Dementia epidemiology.

Determining the incidence and prevalence of dementia is an inexact science. Dementia is difficult to define and detect in the population. Even with the difficulties of determining prevalence and incidence, it is clear that dementia causes a substantial burden on our society. Problems with diagnostic inaccuracy and insidious disease onset influence our ability to observe risk factor associations; factors related to survival may be mistaken for risk/protective factors. Current studies suggest that factors influencing brain development or cognitive reserve may delay the onset of AD, perhaps through a protective mechanism or a delay in diagnosis caused by improved performance on cognitive tests. The recent identification of genes that cause dementia suggests that these genes or their biochemical pathways may be involved in the pathogenesis of nonfamilial cases. The contribution of genes that cause disease in and of themselves may be smaller than that of genes that act to metabolize or potentiate environmental exposures. The interaction between gene and environment should be increasingly well studied in the future. Epidemiology must take advantage of these molecular advances. The tasks of public health and epidemiology should still involve prevention, the nonrandom occurrence of disease, and its environmental context in addition to heredity. The tools to address these tasks should continue to be refined.

[1]  H. Gertz,et al.  The prognosis of mild cognitive impairment in the elderly. , 1998, Journal of neural transmission. Supplementum.

[2]  E. Perry,et al.  Operational criteria for senile dementia of Lewy body type (SDLT) , 1992, Psychological Medicine.

[3]  G. Rauch,et al.  Cardiovascular and Other Risk Factors for Alzheimer's Disease and Vascular Dementia , 2000, Annals of the New York Academy of Sciences.

[4]  C. Brayne,et al.  Vascular Risks and Incident Dementia: Results from a Cohort Study of the Very Old , 1998, Dementia and Geriatric Cognitive Disorders.

[5]  L. Nee,et al.  Alzheimer’s Disease in 22 Twin Pairs – 13-Year Follow-Up: Hormonal, Infectious and Traumatic Factors , 1999, Dementia and Geriatric Cognitive Disorders.

[6]  Association of interleukin‐1 gene polymorphisms with Alzheimer's disease , 2000, Annals of neurology.

[7]  I. Perry Homocysteine and Risk of Stroke , 1999, Journal of cardiovascular risk.

[8]  H. Steiner,et al.  Genes and mechanisms involved in β-amyloid generation and Alzheimer’s disease , 1999, European Archives of Psychiatry and Clinical Neuroscience.

[9]  K. Marder,et al.  Alzheimer's disease after remote head injury: an incidence study. , 1997, Journal of neurology, neurosurgery, and psychiatry.

[10]  B. Winblad,et al.  Tau gene polymorphisms and apolipoprotein E ε4 may interact to increase risk for Alzheimer’s disease , 1999, Neuroscience Letters.

[11]  L. Bouter,et al.  Education and incident Alzheimer's disease: a biased association due to selective attrition and use of a two-step diagnostic procedure? , 1999, International journal of epidemiology.

[12]  W. Meier-Ruge,et al.  Mitochondrial Genome Lesions in the Pathogenesis of Sporadic Alzheimer’s Disease , 1999, Gerontology.

[13]  J. Breitner Inflammatory processes and antiinflammatory drugs in Alzheimer's disease: A current appraisal , 1996, Neurobiology of Aging.

[14]  J. Haines,et al.  Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. , 1997, JAMA.

[15]  Steven M. Horvath,et al.  Alpha-2 macroglobulin is genetically associated with Alzheimer disease , 1998, Nature Genetics.

[16]  S. Dimauro,et al.  Apparent mtDNA heteroplasmy in Alzheimer's disease patients and in normals due to PCR amplification of nucleus-embedded mtDNA pseudogenes. , 1997, Proceedings of the National Academy of Sciences of the United States of America.

[17]  B. Winblad,et al.  Mild cognitive impairment--an early stage of Alzheimer's disease? , 1998, Journal of neural transmission. Supplementum.

