Burden of Disease and Risk Factors

Dementia is the most common form of neurodegenerative condition and is increasingly frequent as world population ages. It is a leading cause of death and is responsible for considerable morbidity, expressed in the high levels of functional dependence and institutionalization. From a resource management and prevention point of view, it becomes crucial to better characterize the epidemiology of this entity, namely its geographic distribution, its risk factors and impact at a population level. The fact that there are at present no disease-modifying treatments justifies an investment in the identification of modifiable risk factors that may be contemplated in prevention strategies. Recent epidemiologi cal studies increasingly recognize an association between vascular risk factors and cognitive deterioration. Key-words: dementia; epidemiology; risk factors; burden of illness.

[1]  A. Wolk,et al.  Midlife fruit and vegetable consumption and risk of dementia in later life in Swedish twins. , 2010, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[2]  A. Hofman,et al.  Incidence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. , 2000, Neurology.

[3]  L. Fratiglioni,et al.  Alcohol and tobacco consumption as risk factors for Alzheimer's disease: a collaborative re-analysis of case-control studies. EURODEM Risk Factors Research Group. , 1991, International journal of epidemiology.

[4]  A. de Mendonça,et al.  [An estimate of the prevalence of dementia and Alzheimer's disease in Portugal]. , 1994, Acta medica portuguesa.

[5]  J. Schmeidler,et al.  Diabetes mellitus in midlife and the risk of dementia three decades later , 2004, Neurology.

[6]  John Breitner,et al.  Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 1. , 2003, Archives of neurology.

[7]  K Yaffe,et al.  Midlife cardiovascular risk factors and risk of dementia in late life , 2005, Neurology.

[8]  H. Soininen,et al.  Incidence and Risk Factors for Mild Cognitive Impairment: A Population-Based Three-Year Follow-Up Study of Cognitively Healthy Elderly Subjects , 2004, Dementia and Geriatric Cognitive Disorders.

[9]  A. Hofman,et al.  Dietary Intake of Antioxidants and Risk of Alzheimer Disease , 2002 .

[10]  A Hofman,et al.  Prognosis with stroke in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. , 2000, Neurology.

[11]  P. Hof,et al.  Clinicopathological validation study of four sets of clinical criteria for vascular dementia. , 2002, The American journal of psychiatry.

[12]  C. Mathers,et al.  Projections of Global Mortality and Burden of Disease from 2002 to 2030 , 2006, PLoS medicine.

[13]  V. Cruz,et al.  Prevalence and pattern of cognitive impairment in rural and urban populations from Northern Portugal , 2010, BMC Neurology.

[14]  L. Launer,et al.  Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies: The Honolulu-Asia Aging Study. , 2002, Diabetes.

[15]  N. Lunet,et al.  Caffeine intake and dementia: systematic review and meta-analysis. , 2010, Journal of Alzheimer's disease : JAD.

[16]  B. Winblad,et al.  Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease , 2005, The Lancet Neurology.

[17]  A. Minarini,et al.  Alzheimer's disease: new approaches to drug discovery. , 2009, Current opinion in chemical biology.

[18]  A. King,et al.  The question of familial meningiomas and schwannomas: , 2000, Neurology.

[19]  B. Winblad,et al.  Alcohol drinking in middle age and subsequent risk of mild cognitive impairment and dementia in old age: a prospective population based study , 2004, BMJ : British Medical Journal.

[20]  A. Hofman,et al.  Smoking and risk of dementia and Alzheimer's disease in a population-based cohort study: the Rotterdam Study , 1998, The Lancet.

[21]  C. Jack,et al.  Qualitative estimates of medial temporal atrophy as a predictor of progression from mild cognitive impairment to dementia. , 2007, Archives of neurology.

[22]  W. Jagust,et al.  The Role of APOE ∊4 in Modulating Effects of Other Risk Factors for Cognitive Decline in Elderly Persons , 1999 .

[23]  Deborah Gustafson,et al.  Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study. , 2004, Archives of neurology.

[24]  M. Wolfe,et al.  Selective amyloid-β lowering agents , 2008, BMC Neuroscience.

[25]  Hilkka Soininen,et al.  Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. , 2005, Archives of neurology.

[26]  Sara Rosenblum,et al.  Neuropsychological prediction of conversion to Alzheimer disease in patients with mild cognitive impairment. , 2006, Archives of general psychiatry.

[27]  J. Manson,et al.  Effect of estrogen plus progestin on global cognitive function in postmenopausal women: the Women's Health Initiative Memory Study: a randomized controlled trial. , 2003, JAMA.

[28]  E. Sigurdsson Tau-focused immunotherapy for Alzheimer's disease and related tauopathies. , 2009, Current Alzheimer research.

[29]  I. Rosenberg,et al.  Vitamin B6, B12, and folic acid supplementation and cognitive function: a systematic review of randomized trials. , 2007, Archives of internal medicine.

[30]  Laura Fratiglioni,et al.  The epidemiology of the dementias: an update , 2007, Current opinion in psychiatry.

