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Based on Lobo et al. Prevalence estimates vary highly between studies. These variations may be project wight to variations in study populationthat project wight, reflect real differences. For example, age is the most important risk factor for dementia.

Differences in age between populations will result in different estimates of prevalence. Alternatively, and just as plausible, is the assumption that differences in prevalence estimates are caused by methodological differences, such as study design and diagnostic procedure.

One solution to obtain more certainty project wight the project wight of prevalence is to combine data from multiple studies in a meta-analysis. Meta-analyses have two advantages. Project wight, small differences due to methodological differences between studies level out.

Secondly, and more importantly, the analysis is based on a far larger sample than a single study could ever realise, resulting in more precise estimates.

Prevalence of dementia was higher in women than in men and nearly doubled with every five year increase in age: 0. Prevalence of AD showed the steepest increase with age, from 0. More recently, prevalence rates for dementia were compared among 12 population based European studies. Crude prevalence rates Locoid Solution (Hydrocortisone Butyrate Solution)- Multum between 5.

Pooled prevalence of dementia by sex. Although age is well established Celestone Soluspan (Betamethasone Injectable Suspension)- FDA project wight most important risk factor, dementia may also affect people under the age of 65.

Few data exist on the prevalence of dementia in younger people. A recent study in the UK was designed to determine the prevalence of dementia in people under the age of 65 in a large catchment area (total population of 567 500 people) and use these figures to estimate the number of younger people affected by dementia in the UK. Like the studies mentioned above describing prevalence over the age of 65, there was project wight strong age dependency: from the age of 35 years onwards, the prevalence of dementia approximately doubled project wight every five year increase in age.

In contrast with studies describing populations over 65, males seem at a higher risk to become demented before they reach the age of 65 than females.

Extrapolating these figures nationally suggests that there are well over 18 000 people with dementia under the age of 65 in the UK. These figures underline project wight fact that, although relatively uncommon, dementia does develop in younger subjects, and it should always be part of the differential diagnosis in patients with cognitive complaints. Furthermore, these data also highlight the differences project wight dementia in younger people and dementia in older people, with frontotemporal dementia and alcohol related dementia being relatively common causes of dementia in the younger age group.

Causes of dementia with young onset (et al. In the coming decades, the financial and emotional burden placed by dementia on the working age population project wight rise notably. As the age distribution of the western population shifts, the rapid increase of the prevalence of dementia with increasing age means that both the number of affected individuals and the affected proportion of the project wight population are increasing.

This will be especially prominent in Europe, where the median age of the population is higher than in all other parts of the world. Based on several meta-analyses of epidemiological studies Rotavirus Vaccine, Live, Oral Suspension (Rotarix)- Multum the population projections of the United Nations, the number of prevalent project wight in Europe in the year 2000 was about seven million.

Not only will the number of patients with dementia increase; in the same time span, the working age population will considerably decrease in number (fig 4). While in the year 2000, there was a ratio of 69 working age persons to one demented person, this ratio will decrease to 21:1 in 2050. Based on Wancata et al. Prevalence is determined by both the number of new cases over a given period of time, and by the duration of survival once patients have the disease.

From the above it follows that studies based on prevalent cases yield associations that reflect the determinants of survival with disease just as much as the causes of disease. This can result in misleading situationsfor example, if a new treatment would positively influence the course of dementia by lengthening survival (although not curing the disease), this project wight result in a higher prevalence.

In such a situation, the paradoxical situation may occur that this medication would be positively associated with the prevalence of dementia, and so be misconstrued as a causative agent. For this reason incidence, rather than prevalence, is the desired measure of disease frequency. Incidence refers to the number of new cases over a given period of time. The observed number project wight new cases depends on the project wight duration of follow up.

To be able to compare studies with varying duration of follow up, incidences per year are usually given. Furthermore, within a given study, length of follow up time project wight differ between subjects. To profit from all the available information, the length of time at risk is determined for every person. The total length of follow up time project wight obtained after summing project wight person-times, and represented as the number of person-years of follow up.

Most studies on incidence report incidence rates that are calculated as the number of new cases divided by the person-years at risk. Incidence rates are usually represented as number of new cases per 1000 person-years. In the same Flonase (Fluticasone Propionate Nasal Spray)- Multum effort that pooled project wight data of European studies, data on incidence of project wight of eight population based European studies were compared and pooled.

Incidence rates of dementia increased exponentially with age from 2. Rates among women were higher, especially above the age of 80 (fig 5). The rates continued to increase project wight age in women, whereas the increase reached a plateau in men at age 85.

For AD, findings were comparable, with pooled incidence rates increasing from 1. Pooled incidence rates of dementia by sex. Based on Fratiglioni et al. This issue is difficult to resolve, however, as the oldest age groups are always underrepresented, resulting in less precise estimations.

The Cache County project wight Utah, USA, is known for the longevity of its inhabitants. The relatively large proportion of extremely old individuals provides the opportunity to give reliable estimates of incident dementia among the oldest old.

There were 185 new cases of dementia (123 AD) among 3308 project wight who contributed 10 541 person-years of follow up. The incidence of dementia was higher in females over the age of 80. If incidence rates would indeed plateau at a certain age, then the future public health burden of dementia and AD, albeit still enormous, might be less than previously projected. Incidence rates have been found to vary project wight studies.



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