. Multidisciplinary research has explored the potential for various approaches to prevent or delay the onset of late-life dementias. Outlining that research, including our team's Adult Changes in Thought and Kame studies, this review concludes that delaying the onset of these dementias appears feasible, although absolute prevention may not be. Today, the most promising methods appear to include controlling vascular risk factors like hypertension and engaging in physical exercise – and possibly mental exercise. If people can delay the onset of dementias, they can lead more fulfilling lives for longer, spending less time suffering from dementia and letting their families spend less time coping with the disease. It is possible that trends toward more knowledge-based societies, where cognitive health is so vital, may increasingly exert evolutionary pressure favoring larger and healthier brains – and a “compression of cognitive morbidity” – well into old age. Public health's great triumph, increased lifespan, should give more of the world's people the reward of many years of dementia-free life. Rather than the personal difficulties and public health burdens of many years of functional impairment, dependency, and suffering with dementia, some interventions may delay the onset of Alzheimer's disease and other dementias.

Keywords

Alzheimer's diseasepreventionlifestyle risk factorsagingexercisedemographicsevolution
Type
Focus on prevention in psychogeriatrics
Information
International Psychogeriatrics , Volume 22 , Special Issue 8: Focus on prevention in psychogeriatrics , December 2010 , pp. 1196 - 1202
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbott, R. D., White, L. R., Ross, G. W., Masaki, K. H., Curb, J. D. and Petrovitch, H. (2004). Walking and dementia in physically capable elderly men. JAMA, 292, 1447–1453.CrossRefGoogle ScholarPubMed
Albert, M. S. et al. (1995). Predictors of cognitive change in older persons: MacArthur studies of successful aging. Psychology and Aging, 10, 578–589.CrossRefGoogle ScholarPubMed
Angevaren, M., Aufdemkampe, G., Verhaar, H. J. J., Aleman, A. and Vanhees, L. (2008). Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: DC005381. doi: 10.1002/14651858.CD005381.pub3.CrossRefGoogle ScholarPubMed
Anstey, K. J., von Sanden, C., Salim, A. and O'Kearney, R. (2007). Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. American Journal of Epidemiology, 166, 367–378.CrossRefGoogle ScholarPubMed
Arriagada, P. V., Growdon, J. H., Hedley-Whyte, E. T. and Hyman, B. T. (1992). Neurofibrillary tangles but not senile plaques parallel duration and severity of Alzheimer's disease. Neurology, 42, 631–639.Google Scholar
Balter, M. (2005). Are human brains still evolving? Brain genes show signs of selection. Science, 309, 1662–1663.CrossRefGoogle ScholarPubMed
Boyle, P. A., Buchman, A. S., Barnes, L. L. and Bennett, D. A. (2010). Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons. Archives of General Psychiatry, 67, 304–310.CrossRefGoogle ScholarPubMed
Braak, H., and Braak, E. (1991). Neuropathological staging of Alzheimer-related changes. Acta Neuropathologica, 82, 239–259.Google Scholar
Breitner, J. C. et al. (2009). Risk of dementia and AD with prior exposure to NSAIDs in an elderly community-based cohort. Neurology, 72, 1899–1905.CrossRefGoogle Scholar
Brookmeyer, R., Gray, S. and Kawas, C. (1998). Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. American Journal of Public Health, 88, 1337–1342.Google Scholar
Brookmeyer, R., Johnson, E., Ziegler-Graham, K. and Arrighi, H. M. (2007) Forecasting the global burden of Alzheimer's disease. Alzheimer's and Dementia, 3, 186–191.CrossRefGoogle ScholarPubMed
Conel, J. L. (1939–1967). The Postnatal Development of the Human Cerebral Cortex. Vols. 1–8. Cambridge, MA: Harvard University Press.Google Scholar
den Dunnen, W. F. et al. (2008). No disease in the brain of a 115-year-old woman. Neurobiology of Aging, 29, 1127–1132.CrossRefGoogle ScholarPubMed
Drucker, P. F. (1983). Concept of the Corporation. Piscataway, NJ: Transaction Publishers – Rutgers.Google Scholar
Drucker, P. F. (2001). The next society, Economist, 3 November, 2–20.Google Scholar
