Abstract
IntroductionFew recent studies have suggested declining trends in dementia frequency. French cohorts with long follow-up allowed us to explore incidence evolution trends. MethodsTwo different populations of subjects aged ≥65 years included in 1988–1989 (n = 1469) and 1999–2000 (n = 2104) were followed up over 10 years, with systematic assessment for cognition and dementia. Multistates illness-death models were used to compare dementia incidence using both clinical and algorithmic diagnoses. ResultsUsing the algorithmic diagnosis, incidence declined significantly overall and for women (age-adjusted hazard ratio [HR] = 0.62; confidence interval (CI) = 0.48–0.80 for women between the two populations). Differences in education, vascular factors, and depression accounted only to some extent for this reduction (women full-adjusted HR = 0.73; CI = 0.57–0.95). No significant decreasing trends were found for men or when using the clinical diagnosis for either sex. DiscussionOur study provides further support for a decrease in dementia incidence in women using algorithmic diagnosis. Changes in diagnostic boundaries mask this reduction.
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