Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-25T07:45:28.408Z Has data issue: false hasContentIssue false
  • English
  • Français

The prevalence of dementia in a population-based study carried out in Granarolo, Ravenna

Published online by Cambridge University Press:  11 October 2011

Diana De Ronchi ,
Elisa Bucchi ,
Monica Pederzini ,
Sara Scaini ,
Carmine Petio ,
Giuseppe Ferrari  and
Edoardo Dalmonte
Diana De Ronchi*
Affiliation:
Istituto di Psichiatria “P. Ottonello”, Università di Bologna, Bologna Division of Geriatric Epidemiology, NEUROTEC, Karolinska Institutet, Stockholm, Sweden
Elisa Bucchi
Affiliation:
Istituto di Psichiatria “P. Ottonello”, Università di Bologna, Bologna
Monica Pederzini
Affiliation:
Istituto di Psichiatria “P. Ottonello”, Università di Bologna, Bologna
Sara Scaini
Affiliation:
Istituto di Psichiatria “P. Ottonello”, Università di Bologna, Bologna
Carmine Petio
Affiliation:
Istituto di Psichiatria “P. Ottonello”, Università di Bologna, Bologna
Giuseppe Ferrari
Affiliation:
Istituto di Psichiatria “P. Ottonello”, Università di Bologna, Bologna
Edoardo Dalmonte
Affiliation:
Dipartimento di Geriatria, Azienda ASL Ravenna, Faenza
*
Address for correspondence: Dr.ssa D. De Ronchi, Istituto di Psichiatria “P. Ottonello”, Università di Bologna, Viale Carlo Pepoli 5, 40123 Bologna. Fax: +39-051-521.030 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

Objective – To evaluate the prevalence of dementia among persons born in the year 1930 or before, who were living in Granarolo, Ravenna province, on December 31, 1991. Design – Population study, carried out in two phases: in the first was phase all persons were administered two screening tests for dementia. In the second phase, persons who screened positive underwent detailed clinical and cognitive assessments. Main outcome measures – The Mini Mental State Examination (MMSE) and the Global Deterioration Scale (GDS) were administered as screening tests. In the second phase the screened-positive subjects underwent a general and neurological examination, and a detailed neuropsychological assessment. Results – Of the 557 participants, 56 were clinically diagnosed as demented. Twenty-nine persons were diagnosed as affected by Alzheimer's disease (AD) and 14 patients by vascular dementia (VaD). The crude prevalence ratios for dementia were 9.1% (95% C.I.= 5.29−12.89) for men and 12.7 % (95% C.I.= 8.84−16.6) for women. The prevalence of all dementias, as well as AD, increased steeply every five years of age for both men and women up to 90 years of age. Women had higher prevalence of all dementias and AD than men, more evident in the advanced ages. Conclusions – Our findings are in agreement with similar studies carried out in European populations, showing that prevalence of dementia increases with increasing age. If we consider that in Italy the oldest (those 80 years and older) are the fastest growing part of the elderly population, we can expect that dementia will be a major emerging public health problem, as it is one of the most common diseases in the very elderly and a major cause of disability and mortality.

Riassunto

Scopo – Valutare la prevalenza della demenza e dei diversi tipi di demenza tra i soggetti con più di 60 anni d'eta residenti a Granarolo (RA) alia data del 31.12.1991. Disegno – Studio di popolazione, articolato in due fasi. Nella prima fase l'intera popolazione anziana e stata studiata mediante test di screening, nella seconda i soggetti positivi ai test sono stati sottoposti ad indagini più specifiche. Principali misure utilizzate – Nella prima fase sono stati utilizzati il Mini Mental State Examination (MMSE) e la Global Deterioration Scale (GDS). Nella seconda fase erano previste una visita medica, una valutazione neurologica, la somministrazione di test neuropsicologici e la diagnosi di demenza in accordo con i criteri del DSM-III-R. Risultati – Dei 557 partecipanti allo studio, 56 risultarono dementi. Per 29 persone fu formulata la diagnosi di Malattia di Alzheimer (AD) e per 14 pazienti la diagnosi di demenza di tipo vascolare (VaD). Il tasso di prevalenza della demenza era 11.1%, 9.1% per gli uomini (95% CI=5.29−12.89) e 12.7% per le donne (95% CI=8.84−16.6). La prevalenza della demenza nel suo insieme, cosi come dell'ad, aumentava in modo esponenziale ogni cinque anni in entrambi i sessi fino ai 90 anni di eta. Le donne evidenziavano una più elevata prevalenza della demenza in generale e di AD rispetto agli uomini e tale dato era più evidente nelle eta più avanzate. Conclusioni – I nostri dati concordano con quelli emersi in altri studi europei ed evidenziano come la prevalenza della demenza aumenti con l'elevarsi dell'eta. Se pensiamo che in Italia i grandi anziani (coloro con più di 80 anni) sono la parte di popolazione che aumenta più rapidamente rispetto alle altre fasce di eta, possiamo attenderci che la demenza diventera sempre più un problema di salute pubblica di grandissima rilevanza, essendo la più frequente patologia della popolazione molto anziana e causa primaria di disabilità e mortalità.

