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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2008 Feb-Mar;23(1):67–76. doi: 10.1177/1533317507310570

The Prevalence of Dementia in an Urban Turkish Population

H Gurvit 1, M Emre 2, S Tinaz 3, B Bilgic 4, H Hanagasi 5, H Sahin 6, E Gurol 7, JT Kvaloy 8, H Harmanci 9
PMCID: PMC10846186  PMID: 18276959

Abstract

A cross-sectional, population-based, 2-stage prevalence study was conducted in a sample of 1019 community-dwelling persons over the age of 70 years living in Istanbul. In the first phase, participants were screened with the Mini-Mental State Examination for evidence of cognitive impairment. In the second phase, 79% of those who screened positive (n = 322) and 9% of screen-negatives (n = 63) underwent a standardized diagnostic workup. Diagnosis of dementia and Alzheimer's disease (AD) was made according to established criteria. Ninety-three cases of dementia were identified, 58 of whom were diagnosed with probable AD. Based on these numbers, the prevalence rates of probable AD and dementia were calculated to be 11.0% (95% CI, 7.0% to 15.0%) and 20.0% (95% CI, 14.0% to 26.0%), respectively, in this population. Prevalence rates of dementia and AD in Istanbul, Turkey, are comparable with those seen in the Western world.

Keywords: dementia, Alzheimer's disease, epidemiology, prevalence

Full Text

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Contributor Information

H. Gurvit, Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey, gurvit@istanbul.edu.tr .

M. Emre, Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey.

S. Tinaz, Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey, Department of Neurology, School of Medicine, Boston University, Boston, MA.

B. Bilgic, Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey, Department of Neurology, Istanbul Neuropsychiatric Hospital, Umraniye, Istanbul, Turkey.

H. Hanagasi, Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey.

H. Sahin, Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey, Department of Neurology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.

E. Gurol, Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey, Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA.

J.T. Kvaloy, Department of Mathematics and Natural Sciences, University of Stavanger, Stavanger, Norway.

