A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012

By Kenneth M. Langa, E. Larson, Eilieen M. Crimmins, J. Faul, D. Levine, Mohammed U. Kabeto, D. Weir. JAMA Internal Medicine, 2017

814 citations recorded by the source corpus.

Importance The aging of the US population is expected to lead to a large increase in the number of adults with dementia, but some recent studies in the United States and other high-income countries suggest that the age-specific risk of dementia may have declined over the past 25 years. Clarifying current and future population trends in dementia prevalence and risk has important implications for patients, families, and government programs. Objective To compare the prevalence of dementia in the United States in 2000 and 2012. Design, Setting, and Participants We used data from the Health and Retirement Study (HRS), a nationally representative, population-based longitudinal survey of individuals in the United States 65 years or older from the 2000 (n = 10 546) and 2012 (n = 10 511) waves of the HRS. Main Outcomes and Measures Dementia was identified in each year using HRS cognitive measures and validated methods for classifying self-respondents, as well as those represented by a proxy. Logistic regression was used to identify socioeconomic and health variables associated with change in dementia prevalence between 2000 and 2012. Results The study cohorts had an average age of 75.0 years (95% CI, 74.8-75.2 years) in 2000 and 74.8 years (95% CI, 74.5-75.1 years) in 2012 (P = .24); 58.4% (95% CI, 57.3%-59.4%) of the 2000 cohort was female compared with 56.3% (95% CI, 55.5%-57.0%) of the 2012 cohort (P < .001). Dementia prevalence among those 65 years or older decreased from 11.6% (95% CI, 10.7%-12.7%) in 2000 to 8.8% (95% CI, 8.2%-9.4%) (8.6% with age- and sex-standardization) in 2012 (P < .001). More years of education was associated with a lower risk for dementia, and average years of education increased significantly (from 11.8 years [95% CI, 11.6-11.9 years] to 12.7 years [95% CI, 12.6-12.9 years]; P < .001) between 2000 and 2012. The decline in dementia prevalence occurred even though there was a significant age- and sex-adjusted increase between years in the cardiovascular risk profile (eg, prevalence of hypertension, diabetes, and obesity) among older US adults. Conclusions and Relevance The prevalence of dementia in the United States declined significantly between 2000 and 2012. An increase in educational attainment was associated with some of the decline in dementia prevalence, but the full set of social, behavioral, and medical factors contributing to the decline is still uncertain. Continued monitoring of trends in dementia incidence and prevalence will be important for better gauging the full future societal impact of dementia as the number of older adults increases in the decades ahead.

Subfields: General Health Professions, Physical Therapy, Sports Therapy and Rehabilitation, Psychiatry and Mental health

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In General Health Professions

Ingmar Skoog

In Psychiatry and Mental health

Citations in the corpus

The changing prevalence and incidence of dementia over time — current evidence (2017, methodology): “There is a strengthening evidence base that dementia, age for age, is declining in some countries and the number of people with dementia can remain stable despite population ageing.(31,33) It is possible that substantial reduction in dementia risk for whole populations can balance out growing number”
Understanding the impact of sex and gender in Alzheimer's disease: A call to action (2018, background): “The improvement in education and occupational attainment in women over the last few decades may be one explanation as to why the incidence of dementia may be declining more for women [45,46].”
Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019 (2022, neutral): “14,15 Therefore, incorporating the potential effect of changes in risk factors should be a key component of any forecast of dementia prevalence.”