Leslie Grasset1, Carol Brayne2, Pierre Joly3, Hélène Jacqmin-Gadda3, Karine Peres3, Alexandra Foubert-Samier4, Jean-François Dartigues4, Catherine Helmer5. 1. INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France. Electronic address: Leslie.Grasset@isped.u-bordeaux2.fr. 2. Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge, UK. 3. INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France. 4. INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France; University Hospital, Memory Consultation, CMRR, Bordeaux, France. 5. INSERM, ISPED, Centre INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France; INSERM, Clinical Investigation Center-Clinical Epidemiology 1401, Bordeaux, France.
Abstract
INTRODUCTION: Few recent studies have suggested declining trends in dementia frequency. French cohorts with long follow-up allowed us to explore incidence evolution trends. METHODS: Two different populations of subjects aged ≥65 years included in 1988-1989 (n = 1469) and 1999-2000 (n = 2104) were followed up over 10 years, with systematic assessment for cognition and dementia. Multistates illness-death models were used to compare dementia incidence using both clinical and algorithmic diagnoses. RESULTS: Using the algorithmic diagnosis, incidence declined significantly overall and for women (age-adjusted hazard ratio [HR] = 0.62; confidence interval (CI) = 0.48-0.80 for women between the two populations). Differences in education, vascular factors, and depression accounted only to some extent for this reduction (women full-adjusted HR = 0.73; CI = 0.57-0.95). No significant decreasing trends were found for men or when using the clinical diagnosis for either sex. DISCUSSION: Our study provides further support for a decrease in dementia incidence in women using algorithmic diagnosis. Changes in diagnostic boundaries mask this reduction.
INTRODUCTION: Few recent studies have suggested declining trends in dementia frequency. French cohorts with long follow-up allowed us to explore incidence evolution trends. METHODS: Two different populations of subjects aged ≥65 years included in 1988-1989 (n = 1469) and 1999-2000 (n = 2104) were followed up over 10 years, with systematic assessment for cognition and dementia. Multistates illness-death models were used to compare dementia incidence using both clinical and algorithmic diagnoses. RESULTS: Using the algorithmic diagnosis, incidence declined significantly overall and for women (age-adjusted hazard ratio [HR] = 0.62; confidence interval (CI) = 0.48-0.80 for women between the two populations). Differences in education, vascular factors, and depression accounted only to some extent for this reduction (women full-adjusted HR = 0.73; CI = 0.57-0.95). No significant decreasing trends were found for men or when using the clinical diagnosis for either sex. DISCUSSION: Our study provides further support for a decrease in dementia incidence in women using algorithmic diagnosis. Changes in diagnostic boundaries mask this reduction.
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