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      Global Cognitive Impairment Prevalence and Incidence in Community Dwelling Older Adults—A Systematic Review

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          Abstract

          (1) Background: We proposed to review worldwide estimates of cognitive impairment prevalence and incidence in adults older than 50 years of age living in the community. (2) Methods: Systematic searches were performed in January 2019 using MEDLINE/PubMed. Articles were selected if they referred to cognitive impairment, prevalence, incidence, elders, and population or community-based studies. Analysis, aggregated by different methodologic features, was performed. (3) Results: Prevalence (80 studies) ranged between 5.1% and 41% with a median of 19.0% (25th percentile = 12.0%; 75th percentile = 24.90%). Incidence (11 studies) ranged from 22 to 76.8 per 1000 person-years with a median of 53.97 per 1000 person-years (25th percentile = 39.0; 75th percentile = 68.19). No statistically significant effects were found except for inclusion age. (4) Conclusion: We propose that the homogenization and clarification of the definition of what constitutes cognitive impairment are essential to refine the epidemiological understanding of this entity. The results of this review reinforce the importance of adherence to standardized cut-off scores for cognitive tests to promote study comparability.

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          Assessment of cognition using surveys and neuropsychological assessment: the Health and Retirement Study and the Aging, Demographics, and Memory Study.

          Eileen M. Crimmins, Jung Ki Kim, Kenneth M Langa … (2011)
          This study examines the similarity of cognitive assessments using 1 interview in a large population study, the Health and Retirement Study (HRS), and a subsample in which a detailed neuropsychiatric assessment has been performed (Aging, Demographics, and Memory Study [ADAMS]).
          Article 0 comments Cited 221 times – based on 0 reviews     Review now
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            Classification and epidemiology of MCI.

            Rosebud O Roberts, David S. Knopman (2013)
            Mild cognitive impairment (MCI) is an intermediate stage in the trajectory from normal cognition to dementia. Despite controversies about the classification of MCI, recent published criteria for MCI allow better comparison of the prevalence, incidence, and outcomes of MCI. Subjects with MCI have a high rate of progression to dementia over a relatively short period. In this review, we present an overview of the classification of MCI, estimates of the incidence and prevalence of MCI, risk factors for MCI, and the outcomes following an MCI diagnosis.
            Article 0 comments Cited 195 times – based on 0 reviews     Review now
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              Trends in the prevalence and mortality of cognitive impairment in the United States: is there evidence of a compression of cognitive morbidity?

              Kenneth M Langa, Eric Larson, Jason Karlawish … (2008)
              Recent medical, demographic, and social trends might have had an important impact on the cognitive health of older adults. To assess the impact of these multiple trends, we compared the prevalence and 2-year mortality of cognitive impairment (CI) consistent with dementia in the United States in 1993 to 1995 and 2002 to 2004. We used data from the Health and Retirement Study (HRS), a nationally representative population-based longitudinal survey of U.S. adults. Individuals aged 70 years or older from the 1993 (N = 7,406) and 2002 (N = 7,104) waves of the HRS were included. CI was determined by using a 35-point cognitive scale for self-respondents and assessments of memory and judgment for respondents represented by a proxy. Mortality was ascertained with HRS data verified by the National Death Index. In 1993, 12.2% of those aged 70 or older had CI compared with 8.7% in 2002 (P < .001). CI was associated with a significantly higher risk of 2-year mortality in both years. The risk of death for those with moderate/severe CI was greater in 2002 compared with 1993 (unadjusted hazard ratio, 4.12 in 2002 vs 3.36 in 1993; P = .08; age- and sex-adjusted hazard ratio, 3.11 in 2002 vs 2.53 in 1993; P = .09). Education was protective against CI, but among those with CI, more education was associated with higher 2-year mortality. These findings support the hypothesis of a compression of cognitive morbidity between 1993 and 2004, with fewer older Americans reaching a threshold of significant CI and a more rapid decline to death among those who did. Societal investment in building and maintaining cognitive reserve through formal education in childhood and continued cognitive stimulation during work and leisure in adulthood might help limit the burden of dementia among the growing number of older adults worldwide.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Geriatrics (Basel)
                Journal ID (iso-abbrev): Geriatrics (Basel)
                Journal ID (publisher-id): geriatrics
                Title: Geriatrics
                Publisher: MDPI
                ISSN (Electronic): 2308-3417
                Publication date (Electronic): 27 October 2020
                Publication date Collection: December 2020
                Volume: 5
                Issue: 4
                Electronic Location Identifier: 84
                Affiliations
                [1 ]EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; lmruano@ 123456gmail.com (L.R.); opcarvalho20@ 123456gmail.com (O.P.C.); henrique.barros@ 123456ispup.up.pt (H.B.)
                [2 ]Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
                [3 ]Unidade de Saúde Familiar Lusitana, Aces Dão Lafões, A.R.S. Centro, Av. António José Almeida, 3514-511 Viseu, Portugal
                [4 ]Departamento de Neurologia, Hospital de São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Rua Cândido Pinho, 4520-211 Santa Maria da Feira, Portugal
                Author notes
                [* ]Correspondence: pais.ricardo@ 123456gmail.com ; Tel.: +351-222-061-820
                Author information
                https://orcid.org/0000-0002-1931-2659
                https://orcid.org/0000-0002-7450-9980
                Article
                Publisher ID: geriatrics-05-00084
                DOI: 10.3390/geriatrics5040084
                PMC ID: 7709591
                PubMed ID: 33121002
                SO-VID: 7f2b704b-5309-42ae-b87e-12411b05b6bc
                Copyright © © 2020 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 09 October 2020
                Date accepted : 26 October 2020
                Categories
                Subject: Review

                Keywords: epidemiology,cognitive impairment,prevalence,incidence
                Data availability:
                Keywords: epidemiology, cognitive impairment, prevalence, incidence

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