H. Harmanci, Department of Public Health, Faculty of Medicine, Marmara University, Haydarpasa, Istanbul, Turkey.

References

  1. Rocca WA, Hofman A., Brayne C., et al. Frequency and distribution of Alzheimer's disease in Europe: a collaborative study of 1980-1990 prevalence findings. The EURODEM-Prevalence Research Group. Ann Neurol. 1991;30:381-390. [DOI] [PubMed] [Google Scholar]
  2. Evans DA, Funkenstein HH, Albert MS, et al. Prevalence of Alzheimer's disease in a community population of older persons. Higher than previously reported. JAMA. 1989;262:2551-2556. [PubMed] [Google Scholar]
  3. Hebert LE, Scherr PA, Beckett LA, et al. Age-specific incidence of Alzheimer's disease in a community population. JAMA. 1995;273:1354-1359. [PubMed] [Google Scholar]
  4. Canadian Study of Health and Aging Working Group. Canadian Study of Health and Aging: study methods and prevalence of dementia. Can Med Assoc J. 1994;150:899-913. [PMC free article] [PubMed] [Google Scholar]
  5. Fukunishi I. , Hayabara T., Hosokawa K. Epidemiological surveys of senile dementia in Japan. Int J Soc Psychiatry. 1991;37:51-56. [DOI] [PubMed] [Google Scholar]
  6. Ferri CP, Prince M., Brayne C., et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366:2112-2117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Prince MJ The need for research on dementia in developing countries. Trop Med Health. 1997;2:993-1000. [DOI] [PubMed] [Google Scholar]
  8. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatric Res. 1983;17:37-49. [DOI] [PubMed] [Google Scholar]
  9. Harmanci H., Emre M., Gürvit H., et al. Risk factors for Alzheimer disease: a population-based case—control study in Istanbul, Turkey. Alzheimer Dis Assoc Disord. 2003;17:139-145. [DOI] [PubMed] [Google Scholar]
  10. Şahin HA, Gürvit H., Emre M., et al. The attitude of elderly lay people towards the symptoms of dementia. Int Psychogeriatr. 2006;18:251-258. [DOI] [PubMed] [Google Scholar]
  11. Kulaksizoglu, IB, Gürvit H., Polat A., et al. Unrecognized depression in community-dwelling elderly persons in Istanbul. Int Psychogeriatr. 2004;16:4-10. [DOI] [PubMed] [Google Scholar]
  12. Yokeş MB, Emre M., Harmanci H., et al. The apolipoprotein E (APOE) genotype in a Turkish population with Alzheimer's disease. Balkan J Med Genet. 2005;8:57-63. [Google Scholar]
  13. Gungen C., Ertan T., Eker E., et al. The standardized Mini-Mental State Examination in Turkish. Paper presented at: 9th Congress of International Psychogeriatric Association; August 15-20, 1999; Vancouver, Canada. [Google Scholar]
  14. Folstein M. , Folstein S., McHugh PR Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198. [DOI] [PubMed] [Google Scholar]
  15. Ertan T., Eker E., Gungen C., et al. The Standardized Mini-Mental State Examination for illiterate Turkish elderly population. Paper presented at: 2nd International Symposium on Neurophysiological and Neuropsychological Assessment of Mental and Behavioral Disorders; August 28-30, 1999; Kirazliyayla, Bursa, Turkey. [Google Scholar]
  16. Katzman R., Brown T., Fuld P., Peck A., Schechter R., Schimmel H. Validation of the short orientation-memory-concentration test of cognitive impairment. Am J Psychiatry. 1983;140:734-739. [DOI] [PubMed] [Google Scholar]
  17. Blessed G., Tomlinson B., Roth M. The association between quantitative measures of dementia and of senile change in the cerebral gray matter of elderly subjects. Brit J Psychiatry . 1968;114:797-811. [DOI] [PubMed] [Google Scholar]
  18. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association; 1980. [Google Scholar]
  19. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan EM 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;34:939-944. [DOI] [PubMed] [Google Scholar]
  20. Roman GC, Tatemichi TK, Erkinjuntti T., et al. Vascular dementia; diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology . 1993;43:250-260. [DOI] [PubMed] [Google Scholar]
  21. McKeith IG, Galasko D., Kosaka K., et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB International Workshop. Neurology. 1996;47:1113-1124. [DOI] [PubMed] [Google Scholar]
  22. Neary D., Snowden JS, Gustafson L., et al. Frontotemporal lobar degeneration: A consensus on clinical diagnostic criteria. Neurology. 1998;51:1546-1554. [DOI] [PubMed] [Google Scholar]
  23. Petersen RC , Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999;56:303-308. [DOI] [PubMed] [Google Scholar]
  24. Morris J. The clinical dementia rating (CDR): current version and scoring rules. Neurology. 1993;43:2412-2414. [DOI] [PubMed] [Google Scholar]
  25. Reisberg B. , Ferris S., de Leon M., Crook T. The global deterioration scale for the assessment of primary progressive dementia. Am J Psychiatry. 1982;139:1136-1139. [DOI] [PubMed] [Google Scholar]
  26. Kawas CH, Katzman R. Epidemiology of dementia and Alzheimer's disease. In: Terry RD, Katzman R, Bick KL, Sisodia SS, eds. Alzheimer Disease. Philadelphia, PA: Lippincott Williams and Wilkins; 1999:95-116. [Google Scholar]
  27. Bohnstedt M. , Fox PJ, Kohatsu ND Correlates of Mini-Mental Status Examination scores among elderly demented patients: the influence of race-ethnicity. J Clin Epidemiol. 1994;47:1381-1387. [DOI] [PubMed] [Google Scholar]
