Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 Jun;60(6):628–633. doi: 10.1136/jnnp.60.6.628

Prevalence of dementia in an elderly rural population: effects of age, sex, and education.

M Prencipe 1, A R Casini 1, C Ferretti 1, M T Lattanzio 1, M Fiorelli 1, F Culasso 1
PMCID: PMC1073945  PMID: 8648328

Abstract

OBJECTIVES--To estimate the prevalence of dementia in an elderly rural population and to determine the effects of age, sex, and education. METHODS--To obtain prevalence estimates of both cognitive impairment and dementia a door to door two phase population survey was carried out in three rural villages in central Italy. Of 1147 inhabitants older than 64, 968 (84.4%) completed the protocol. RESULTS--The prevalence rates (cases per 100 population over 64) were 8.0 for dementia and 27.3 for cognitive impairment. The prevalence rate for dementia did not differ between men and women (7.9 v 8.2), but increased with age (from 1.1 at age 65-69 to 34.8 at age 90-96). Subjects with less than three years of schooling had a significantly higher prevalence of dementia (14.6; 95% confidence interval (95% CI) 10.2-19.1) than subjects with three or more years of schooling (5.9; 95% CI 4.2-7.7). At the multivariate logistic analysis, the risk related with a low level of education was still present after adjustment for age and sex (OR = 2.0; 95% CI 1.2-3.3). Alzheimer's disease was diagnosed in 64% of the 78 demented patients, vascular dementia in 27%, and other dementing diseases in 9%. CONCLUSIONS--In both Alzheimer and vascular dementia subtypes, the prevalence rates did not differ between men and women, but increased with age and were higher in subjects with a low level of education.