Evans, P. D. et al. (2005). Microcephalin, a gene regulating brain size, continues to evolve adaptively in humans. Science, 309, 1717–1720.Google Scholar
Féart, C. et al. (2009). Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA, 302, 638–648. Erratum in JAMA, 2009, 302, 2436.CrossRefGoogle ScholarPubMed
Forbes, D., Forbes, S., Morgan, D. G., Markle-Reid, M., Wood, J. and Culum, I. (2009). Physical activity programs for persons with dementia. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD006489. doi: 10.1002/14651858.CD006489.pub2.Google Scholar
Fratiglioni, L., Wang, H. X., Ericsson, K., Maytan, M. and Winblad, B. (2000). Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet, 355, 1315–1319.CrossRefGoogle ScholarPubMed
Fratiglioni, L., Paillard-Barg, S. and Winblad, B. (2004). An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurology 3, 343–353.CrossRefGoogle ScholarPubMed
Fries, J. F. (1980). Aging, natural death, and the compression of morbidity. New England Journal of Medicine, 303, 130–135.CrossRefGoogle ScholarPubMed
Galbraith, J. K. (1957). The New Industrial State. Princeton, NJ: Princeton University Press.Google Scholar
Gould, E., Beylin, A., Tanapat, P., Reeves, A. and Shors, T. J. (1999). Learning enhanced adult neurogenesis in the hippocampal formation. Nature Neuroscience, 3, 260–265.CrossRefGoogle Scholar
Graves, A. B. et al. (1996). Prevalence of dementia and its subtypes in the Japanese American population for King County Washington State: the KAME project. American Journal of Epidemiology, 144, 760–771.CrossRefGoogle Scholar
Gray, S. L. (2008). Antioxidant vitamin supplement use and risk of dementia or Alzheimer's disease in older adults. Journal of the American Geriatrics Society, 56, 291–295.Google Scholar
Hayakawa, T., Angata, T., Lewis, A. L., Mikkelsen, T. S., Varki, N.M. and Varki, A. (2005). A human-specific gene in microglia. Science, 309, 1693.CrossRefGoogle ScholarPubMed
Karp, A., Paillard-Borg, S., Wang, H. X., Silverstein, M., Winblad, B. and Fratiglioni, L. (2006). Mental, physical and social components in leisure activities equally contribute to decrease dementia risk. Dementia and Geriatric Cognitive Disorders, 21, 65–73.Google Scholar
Kramer, A. F., Bherer, L., Colcombe, S. J., Dong, W. and Greenough, W. T. (2004). Environmental influences on cognitive and brain plasticity during aging. Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 59A, 940–957.Google Scholar
Kukull, W. A. et al. (2002). Dementia and Alzheimer disease incidence: a prospective cohort study. Archives of Neurology, 59, 1737–1746.CrossRefGoogle ScholarPubMed
Langa, K. M., Foster, N. L. and Larson, E. B. (2004). Mixed dementia: emerging concepts and therapeutic implications. JAMA, 292, 2901–2908.Google Scholar
Langa, K. M. et al. (2008). Trends in the prevalence and mortality of cognitive impairment in the United States: is there evidence of a compression of cognitive morbidity? Alzheimer's and Dementia, 4, 134–144.CrossRefGoogle ScholarPubMed
Larson, E. B. and Langa, K. M. (2008). The rising tide of dementia worldwide. Lancet, 372, 430–432.Google Scholar
Larson, E. B. and Wang, L. (2004). Exercise, aging and Alzheimer disease. Alzheimer's Disease and Associated Disorders, 18, 54–56.CrossRefGoogle ScholarPubMed
Larson, E. B. et al. (2004). Survival after initial diagnosis of Alzheimer disease. Annals of Internal Medicine, 140, 501–509.Google Scholar
Larson, E. B. et al. (2006). Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine, 144, 73–81.CrossRefGoogle ScholarPubMed
Lautenschlager, N. T. et al. (2008). Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA, 300, 1027–1037. Erratum in: JAMA, 2009, 301, 276.Google Scholar
Li, G. et al. (2004). Statin therapy and risk of dementia in the elderly: a community based prospective cohort study. Neurology, 63, 1624–1628.CrossRefGoogle ScholarPubMed
Li, G. et al. (2005). Serum cholesterol and risk of Alzheimer disease: a community-based cohort study. Neurology, 65, 1045–1050.Google Scholar
Li, G. et al. (2007a). Statin therapy is associated with reduced neuropathologic changes of Alzheimer disease. Neurology, 69, 878–885.CrossRefGoogle ScholarPubMed
Li, G. et al. (2007b). Age-varying association of blood pressure and risk of dementia varies with age: a community-based prospective cohort study. Journal of the American Geriatrics Society, 55, 1161–1167.CrossRefGoogle ScholarPubMed