[18]  M. Bullido,et al.  A polymorphism in the tau gene associated with risk for Alzheimer's disease , 2000, Neuroscience Letters.

[19]  L. Beckett,et al.  Vitamin E and Vitamin C Supplement Use and Risk of Incident Alzheimer Disease , 1998, Alzheimer disease and associated disorders.

[20]  K. Morgan,et al.  Genetic risk factors in Alzheimer's disease. , 1998, Molecular pathology : MP.

[21]  L. Pantoni,et al.  Hachinski's ischemic score and the diagnosis of vascular dementia: A review , 1993, The Italian Journal of Neurological Sciences.

[22]  J. Yesavage,et al.  α2 Macroglobulin and the risk of Alzheimer’s disease , 2000, Neurology.

[23]  A. Hoes,et al.  NSAIDs and incident Alzheimer’s disease. the Rotterdam study , 1998, Neurobiology of Aging.

[24]  C. Morris,et al.  Lack of association of the α2-macroglobulin locus on chromosome 12 in AD , 2000, Neurology.

[25]  P. Celsis,et al.  Age-related cognitive decline, mild cognitive impairment or preclinical Alzheimer's disease? , 2000, Annals of medicine.

[26]  C. Brayne The EURODEM collaborative re-analysis of case-control studies of Alzheimer's disease: implications for public health. , 1991, International journal of epidemiology.

[27]  B. Ghetti,et al.  Mutations in the Tau gene cause frontotemporal dementia , 1999, Brain Research Bulletin.

[28]  W. Jagust,et al.  Clinical criteria for the diagnosis of vascular dementia: a multicenter study of comparability and interrater reliability. , 2000, Archives of neurology.

[29]  G. C. Román,et al.  Vascular dementia , 1993, Neurology.

[30]  W F Stewart,et al.  Risk of Alzheimer's disease and duration of NSAID use , 1997, Neurology.

[31]  J. Treanor,et al.  Beta-secretase cleavage of Alzheimer's amyloid precursor protein by the transmembrane aspartic protease BACE. , 1999, Science.

[32]  W. Jagust,et al.  Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers , 1992, Neurology.

[33]  Ove Almkvist,et al.  Early diagnosis of Alzheimer dementia based on clinical and biological factors , 1999, European Archives of Psychiatry and Clinical Neuroscience.

[34]  R. Horwitz,et al.  The effect of estrogen replacement therapy on cognitive function in women: a critical review of the literature. , 1997, Journal of clinical epidemiology.

[35]  S. Sisodia Alzheimer's disease: perspectives for the new millennium. , 1999, The Journal of clinical investigation.

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

[37]  E. Kokmen,et al.  Incidence of dementia and Alzheimer's disease: a reanalysis of data from Rochester, Minnesota, 1975-1984. , 1998, American journal of epidemiology.

[38]  A D Roses,et al.  Utility of the apolipoprotein E genotype in the diagnosis of Alzheimer's disease. Alzheimer's Disease Centers Consortium on Apolipoprotein E and Alzheimer's Disease. , 1998, The New England journal of medicine.

[39]  M. Doran,et al.  Undifferentiated dementia, Alzheimer's disease and vascular dementia: Age- and gender-related incidence in Liverpool , 1999, British Journal of Psychiatry.

[40]  D. Carter,et al.  Ibuprofen: effect on inducible nitric oxide synthase. , 1997, Brain research. Molecular brain research.

[41]  G Gainotti,et al.  Sensitivity and Specificity of Some Neuropsychological Markers of Alzheimer Dementia , 1998, Alzheimer disease and associated disorders.

[42]  A. Sinclair,et al.  Mitochondrial DNA mutations in Alzheimer's disease. , 1997, Biochemical and biophysical research communications.

[43]  A. Hofman,et al.  Estrogen use and early onset Alzheimer's disease: a population-based study , 1999, Journal of neurology, neurosurgery, and psychiatry.