Keywords

demenzamalattia di Alzheimerdemenza vascolareepidemiologiadementiaAlzheimer's diseasevascular dementiaepidemiology
Type
Articles
Information
Epidemiology and Psychiatric Sciences , Volume 11 , Issue 4 , December 2002 , pp. 258 - 265
Copyright
Copyright © Cambridge University Press 2002

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

BIBLIOGRAFIA

Aevarsson, O., Svanborg, A. & Skoog, I. (1998). Seven-year survival rate after age 85 years. Archives of Neurology 55, 1226–1232.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd. ed. rev.). American Psychiatric Association: Washington, DC.Google Scholar
Armitage, P. & Berry, G. (1987). Statistical Methods in Medical Research. Blackwell Scientific: Oxford.Google Scholar
Blessed, G., Tomlinson, B.E. & Roth, M. (1968). The association between quantitative measures of dementia and senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry 114, 797–811.CrossRefGoogle ScholarPubMed
Buschke, H. & Fuld, P.A. (1974). Evaluating storage, retention and retrieval in disordered memory and learning. Neurology 24, 1019–1025.CrossRefGoogle ScholarPubMed
Cooper, B. (1989). The epidemiological contribution to research on late life dementia. In Scope of Epidemiological Psychiatry (ed. Williams, P., Wilkinson, G. and Rawnsley, K.), pp. 264–287. Brunner-Routledge: Brighton.Google Scholar
D'Alessandro, R., Pandolfo, G., Azzimondi, G. & Feruglio, F.S. (1996). Prevalence of dementia among elderly people in Troina, Sicily. European Journal of Epidemiology 12, 595–599.CrossRefGoogle ScholarPubMed
de Girolamo, G. & De Ronchi, D. (2001). Malattie neurologiche. Demenze. In Relazione sullo Stato Sanitario del Paese 2000, pp. 153–154. Ministero della Sanita, Direzione Generate Studi, Documentazione Sanitaria e Comunicazione ai Cittadini: Roma.Google Scholar
De Ronchi, D., Fratiglioni, L., Rucci, P., Paternico, A., Graziani, S. & Dalmonte, E. (1998). The effect of education on dementia occurrence in an Italian population with middle to high socioeconomic status. Neurology 50, 1231–1238.CrossRefGoogle Scholar
Ebly, E.M., Parhad, I.M., Hogan, D.B. & Fung, T.S. (1994) Prevalence and types of dementia in the very old: results from the Canadian Study of Health and Aging. Neurology 44, 1593–1600.CrossRefGoogle ScholarPubMed
Engedal, K. (1996). Mortality in the elderly: a 3-year follow-up of an elderly community sample. International Journal of Geriatric Psychiatry 11, 467–471.3.0.CO;2-S>CrossRefGoogle Scholar
Ferini-Strambi, L., Marcone, A., Garancini, P., Danelon, F., Zamboni, M., Massussi, P., Tedesi, B. & Smirne, S. (1997). Dementing disorders in North Italy: prevalence study in Vescovato, Cremona province. European Journal of Epidemiology 13, 201–204.CrossRefGoogle ScholarPubMed
Fichter, M.M., Meller, I., Schroppel, H. & Steinkirchner, R. (1995). Dementia and cognitive impairment in the oldest old in the community. Prevalence and comorbidity. British Journal of Psychiatry 166, 621–629.CrossRefGoogle ScholarPubMed
Folstein, M.F., Folstein, S.E. & Me Hugh, 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.CrossRefGoogle Scholar
Fratiglioni, L., Grut, M., Forsell, Y., Viitanen, M., Grafstrom, M., Holmen, K., Ericsson, K., Backman, L., Ahlbom, A. & Winblad, B. (1991). Prevalence of Alzheimer's disease and other dementias in an elderly urban population: relationship with age, sex, and education. Neurology 41, 1886–1892.CrossRefGoogle Scholar
Fratiglioni, L., Aguero-Torres, H. & Winblad, B. (1997). Impact of dementia in our societies and current possibilities of prevention. International Journal of Geriatric Psychopharmacology 1, 12–17.Google Scholar
Fratiglioni, L., De Ronchi, D. & Aguero-Torres, H. (1999). Worldwide prevalence and incidence of dementia. Drugs Aging 15, 365–375.CrossRefGoogle ScholarPubMed
Geldmacher, D.S. & Whitehouse, P.J. (1996). Evaluation of dementia. New England Journal of Medicine 335, 330–336.CrossRefGoogle ScholarPubMed
Hachinski, V.C., Iliff, L.D., Zilhka, E., Du Boulay, G.H., McAllister, V.L., Marshall, J., Russell, R.W. & Symon, L. (1975). Cerebral blood flow in dementia. Archives of Neurology 32, 632–637.CrossRefGoogle ScholarPubMed
Hofman, A., Rocca, W.A., Brayne, C., Breteler, M.M., Clarke, M., Cooper, B., Copeland, J.R., Dartigues, J.F., da Silva Droux, A. & Hagnell, O. (1991). The prevalence of dementia in Europe: a collaborative study of 1980–1990 findings. Eurodem Prevalence Research Group. International Journal of Epidemiology 20, 736–748.CrossRefGoogle ScholarPubMed