Lim, A. et al. (1999). Clinico-neuropathological correlation of Alzheimer's disease in a community-based case series. Journal of the American Geriatrics Society, 47, 564–569.Google Scholar
Llibre Rodriguez, J. J. et al. (2008). Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey, Lancet, 372, 430–432. doi: 10.1016/S0140–6736(08)61002–8.Google Scholar
Lobo, A. et al. (2000). Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts, Neurology, 54 (Suppl. 5), S4–S9.Google ScholarPubMed
Malouf, R. and Birks, J. (2004). Donepezil for vascular cognitive impairment. Cochrane Database of Systematic Reviews, 1, CD004395.Google Scholar
Manton, K. G., Gu, X. L. and Ukraintseva, S. V. (2005). Declining prevalence of dementia in the U.S. elderly population. Advances in Gerontology, 16, 30–37.Google Scholar
McGuinness, B., Craig, D., Bullock, R. and Passmore, P. (2009a). Statins for the prevention of dementia. Cochrane Database of Systematic Reviews, Issue 2, Art. No.: CD003160. doi: 10.1002/14651858. CD003160.pub2.CrossRefGoogle ScholarPubMed
McGuinness, B., Todd, S., Passmore, P. and Bullock, R. (2009b). Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Cochrane Database of Systematic Reviews Issue 4, Art. No.: CD004034. doi: 10.1002/14651858. CD004034.pub3.Google Scholar
Mekel-Bobrov, N. et al. (2005). Ongoing adaptive evolution of ASPM, a brain size determinant in Homo sapiens. Science, 309, 1720–1722.Google Scholar
Moceri, V. M., Kukull, W. A., Emanuel, I., van Belle, G. and Larson, E. B. (2000). Early-life risk factors and the development of Alzheimer's disease. Neurology, 554, 415–420.Google Scholar
Moceri, V. M. et al. (2001). Using census data and birth certificates to reconstruct the early-life socioeconomic environment and the relation to the development of Alzheimer's disease. Epidemiology, 12, 383–389.Google Scholar
Montine, T. J. and Larson, E. B. (2009). Late-life dementias: does this unyielding global challenge require a broader view? JAMA, 302, 2593–2594.Google Scholar
Podewils, L. J. et al. (2005). Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. American Journal of Epidemiology, 161, 639–651.CrossRefGoogle ScholarPubMed
Scarmeas, N. et al. (2009). Physical activity, diet, and risk of Alzheimer disease. JAMA, 302, 627–637.CrossRefGoogle ScholarPubMed
Schaie, K. W. (2005). Observations from the Seattle Longitudinal Study of Adult Intelligence. John Hopkins Memory Bulletin, 28 January, 23–30.Google Scholar
Skoog, I., Nilsson, L., Palmertz, B., Andreasson, L. A. and Svanborg, A. (1993). A population-based study of dementia in 85-year-olds. The New England Journal of Medicine, 328, 153–158.Google Scholar
Snitz, B. E. et al. (2009). Ginkgo Evaluation of Memory (GEM) Study. Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial. JAMA, 302, 2663–2670.Google Scholar
Sonnen, J. A. et al. (2007). Pathological correlates of dementia in a longitudinal, population-based sample of aging. Annals of Neurology, 62, 406–413.CrossRefGoogle Scholar
van Gelder, B. M., Tijhuis, M. A., Kalmijn, S., Giampaoli, S., Nissinen, A. and Kromhout, D. (2004). Physical activity in relation to cognitive decline in elderly men: the FINE Study. Neurology, 63, 2316–2321.Google Scholar
Wang, L., Larson, E. B., Bowen, J. D. and van Belle, G. (2006). Performance-based physical function and future dementia in older people. Archives of Internal Medicine, 166, 1115–1120.CrossRefGoogle ScholarPubMed
Wang, L. et al. (2009). Blood pressure and brain injury in older adults: findings from a community-based autopsy study. Journal of the American Geriatrics Society, 57, 1975–1981.Google Scholar
Weuve, J., Kang, J. H., Manson, J. E., Breteler, M. M., Ware, J. H. and Grodstein, F. (2004). Physical activity, including walking, and cognitive function in older women. JAMA, 292, 1454–1461.CrossRefGoogle ScholarPubMed
Willis, S. L. et al. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA, 296, 2805–2814.CrossRefGoogle ScholarPubMed
Yakovlev, P. I. and Lecours, A. R. (1967). The myelogenetic cycles of regional maturation of the brain. In Minkowski, A. (ed.), Regional Development of the Brain in Early Life. Oxford: Blackwell.Google Scholar