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Undifferentiated dementia, Alzheimer's disease and vascular dementia: Age- and gender-related incidence in Liverpool

The MRC–ALPHA Study

Published online by Cambridge University Press:  03 January 2018

J. R. M. Copeland ,
Cherie McCracken ,
M. E. Dewey ,
K. C. M. Wilson ,
Mark Doran ,
Chris Gilmore ,
Anne Scott  and
Bernie Larkin
J. R. M. Copeland*
Affiliation:
Department of Psychiatry, University of Liverpool, Royal Liverpool University Hospital, Liverpool
Cherie McCracken
Affiliation:
Department of Psychiatry, University of Liverpool, Royal Liverpool University Hospital, Liverpool
M. E. Dewey
Affiliation:
Nottingham Unit, Medical School, Queens Medical Centre, Nottingham
K. C. M. Wilson
Affiliation:
Academic Unit, EMI Directorate, St Catherines Hospital, Birkenhead
Mark Doran
Affiliation:
Department of Neurology and Neurosurgery, Walton Hospital, Walton, Liverpool
Chris Gilmore
Affiliation:
Wirral and West Cheshire Community NHS Trust, West Cheshire Hospital, Chester
Anne Scott
Affiliation:
Centre for Social Policy Research and Development, Bryn Afon, University of Wales, Bangor, Gwynedd
Bernie Larkin
Affiliation:
Stepping Hill Hospital, Stockport
*
Professor J. R. M. Copeland, Department of Psychiatry, University of Liverpool, Royal Liverpool University Hospital, Liverpool L69 3GA
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Abstract

Background

Does incidence of dementia follow the age pattern of prevalence? Is gender a risk factor? Do patterns of incidence differ between dementias?

Aims

To assess age-specific incidence rates of undifferentiated dementias, Alzheimer's disease and vascular dementia.

Method

5222 individuals aged $65 years, were interviewed using the Geriatric Mental State/History and Aetiology Schedule. The AGECAT package was used to identify cases at three interviewing waves at two-year intervals. Diagnoses were made using ICD −10 Research Criteria and validated against neurological and psychological examination, with imaging and neuropathology on unselected subsamples.

Results

Incidence rates of the dementias increase with age. Age patterns are similar between Alzheimer's disease and vascular dementia. Gender appears influential in Alzheimer's disease. In England and Wales, 39 437 new cases of Alzheimer's disease (4.9/1000 person-years at risk); 20 513 of vascular dementia (2.6/1000 person-years) and 155 169 of undifferentiated dementia (19/1000 person-years) can be expected each year.

Conclusions

Incidence rates for Alzheimer's disease and vascular dementia appear to behave differently with an increased risk of Alzheimer's disease for women compared to vascular dementia.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 5 , November 1999 , pp. 433 - 438
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Funding was received from the Medical Research Council (UK), Lilly Industries and the Human Ageing Trust.

References

Aevarsson, O. & Skoog, I. (1996) A population-based study on the incidence of dementia disorders between 85 and 88 years of age. American Journal of Geriatric Society, 44, 1455–1460.CrossRefGoogle Scholar
Arnes, D., Flynn, E., Tuckwell, V., et al (1994) Diagnosis of psychiatric disorder in elderly general and geriatric hospital patients: AGECAT and DSM lllR compared. International Journal of Geriatric Psychiatry, 9, 627–633.Google Scholar
Bickel, H. & Cooper, B. (1994) Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study. Journal of Psychological Medicine, 24, 179–192.CrossRefGoogle Scholar
Blessed, G., Black, S. E., Butler, T., et al (1991) The diagnosis of dementia in the elderly. A comparison of CAMCOG (the cognitive section of CAMDEX), the AGECAT program, DSM–III, the Mini-Mental State Examination and some short rating scales. British Journal of Psychiatry, 159, 193–198.CrossRefGoogle ScholarPubMed
Boothby, H., Blizard, R., Livingston, G., et al (1994) The Gospel Oak Study stage III: the incidence of dementia. Psychological Medicine, 24, 89–95.CrossRefGoogle ScholarPubMed
Brayne, C., Gill, C., Huppert, F. A., et al (1995) Incidence of clinically diagnosed subtypes of dementia in an elderly population. Cambridge Project for Later Life. British Journal of Psychiatry, 167, 255–262.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1989) Computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Journal of Psychological Medicine, 16, 89–99.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E., Wood, N., et al (1917) Range of mental illness amongst the elderly in the community. Prevalence in Liverpool using the GMS-AGECAT package. British Journal of Psychiatry, 150, 815–823.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1990) Dementia and depression in elderly persons: AGECAT compared with DSM III and pervasive illness. International Journal of Geriatric Psychiatry, 5, 47–51.CrossRefGoogle Scholar
Copeland, J. R. M., & Dewey, M. E. (1991) Neuropsychological diagnosis (GMS–HAS-AGECAT package). International Psychogeriatrics, 3 (suppl.), 43–49.CrossRefGoogle Scholar
Copeland, J. R. M., Davidson, I. A., Dewey, M. E., et al (1992) Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool. British Journal of Psychiatry, 161, 230–239.CrossRefGoogle ScholarPubMed
Davidson, I. A., Dewey, M. E. & Copeland, J. R. M. (1988) The relationship between mortality and mental disorder: evidence from the Liverpool Longitudinal study. International Journal of Psychiatry, 3, 95–98.Google Scholar
Dewey, M. E. & Copeland, J. R. M. (1986) Computerised psychiatric diagnosis in the elderly: AGECAT. Journal of Microcomputer Applications, 9, 135–140.CrossRefGoogle Scholar
Fichter, M. M., Meller, I., Schröppel, H., et al (1995) Dementia and cognitive impairment in the oldest old in the community. Prevalence and comorbidity. British Journal of Psychiatry, 166, 621–629.CrossRefGoogle ScholarPubMed
Fobtein, M. F., Folstein, S. E. & 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.Google Scholar
Jorm, A. F. & Jacomb, P. A. (1989) The Informant Questionnaire on Cognitive Dedine in the Elderly (IQCCOE): socio-demographic correlates, reliability, validity and some norms. Psychological Medicine, 19, 1015–1022.CrossRefGoogle Scholar
Kua, E. H. & Ko, S. M. (1994) The ageing of elderly people. Singapore Medical Journal, 35, 386–389.Google ScholarPubMed
Mirra, S. S., Heyman, A., McKeel, D. N., et al (1991) The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). II: Standardisation of the neuropathologic assessment of Alzheimer's Disease. Neurology, 41, 479–186.CrossRefGoogle Scholar
Payami, H., Zareparsl, S., Montee, K. R., et al (1996) Gender difference in apolipoprotein E – associated risk for familial Alzheimer's disease: a possible clue to the higher incidence of Alzheimer's disease in women. American Journal of Human Genetics, 58, 803–811.Google Scholar
Roth, M., Tym, E., Mountjoy, C. Q., et al (1986) CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry 149, 698–709.CrossRefGoogle Scholar
Saunders, P. A., Copeland, J. R. M., Dewey, M. E., et al (1993) The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC-ALPHA study. International Journal of Epidemiology, 22, 838–847.CrossRefGoogle ScholarPubMed
World Health Organization (1986) The ICD–10 Classification of Mental and behavioural Disorders: Diagnostic Criteria for Research. Geneva: WHO.Google Scholar
Yoshitake, T., Kiyohara, Y., Kato, I., et al (1995) Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population: the Hisayama Study. Neurology 45, 1161–1168.CrossRefGoogle Scholar
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