[44]  M. Pericak-Vance,et al.  Apolipoprotein E: high-avidity binding to beta-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[45]  V. Hachinski,et al.  Educational attainment and socioeconomic status of patients with autopsy-confirmed Alzheimer disease. , 2000, Archives of neurology.

[46]  R. Barbour,et al.  Purification and cloning of amyloid precursor protein β-secretase from human brain , 1999, Nature.

[47]  V. Hachinski Multi-infarct dementia: a reappraisal. , 1991, Alzheimer disease and associated disorders.

[48]  J. Haines,et al.  Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease in late onset families. , 1993, Science.

[49]  G. Román A historical review of the concept of vascular dementia: lessons from the past for the future. , 1999, Alzheimer disease and associated disorders.

[50]  T. Bird,et al.  Recent Advances in the Genetics of Alzheimer's Disease , 1998, Journal of geriatric psychiatry and neurology.

[51]  A. Roses,et al.  Cognitive function and apolipoprotein E in very old adults: findings from the Nun Study. , 2000, The journals of gerontology. Series B, Psychological sciences and social sciences.

[52]  C. Czech,et al.  The Role of Presenilin-1 in the γ-Secretase Cleavage of the Amyloid Precursor Protein of Alzheimer's Disease* , 2000, The Journal of Biological Chemistry.

[53]  Patrick L. McGeer,et al.  Arthritis and anti-inflammatory agents as possible protective factors for Alzheimer's disease , 1996, Neurology.

[54]  L. Bouter,et al.  Cognitive reserve and mortality in dementia: the role of cognition, functional ability and depression , 1999, Psychological Medicine.

[55]  B. Shastry,et al.  Genes and susceptible loci of Alzheimer’s disease , 1999, Brain Research Bulletin.

[56]  D L Price,et al.  Alzheimer's disease: genetic studies and transgenic models. , 1998, Annual review of genetics.

[57]  D. Jolley,et al.  Cost benefits of a medically supervised day treatment program for patients with Alzheimer's disease and other forms of dementia , 1989 .

[58]  R Brookmeyer,et al.  Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. , 1998, American journal of public health.

[59]  E G Tangalos,et al.  Postmenopausal estrogen replacement therapy and risk of AD , 1999, Neurology.

[60]  R. Brookmeyer,et al.  A prospective study of estrogen replacement therapy and the risk of developing Alzheimer's disease , 1997, Neurology.

[61]  A. Hofman,et al.  Head trauma and risk of dementia and Alzheimer’s disease , 1999, Neurology.

[62]  R. Tanzi,et al.  REVIEWThe Gene Defects Responsible for Familial Alzheimer's Disease , 1996, Neurobiology of Disease.

[63]  A. Hofman,et al.  Rates and risk factors for dementia and Alzheimer’s disease , 1999, Neurology.

[64]  David G. Tew,et al.  Identification of a Novel Aspartic Protease (Asp 2) as β-Secretase , 1999, Molecular and Cellular Neuroscience.

[65]  M. Albert,et al.  Genetic association of an (α2-macroglobulin (Val1000lle) polymorphism and Alzheimer's disease , 1998 .

[66]  G. Schellenberg,et al.  Head injury and risk of Alzheimer's disease by apolipoprotein E genotype. , 1997, American journal of epidemiology.

[67]  K. Hall,et al.  Low education and childhood rural residence , 2000, Neurology.

[68]  Alfredo G. Tomasselli,et al.  Membrane-anchored aspartyl protease with Alzheimer's disease β-secretase activity , 1999, Nature.

[69]  R Doll,et al.  Smoking and dementia in male British doctors: prospective study , 2000, BMJ : British Medical Journal.

[70]  O. Wolkowitz,et al.  Estrogen replacement therapy and cognitive decline in memory-impaired post-menopausal women , 1999, Biological Psychiatry.

[71]  A. Hofman,et al.  Mutation screening of the tau gene in patients with early-onset Alzheimer's disease , 1999, Neuroscience Letters.

[72]  P. Lee,et al.  Smoking and Alzheimer's disease: a review of the epidemiological evidence. , 1994, Neuroepidemiology.