  28. Ford GR, Haley WE, Thrower SL, West CA, Harrell LE Utility of Mini-Mental State Exam scores in predicting functional impairment among white and African American dementia patients. J Gerontol A Biol Sci Med Sci. 1996;51:M185-M188. [DOI] [PubMed] [Google Scholar]
  29. Espino DV, Lichtenstein MJ, Palmer RF, Hazuda HP Ethnic differences in mini-mental state examination (MMSE) scores: where you live makes a difference. J Am Geriatr Soc. 2001;49:538-548. [DOI] [PubMed] [Google Scholar]
  30. Wood RY, Giuliano KK, Bignell CU, Pritham WW Assessing cognitive ability in research: use of MMSE with minority populations and elderly adults with low education levels. J Gerontol Nurs. 2006;32:45-54. [DOI] [PubMed] [Google Scholar]
  31. Vas CJ, Pinto C., Panikker D., et al. Prevalence of dementia in an urban Indian population. Int Psychogeriatr. 2001;13:439-450. [DOI] [PubMed] [Google Scholar]
  32. Lin RT, Lai CL, Tai CT, Liu CK, Yen YY, Howng SL Prevalence and subtypes of dementia in southern Taiwan: impact of age, sex, education, and urbanization. J Neurol Sci. 1998;160:67-75. [DOI] [PubMed] [Google Scholar]
  33. Zhang ZX, Zahner GE, Román GC, et al. Dementia subtypes in China. Prevalence in Beijing, Xian, Shanghai, and Chengdu. Arch Neurol. 2005;62:447-453. [DOI] [PubMed] [Google Scholar]
  34. Andersen K. , Lolk A., Nielsen H., Andersen J., Olsen C., Kragh-Sorensen P. Prevalence of very mild to severe dementia in Denmark. Acta Neurol Scand. 1997; 96:82-87. [DOI] [PubMed] [Google Scholar]
  35. Bilgiç B. Gürvit H., HanağasI H., et al. Erken evre Alzheimer hastalIğI ve demanssIz kognitif bozukluk tanIlI hastalarIn klinik ve laboratuar parametrelerinin karşIlatşrIlmasI . Paper presented at: 38th Turkish National Congress of Neurology; October 2002; Antalya. Turkish J Neurol. (special edition) 2002:41. Abstract. [Google Scholar]
  36. Jorm AF, Korten AE, Henderson AS The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand. 1987;76:465-479. [DOI] [PubMed] [Google Scholar]
  37. Fratiglioni L., Viitanen M., von Strauss E., Tontodonati V., Herlitz A., Winblad B. Very old women at highest risk of dementia and Alzheimer's disease: incidence data from the Kungsholmen Project, Stockholm . Neurology. 1997;48:132-138. [DOI] [PubMed] [Google Scholar]
  38. Brayne C., Gill C., Huppert FA, et al. Incidence of clinically diagnosed subtypes of dementia in an elderly population. Cambridge Project for Later Life. Br J Psychiatry. 1995;167:255-262. [DOI] [PubMed] [Google Scholar]
  39. Yoshitake T. , Kiyohara Y., Kato I., et al. Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population: the Hisayama Study. Neurology. 1995;45:1161-1168. [DOI] [PubMed] [Google Scholar]
  40. Paykel ES, Brayne C., Huppert FA, et al. Incidence of dementia in a population older than 75 years in the United Kingdom. Arch Gen Psychiatry. 1994. ;51:325-332. [DOI] [PubMed] [Google Scholar]
  41. Bachman DL, Wolf PA, Linn RT, et al. Incidence of dementia and probable Alzheimer's disease in a general population: the Framingham Study. Neurology. 1993;43:515-519. [DOI] [PubMed] [Google Scholar]
  42. Andersen K. , Launer LJ, Dewey ME, et al. Gender differences in the incidence of AD and vascular dementia: the EURODEM Studies. Neurology . 1999;53:1992-1997. [DOI] [PubMed] [Google Scholar]
  43. Blansjaar BA, Thomassen R., Van Schaick HW Prevalence of dementia in centenarians. Int J Geriatr Psychiatry . 2000;15:219-225. [DOI] [PubMed] [Google Scholar]
  44. Ritchie K., Kildea D. Is senile dementia “age-related” or “ageing-related?”—evidence from meta-analysis of dementia prevalence in the oldest old. Lancet. 1995;346: 931-934. [DOI] [PubMed] [Google Scholar]
  45. Letenneur L., Gilleron V., Commenges D., Helmer C., Orgogozo JM, Dartiques JF Are sex and educational level independent predictors of dementia and Alzheimer's disease? Incidence data from the PAQUID project. J Neurol Neurosurg Psychiatry. 1999;66:177-183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Evans DA, Hebert LE, Beckett LA, et al. Education and other measures of socioeconomic status and risk of incident Alzheimer disease in a defined population of older persons. Arch Neurol. 1997;54:1399-1405. [DOI] [PubMed] [Google Scholar]
  47. Qiu C., Bäckman L., Winblad B., Aquero-Torres H., Frataglioni L. The influence of education on clinically diagnosed dementia incidence and mortality data from the Kungsholmen Project. Arch Neurol. 2001;58:2034-2039. [DOI] [PubMed] [Google Scholar]
  48. Ott A., Breteler MM, van Harskamp F., Stijnen T., Hofman A. Prevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam study. BMJ. 1995;310:970-973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Letenneur L. , Launer LJ, Andersen K., et al. Education and the risk for Alzheimer's disease: sex makes a difference. EURODEM pooled analyses. Am J Epidemiol. 2000;151:1064-1071. [DOI] [PubMed] [Google Scholar]
  50. Cobb JL, Wolf PA, Au R., White R., D'Agostino RB The effect of education on the incidence of dementia and Alzheimer's disease in the Framingham Study. Neurology. 1995;45:1707-1712. [DOI] [PubMed] [Google Scholar]
  51. Sklavounou E., Economou-Petersen E., Karadima G., et al. Apolipoprotein E polymorphism in the Greek population. Clin Genet. 1997;52:216-218. [DOI] [PubMed] [Google Scholar]

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