Full text

PDF
628

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bachman D. L., Wolf P. A., Linn R., Knoefel J. E., Cobb J., Belanger A., D'Agostino R. B., White L. R. Prevalence of dementia and probable senile dementia of the Alzheimer type in the Framingham Study. Neurology. 1992 Jan;42(1):115–119. doi: 10.1212/wnl.42.1.115. [DOI] [PubMed] [Google Scholar]
  2. Beard C. M., Kokmen E., Offord K. P., Kurland L. T. Lack of association between Alzheimer's disease and education, occupation, marital status, or living arrangement. Neurology. 1992 Nov;42(11):2063–2068. doi: 10.1212/wnl.42.11.2063. [DOI] [PubMed] [Google Scholar]
  3. Bonaiuto S., Rocca W. A., Lippi A., Giannandrea E., Mele M., Cavarzeran F., Amaducci L. Education and occupation as risk factors for dementia: a population-based case-control study. Neuroepidemiology. 1995;14(3):101–109. doi: 10.1159/000109785. [DOI] [PubMed] [Google Scholar]
  4. Brayne C., Calloway P. An epidemiological study of dementia in a rural population of elderly women. Br J Psychiatry. 1989 Aug;155:214–219. doi: 10.1192/bjp.155.2.214. [DOI] [PubMed] [Google Scholar]
  5. Broe G. A., Akhtar A. J., Andrews G. R., Caird F. I., Gilmore A. J., McLennan W. J. Neurological disorders in the elderly at home. J Neurol Neurosurg Psychiatry. 1976 Apr;39(4):362–366. doi: 10.1136/jnnp.39.4.362. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Coria F., Gomez de Caso J. A., Minguez L., Rodriguez-Artalejo F., Claveria L. E. Prevalence of age-associated memory impairment and dementia in a rural community. J Neurol Neurosurg Psychiatry. 1993 Sep;56(9):973–976. doi: 10.1136/jnnp.56.9.973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. De Renzi E., Motti F., Nichelli P. Imitating gestures. A quantitative approach to ideomotor apraxia. Arch Neurol. 1980 Jan;37(1):6–10. doi: 10.1001/archneur.1980.00500500036003. [DOI] [PubMed] [Google Scholar]
  8. Evans D. A., Funkenstein H. H., Albert M. S., Scherr P. A., Cook N. R., Chown M. J., Hebert L. E., Hennekens C. H., Taylor J. O. Prevalence of Alzheimer's disease in a community population of older persons. Higher than previously reported. JAMA. 1989 Nov 10;262(18):2551–2556. [PubMed] [Google Scholar]
  9. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  10. Fratiglioni L., Grut M., Forsell Y., Viitanen M., Grafström M., Holmén K., Ericsson K., Bäckman L., Ahlbom A., Winblad B. Prevalence of Alzheimer's disease and other dementias in an elderly urban population: relationship with age, sex, and education. Neurology. 1991 Dec;41(12):1886–1892. doi: 10.1212/wnl.41.12.1886. [DOI] [PubMed] [Google Scholar]
  11. Hachinski V. C., Iliff L. D., Zilhka E., Du Boulay G. H., McAllister V. L., Marshall J., Russell R. W., Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632–637. doi: 10.1001/archneur.1975.00490510088009. [DOI] [PubMed] [Google Scholar]
  12. Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967 Dec;6(4):278–296. doi: 10.1111/j.2044-8260.1967.tb00530.x. [DOI] [PubMed] [Google Scholar]
  13. Hofman A., Rocca W. A., Brayne C., Breteler M. M., Clarke M., Cooper B., Copeland J. R., Dartigues J. F., da Silva Droux A., Hagnell O. The prevalence of dementia in Europe: a collaborative study of 1980-1990 findings. Eurodem Prevalence Research Group. Int J Epidemiol. 1991 Sep;20(3):736–748. doi: 10.1093/ije/20.3.736. [DOI] [PubMed] [Google Scholar]
  14. Hughes C. P., Berg L., Danziger W. L., Coben L. A., Martin R. L. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982 Jun;140:566–572. doi: 10.1192/bjp.140.6.566. [DOI] [PubMed] [Google Scholar]
  15. Jorm A. F., Korten A. E., Henderson A. S. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand. 1987 Nov;76(5):465–479. doi: 10.1111/j.1600-0447.1987.tb02906.x. [DOI] [PubMed] [Google Scholar]
  16. KAHN R. L., GOLDFARB A. I., POLLACK M., PECK A. Brief objective measures for the determination of mental status in the aged. Am J Psychiatry. 1960 Oct;117:326–328. doi: 10.1176/ajp.117.4.326. [DOI] [PubMed] [Google Scholar]
  17. Katzman R. Education and the prevalence of dementia and Alzheimer's disease. Neurology. 1993 Jan;43(1):13–20. doi: 10.1212/wnl.43.1_part_1.13. [DOI] [PubMed] [Google Scholar]
  18. Kokmen E., Beard C. M., Offord K. P., Kurland L. T. Prevalence of medically diagnosed dementia in a defined United States population: Rochester, Minnesota, January 1, 1975. Neurology. 1989 Jun;39(6):773–776. doi: 10.1212/wnl.39.6.773. [DOI] [PubMed] [Google Scholar]
  19. Landis J. R., Koch G. G. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159–174. [PubMed] [Google Scholar]
  20. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
  21. Morris J. C. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1993 Nov;43(11):2412–2414. doi: 10.1212/wnl.43.11.2412-a. [DOI] [PubMed] [Google Scholar]
  22. Ott A., Breteler M. M., van Harskamp F., Claus J. J., van der Cammen T. J., Grobbee D. E., Hofman A. Prevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam study. BMJ. 1995 Apr 15;310(6985):970–973. doi: 10.1136/bmj.310.6985.970. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Raskin N. H. Acute and prophylactic treatment of migraine: practical approaches and pharmacologic rationale. Neurology. 1993 Jun;43(6 Suppl 3):S39–S42. [PubMed] [Google Scholar]
  24. Rocca W. A., Bonaiuto S., Lippi A., Luciani P., Turtù F., Cavarzeran F., Amaducci L. Prevalence of clinically diagnosed Alzheimer's disease and other dementing disorders: a door-to-door survey in Appignano, Macerata Province, Italy. Neurology. 1990 Apr;40(4):626–631. doi: 10.1212/wnl.40.4.626. [DOI] [PubMed] [Google Scholar]
  25. Román G. C., Tatemichi T. K., Erkinjuntti T., Cummings J. L., Masdeu J. C., Garcia J. H., Amaducci L., Orgogozo J. M., Brun A., Hofman A. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993 Feb;43(2):250–260. doi: 10.1212/wnl.43.2.250. [DOI] [PubMed] [Google Scholar]
  26. Skoog I., Nilsson L., Palmertz B., Andreasson L. A., Svanborg A. A population-based study of dementia in 85-year-olds. N Engl J Med. 1993 Jan 21;328(3):153–158. doi: 10.1056/NEJM199301213280301. [DOI] [PubMed] [Google Scholar]
  27. Stern Y., Gurland B., Tatemichi T. K., Tang M. X., Wilder D., Mayeux R. Influence of education and occupation on the incidence of Alzheimer's disease. JAMA. 1994 Apr 6;271(13):1004–1010. [PubMed] [Google Scholar]
  28. Sunderland T., Hill J. L., Mellow A. M., Lawlor B. A., Gundersheimer J., Newhouse P. A., Grafman J. H. Clock drawing in Alzheimer's disease. A novel measure of dementia severity. J Am Geriatr Soc. 1989 Aug;37(8):725–729. doi: 10.1111/j.1532-5415.1989.tb02233.x. [DOI] [PubMed] [Google Scholar]
  29. Zhang M. Y., Katzman R., Salmon D., Jin H., Cai G. J., Wang Z. Y., Qu G. Y., Grant I., Yu E., Levy P. The prevalence of dementia and Alzheimer's disease in Shanghai, China: impact of age, gender, and education. Ann Neurol. 1990 Apr;27(4):428–437. doi: 10.1002/ana.410270412. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES