Dementia in America—charted by age, education, race, and more

A study published Monday American Medical Association Neurology It found that in 2016, nearly one-third of Americans age 65 and older had dementia or mild cognitive impairment — but the prevalence of these disorders varied by age, education, race and ethnicity.

Study details and key findings

For the study, researchers collected data from 3,496 participants in the Harmonized Cognitive Assessment Protocol (HCAP) program, part of the ongoing Longitudinal Health and Retirement Study (HRS). HCAP included a cross-sectional random sample of HRS participants aged 65 years and older in 2016.

Between June 2016 and October 2017, HCAP participants were asked to complete a comprehensive neuropsychological test and an interview.

The mean age of participants was 76.4 years. Overall, 60% were female, 71% were white, 16% were black, 11% were Hispanic, and 2% were other races.

Dementia and mild cognitive impairment were classified by an algorithm based on standard diagnostic criteria. The researchers then compared the participants’ test performance to a standard sample. To estimate the prevalence of dementia and mild cognitive impairment in the United States, the researchers used population weights.

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According to study author Jennifer Manley Columbia University Irving Medical Centerand colleagues, in 2016 10% of participants had dementia and 22% had mild cognitive impairment.

While the prevalence of dementia was similar in men and women, it varied by age, education, race and ethnicity.

For example, dementia was more common among black participants and mild cognitive impairment was more common among Hispanic participants compared with white participants.

With each five-year increase in age, the participants’ risk of developing dementia and mild cognitive impairment increased. For example, 35% of people aged 90 and older had dementia – a significant increase compared to only 3% of participants aged 65-69.

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The study also found that “each additional year of education was associated with a lower risk of dementia.”

Comment

While the findings mark the first representative study of cognitive impairment in more than 20 years, the study authors note that the findings are similar to other recent estimates of dementia prevalence in the United States.

Because these findings represent a snapshot in time, they cannot accurately assess rates of cognitive impairment or progression in individuals with mild cognitive impairment, the authors say.

In addition, the authors note that other longitudinal studies have determined that the classification of mild cognitive impairment may be inconsistent, with many people in the normal cognitive classification at follow-up.

Ultimately, the authors added, the cross-sectional design of the HCAP study “doesn’t allow the examination of survival bias, which may increase prevalence if certain groups with dementia live longer or reduce estimates for groups with higher mortality rates. “.

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still, “[b]Because the HCAP study is part of a nationally representative and long-running Health and Retirement Study, these data not only show the dementia burden now, but will be used in the future to track trends in the dementia burden for decades to come,” co-authors said. Kenneth Langa says University of Michigan.

“As baby boomers live longer and age, cognitive impairment is expected to increase significantly in the coming decades, affecting individuals, families and programs that provide care and services for people with dementia,” Manley said.

“Following these trends will be especially important given the likely impact of COVID and other recent population health changes on dementia risk in the coming decades,” Langa added. (George, Medicine Today Page10/24; Mueller, hill10/24; Manley et al., American Medical Association Neurology10/24 [subscription required])



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