[31]  B. Winblad,et al.  Aging and the occurrence of dementia: findings from a population-based cohort with a large sample of nonagenarians. , 1999, Archives of neurology.

[32]  B. Winblad,et al.  Low blood pressure and risk of dementia in the Kungsholmen project: a 6-year follow-up study. , 2003, Archives of neurology.

[33]  M. Ganguli,et al.  Modifiable Midlife Risk Factors for Late-Life Cognitive Impairment and Dementia. , 2009, Current psychiatry reviews.

[34]  Ladislav Volicer,et al.  The clinical course of advanced dementia. , 2009, The New England journal of medicine.

[35]  Piero Antuono,et al.  Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors , 2008, The Lancet Neurology.

[36]  Ramon Diaz-Arrastia,et al.  High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial. , 2008, JAMA.

[37]  L. Fratiglioni,et al.  Physical exercise at midlife and risk of dementia three decades later: a population-based study of Swedish twins. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[38]  D. Bennett,et al.  The apolipoprotein E ϵ4 allele and incident Alzheimer’s disease in persons with mild cognitive impairment , 2005 .

[39]  B. Winblad,et al.  Apolipoprotein E ε4 magnifies lifestyle risks for dementia: a population-based study , 2008, Journal of cellular and molecular medicine.

[40]  Sotirios Giannopoulos,et al.  Metabolic Syndrome and Alzheimer's Disease: A Link to a Vascular Hypothesis? , 2008, CNS Spectrums.

[41]  Janice E Graham,et al.  Prevalence and severity of cognitive impairment with and without dementia in an elderly population , 1997, The Lancet.

[42]  R. Mayeux,et al.  The influence of smoking on the risk of Alzheimer’s disease , 1999, Neurology.

[43]  Jean-François Dartigues,et al.  Fish, meat, and risk of dementia: cohort study , 2002, BMJ : British Medical Journal.

[44]  H. Soininen,et al.  Fat Intake at Midlife and Risk of Dementia and Alzheimer’s Disease: A Population-Based Study , 2006, Dementia and Geriatric Cognitive Disorders.

[45]  C. Mathers,et al.  Global prevalence of dementia: a Delphi consensus study , 2005, The Lancet.

[46]  R. Petersen Mild cognitive impairment as a diagnostic entity , 2004, Journal of internal medicine.

[47]  E. Tangalos,et al.  Mild Cognitive Impairment Clinical Characterization and Outcome , 1999 .

[48]  R. Petersen,et al.  Association of Low Plasma Aβ42/Aβ40 Ratios With Increased Imminent Risk for Mild Cognitive Impairment and Alzheimer Disease , 2007 .

[49]  D. Foley,et al.  Midlife dietary intake of antioxidants and risk of late-life incident dementia: the Honolulu-Asia Aging Study. , 2004, American journal of epidemiology.

[50]  S. Riedel-Heller,et al.  Mild cognitive impairment , 2006, Neurology.

[51]  K. Blennow,et al.  Association between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment: a follow-up study , 2006, The Lancet Neurology.

[52]  R. Havlik,et al.  Midlife blood pressure and dementia: the Honolulu–Asia aging study☆ , 2000, Neurobiology of Aging.

[53]  R S Wilson,et al.  Dietary fat intake and 6-year cognitive change in an older biracial community population , 2004, Neurology.

[54]  J. Dickens,et al.  Prevalence of cognitive impairment , 2001, Neurology.

[55]  L. Hansson,et al.  Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. , 1998, Hypertension.

[56]  P. Scheltens,et al.  Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS–ADRDA criteria , 2007, The Lancet Neurology.

[57]  O. Hanon,et al.  Vascular risk factors, cognitve decline, and dementia , 2008, Vascular health and risk management.

[58]  M. Kivipelto,et al.  Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention , 2009, Dialogues in clinical neuroscience.

[59]  R. Mayeux,et al.  Low-density lipoprotein cholesterol and the risk of dementia with stroke. , 1999, JAMA.

[60]  Kaarin J Anstey,et al.  Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. , 2007, American journal of epidemiology.

[61]  P. Ritz,et al.  IANA (International Academy on Nutrition and Aging) Expert Group: weight loss and Alzheimer's disease. , 2007, The journal of nutrition, health & aging.

[62]  A Hofman,et al.  Diabetes mellitus and the risk of dementia , 1999, Neurology.

[63]  JoAnn E. Manson,et al.  Conjugated equine estrogens and global cognitive function in postmenopausal women: Women's Health Initiative Memory Study. , 2004 .

[64]  K. Anstey,et al.  Alcohol consumption as a risk factor for dementia and cognitive decline: meta-analysis of prospective studies. , 2009, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[65]  M. Kaste,et al.  Comparison of Different Clinical Criteria (DSM-III, ADDTC, ICD-10, NINDS-AIREN, DSM-IV) for the Diagnosis of Vascular Dementia , 2000, Stroke.

[66]  K. Ritchie,et al.  Caffeine intake is associated with a lower risk of cognitive decline: a cohort study from Portugal. , 2010, Journal of Alzheimer's disease : JAD.