Karine Pérès1,2, Carol Brayne3, Fanny Matharan1,2, Leslie Grasset1,2, Catherine Helmer1,2,4, Luc Letenneur1,2, Alexandra Foubert-Samier1,2,5, Isabelle Baldi1,2, François Tison5, Hélène Amieva1,2, Jean-François Dartigues1,2,5. 1. University of Bordeaux, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France. 2. ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France. 3. Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge, United Kingdom. 4. Clinical Investigation Center-Clinical Epidemiology 1401, INSERM, Bordeaux, France. 5. Memory Consultation, Centre Mémoire de Ressource et de Recherche, University Hospital, Bordeaux, France.
Abstract
OBJECTIVES: To determine the prevalence of dementia and cognitive impairment in older people across generations. DESIGN: Two prospective cohort studies (Personnes Agées QUID (PAQUID), Aging Multidisciplinary Investigation (AMI)). SETTING: Baseline data from two subsamples of older farmers in southwestern France. PARTICIPANTS: PAQUID (n = 595) and AMI (n = 906) participants aged 65 and older living at home at baseline (1988 PAQUID, 2008 AMI). MEASUREMENTS: Two methods were used to diagnose dementia: a clinical consensus diagnosis and a computer-assisted taxonomy approach (cognitive impairment with disability (CIWD)) using Mini-Mental State Examination and instrumental activity of daily living scores. Crude and standardized prevalences (using PAQUID age-sex structure) and 95% confidence intervals were calculated, and logistic regression was used to explore confounding. RESULTS: The prevalence of consensus diagnosis of dementia was higher in AMI in 2008 than in PAQUID in 1988 (12.0% vs 5.7%, P < .001), whereas the reverse was observed for CIWD (14.8% vs 23.8%, P < .001), confirmed by logistic regressions (odds ratio (OR)AMIvsPAQUID = 2.50, 95% confidence interval (CI) = 1.52-4.12; ORAMIvs.PAQUID = 0.60, 95% CI = 0.42-0.87, respectively). Educational level increased and management of vascular risk factors improved over the study period, and health and living conditions improved globally. CONCLUSION: These findings suggest global cognitive and functional improvement in old farmers (the prevalence of CIWD decreased by 40% over 20 years) and simultaneously a marked change in the subjective boundary between dementia and nondementia according to clinicians.
OBJECTIVES: To determine the prevalence of dementia and cognitive impairment in older people across generations. DESIGN: Two prospective cohort studies (Personnes Agées QUID (PAQUID), Aging Multidisciplinary Investigation (AMI)). SETTING: Baseline data from two subsamples of older farmers in southwestern France. PARTICIPANTS: PAQUID (n = 595) and AMI (n = 906) participants aged 65 and older living at home at baseline (1988 PAQUID, 2008 AMI). MEASUREMENTS: Two methods were used to diagnose dementia: a clinical consensus diagnosis and a computer-assisted taxonomy approach (cognitive impairment with disability (CIWD)) using Mini-Mental State Examination and instrumental activity of daily living scores. Crude and standardized prevalences (using PAQUID age-sex structure) and 95% confidence intervals were calculated, and logistic regression was used to explore confounding. RESULTS: The prevalence of consensus diagnosis of dementia was higher in AMI in 2008 than in PAQUID in 1988 (12.0% vs 5.7%, P < .001), whereas the reverse was observed for CIWD (14.8% vs 23.8%, P < .001), confirmed by logistic regressions (odds ratio (OR)AMIvsPAQUID = 2.50, 95% confidence interval (CI) = 1.52-4.12; ORAMIvs.PAQUID = 0.60, 95% CI = 0.42-0.87, respectively). Educational level increased and management of vascular risk factors improved over the study period, and health and living conditions improved globally. CONCLUSION: These findings suggest global cognitive and functional improvement in old farmers (the prevalence of CIWD decreased by 40% over 20 years) and simultaneously a marked change in the subjective boundary between dementia and nondementia according to clinicians.
Authors: Valory N Pavlik; Samantha C Burnham; Joseph S Kass; Catherine Helmer; Sebastian Palmqvist; Maria Vassilaki; Jean-François Dartigues; Oskar Hansson; Colin L Masters; Karine Pérès; Ronald C Petersen; Erik Stomrud; Lesley Butler; Preciosa M Coloma; Xavier M Teitsma; Rachelle Doody; Mary Sano Journal: J Alzheimers Dis Date: 2022 Impact factor: 4.472