Jorm, A.F., Korten, A.E. & Henderson, A.S. (1987). The prevalence of dementia: a quantitative integration of the litterature. Ada Psychiatrica Scandinavica 76, 465–479.CrossRefGoogle Scholar
Kokmen, E., Beard, C.M., Offord, K.P. & Kurland, L.T. (1989). Prevalence of medically diagnosed dementia in a defined United States population: Rochester, Minnesota, January 1,1975. Neurology 39, 773–776.CrossRefGoogle Scholar
Lobo, A., Launer, L.J., Fratiglioni, L., Andersen, K., Di Carlo, A., Breteler, M.M., Copeland, J.R., Dartigues, J.F., Jagger, C., Martinez-Lage, J., Soininen, H. & Hofman, A. (2000). Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology 54, 4–9.Google ScholarPubMed
O'Connor, D.W., Pollitt, P.A., Hyde, J.B., Fellows, J.L., Miller, N.D., Brook, C.P.B., Reiss, B.B. & Roth, M. (1989). The prevalence of dementia as measured by the Cambridge Mental Disorders of the Elderly Examination. Ada Psychiatrica Scandinavica 79,190–198.CrossRefGoogle ScholarPubMed
Pattie, A.H. (1981). A survey version of the Clifton Assessment Procedures for the Elderly (C.A.P.E.). British Journal of Clinical Psychology 20, 173–178.CrossRefGoogle Scholar
Pfeffer, R.I., Afifi, A.A. & Chance, J.M. (1987). Prevalence of Alzheimer's disease in a retirement community. American Journal of Epidemiology 125, 420–436.CrossRefGoogle Scholar
Prencipe, M., Casini, A.R., Ferretti, C., Lattanzio, M.T., Fiorelli, M. & Culasso, F. (1996). Prevalence of dementia in an elderly rural population: effects of age, sex, and education. Journal of Neurology, Neurosurgery and Psichiatry 60, 628–633.CrossRefGoogle Scholar
Reisberg, B., Ferris, S.H., de Leon, M.J. & Crook, T. (1982). The Global Deterioration Scale for Assessment of Primary Degenerative Dementia. American Journal of Psychiatry 139, 1136–1139.Google ScholarPubMed
Ritchie, K. & Kildea, D. (1995). Is seile dementia “age-related” or “ageing-related”? Evidence from meta-analysis of dementia pre-valence in the oldest old. Lancet 346, 931–934.CrossRefGoogle Scholar
Rocca, W.A. (2000). Dementia, Parkinson's disease, and stroke in Europe: a commentary. Neurology 54, 38–40.Google ScholarPubMed
Rocca, W.A., Bonaiuto, S., Lippi, A., Luciani, P., Turtu, F., Cavarzeran, F. & Amaducci, L. (1990). Prevalence of clinically diagnosed Alzheimer's disease and other dementing disorders: a door to door survey in Appignano, Macerata. Neurology 40, 626–631.CrossRefGoogle ScholarPubMed
Rocca, W.A., Hofmann, A. & Brayne, C. (1991a). Frequency and distribution of Alzheimer's Disease in Europe: a collaborative study of 1980–1990 prevalence findings. The EURODEM Prevalence Research Group. Annals of Neurology 30, 381–390.CrossRefGoogle ScholarPubMed
Rocca, W.A., Hofman, A., Brayne, C., Breteler, M.M., Clarke, M., Copeland, J.R., Dartigues, J.F., Engedal, K., Hagnell, O. & Heeren, T.J. (1991b). The prevalence of vascular dementia in Europe: facts and fragments from 1980–1990 studies. EURODEM-Prevalence Research Group. Annals of Neurology 30, 817–824.CrossRefGoogle ScholarPubMed
Rockwood, K. & Stadnyk, K. (1994). The prevalence of dementia in the elderly: a review. Canadian Journal of Psychiatry 39, 253–257.CrossRefGoogle ScholarPubMed
Ruggeri, M. & Turrina, C. (1993). Mini-Mental State Examination. Epidemiologia e Psichiatria Sociale 2, 137–140.CrossRefGoogle Scholar
Thomassen, R., van Schaick, H.W. & Blansjaar, B.A. (1998). Prevalence of dementia over age 100. Neurology 50, 283–286.CrossRefGoogle ScholarPubMed
von Strauss, E., Viitanen, M., De Ronchi, D., Winblad, B. & Fratiglioni, L. (1999). Aging and the occurrence of dementia: findings from a population-based cohort with a large sample of nonagenarians. Archives of Neurology 56, 587–592.CrossRefGoogle ScholarPubMed
Wernicke, T.F. & Reischies, F.M. (1994). Prevalence of dementia in old age: clinical diagnoses in subjects aged 95 years and older. Neurology 44, 250–253.CrossRefGoogle ScholarPubMed
Weschler, D. (1945). A standardized memory scale for clinical use. Journal of Psychology 19, 87–95.Google Scholar
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Heersema, P.H. & Adey, M. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research 17, 37–49.CrossRefGoogle Scholar