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

[74]  K. Yaffe,et al.  Estrogen therapy in postmenopausal women: effects on cognitive function and dementia. , 1998, JAMA.

[75]  V. Hachinski,et al.  Prevalence and outcomes of vascular cognitive impairment , 2000, Neurology.

[76]  M. Franceschi,et al.  Headache in a Population‐Based Elderly Cohort. An Ancillary Study to the Italian Longitudinal Study of Aging (ILSA) , 1997, Headache.

[77]  B. Winblad,et al.  Smoking and the Occurence of Alzheimer's Disease: Cross-Sectional and Longitudinal Data in a Population-based Study , 1999 .

[78]  A D Roses,et al.  APOE is a major susceptibility gene for Alzheimer's disease. , 1994, Current opinion in biotechnology.

[79]  Anthony Gamst,et al.  Estrogen Replacement Therapy for Treatment of Mild to Moderate Alzheimer Disease: A Randomized Controlled Trial , 2000 .

[80]  Molecular genetics of Alzheimer’s disease , 2000, Biological Psychiatry.

[81]  B L Miller,et al.  Estrogen for Alzheimer’s disease in women , 2000, Neurology.

[82]  W. Tsai,et al.  Effect of Age, Ethnicity, and Head Injury on the Association between APOE Genotypes and Alzheimer's Disease , 1996, Annals of the New York Academy of Sciences.

[83]  G. Belle,et al.  Cholinergic dysfunction in diseases with Lewy bodies , 2000, Neurology.

[84]  A. D. Roses,et al.  Association of apolipoprotein E allele €4 with late-onset familial and sporadic Alzheimer’s disease , 2006 .

[85]  A. Roses Apolipoprotein E is a relevant susceptibility gene that affects the rate of expression of Alzheimer's disease , 1994, Neurobiology of Aging.

[86]  P. Gorelick,et al.  Vascular Dementia: A Contemporary Review of Epidemiology, Diagnosis, Prevention, and Treatment , 1998, Journal of the American Geriatrics Society.

[87]  Y. Stern,et al.  Diabetes mellitus and the risk of dementia , 1999, Neurology.

[88]  M. Pericak-Vance,et al.  Apolipoprotein E ∈4 allele distributions in late-onset Alzheimer's disease and in other amyloid-forming diseases , 1993, The Lancet.

[89]  V. Henderson Estrogen, cognition, and a woman's risk of Alzheimer's disease. , 1997, The American journal of medicine.

[90]  J. Haines,et al.  No association between the HLA-A2 allele and Alzheimer disease , 1999, Neurogenetics.

[91]  V. Henderson The epidemiology of estrogen replacement therapy and Alzheimer's disease , 1997, Neurology.

[92]  L. Amaducci,et al.  Estrogen-replacement therapy and Alzheimer's disease in the Italian Longitudinal Study on Aging , 1998, Neurology.

[93]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[94]  H. Braak,et al.  Neuropathology of Alzheimer’s disease: what is new since A. Alzheimer? , 1999, European Archives of Psychiatry and Clinical Neuroscience.

[95]  Bette Phimister Four companies announce discovery of β-secretase gene , 2000, Nature Biotechnology.

[96]  J. Stewart,et al.  Inverse relation between Braak stage and cerebrovascular pathology in Alzheimer predominant dementia , 1999, Journal of neurology, neurosurgery, and psychiatry.

[97]  H C Hendrie,et al.  Epidemiology of dementia and Alzheimer's disease. , 1998, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[98]  A. Hofman,et al.  Incidence and risk of dementia. The Rotterdam Study. , 1998, American journal of epidemiology.

[99]  C. Hock,et al.  Risk factors and differential diagnosis of Alzheimer’s disease , 1999, European Archives of Psychiatry and Clinical Neuroscience.

[100]  R. Tanzi,et al.  A genetic dichotomy model for the inheritance of Alzheimer's disease and common age-related disorders. , 1999, The Journal of clinical investigation.