Prevalence Of Vascular Dementia Research Articles

Epidemiology of Dementia in China in 2010–2020: A Systematic Review and Meta-Analysis

Background: Dementia has become one of the leading causes of death across the world. Aims: The aim of this study was to investigate the incidence, prevalence, and mortality of dementia in China between 2010 and 2020, and to investigate any geographical, age, and sex differences in the prevalence and incidence of dementia. Methods: Five databases were searched. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the quality of the included studies. A random-effects meta-analysis was performed to estimate the pooled prevalence of dementia. Subgroup analysis was based on the type of dementia. The incidence and mortality of dementia were synthesized qualitatively. Results: A total of 19 studies were included. The meta-analysis showed that the prevalence of dementia was 6% (95%CI 5%, 8%), the prevalence of Alzheimer’s disease (AD) was 5% (95%CI 4%, 6%), and the prevalence of vascular dementia (VaD) was 1% (95%CI 0%, 2%). The subgroup analysis showed that the prevalence rates of dementia in rural (6%, 95%CI 4%, 8%) and urban areas were similar (6%, 95%CI 4%, 8%). Deaths due to dementia increased over time. Conclusion: The prevalence, incidence, and mortality of dementia increased with age and over time. Applying consistent criteria to the diagnosis of cognitive impairment and dementia is necessary to help with disease monitoring. Promoting dementia knowledge and awareness at the community level is necessary.

Pathogenesis, Rehabilitation Assessment, Treatment Status, and Research Progress of Vascular Dementia

Given the global trends in population aging, the prevalence of vascular dementia (VD) is increasing year by year. VD has become the second most common type of dementia and can seriously threaten the quality of life of patients. Since VD is preventable, it is important to study VD clinically in order to improve the prognosis of patients. In recent years, a large number of studies have been carried out at home and abroad, focusing on the pathogenesis, rehabilitation assessment, and treatment of VD. This article is a concise overview of these studies.

Bioinformatic identification of potential biomarkers and therapeutic targets in carotid atherosclerosis and vascular dementia.

Vascular disease is the second most common cause of dementia. The prevalence of vascular dementia (VaD) has increased over the past decade. However, there are no licensed treatments for this disease. Carotid atherosclerosis (CAS) is highly prevalent and is the main cause of ischemic stroke and VaD. We studied co-expressed genes to understand the relationships between CAS and VaD and further reveal the potential biomarkers and therapeutic targets of CAS and VaD. CAS and VaD differentially expressed genes (DEGs) were identified through bioinformatic analysis Gene Expression Omnibus (GEO) datasets GSE43292 and GSE122063, respectively. Furthermore, a variety of target prediction methods and network analysis approaches were used to assess the protein-protein interaction (PPI) networks, the Gene Ontology (GO) terms, and the pathway enrichment for DEGs, and the top 7 hub genes, coupled with corresponding predicted miRNAs involved in CAS and VaD, were assessed as well. A total of 60 upregulated DEGs and 159 downregulated DEGs were identified, of which the top 7 hub genes with a high degree of connectivity were selected. Overexpression of these hub genes was associated with CAS and VaD. Finally, the top 7 hub genes were coupled with corresponding predicted miRNAs. hsa-miR-567 and hsa-miR-4652-5p may be significantly associated with CAS and VaD.

Aggressive behavior of patients with vascular dementia

There is a worldwide trend towards an increase in the number of people aged over 60, which in turn leads to an increase in the prevalence of vascular dementia and neuropsychiatric disorders, including the accompanying aggressive behavior. The authors analyze the relationship of neuropsychiatric symptoms with aggressive behavior and assess the impact of the evolution of dementia, socio-demographic factors on the development of aggressive behavior in some subtypes of vascular dementia based on literature data retrieved from Scopus, PubMed, eLibrary databases as well as national guidelines. Analyzing the publication was made by the method of the system analysis and generalization. The analysis of the literature suggests that aggressive behavior in patients with vascular dementia changes their lifestyle and worsens its quality, in addition, it increases the burden on caregivers. Also, this psychopathological process is one of the reasons for frequent hospitalizations of patients in psychiatric hospitals and social institutions, which becomes an urgent economic and medical problem at the state level. Of all the psychopathological symptoms in the clinical picture of vascular dementia, aggressive behavior periodically occurs together with apathy, depression, anxiety, abnormal motor activity and hallucinations. The question of the highest frequency of occurrence of aggressive tendencies in one or another subtype of vascular dementia remains debatable. Research on the relationship between dementia severity, gender, and aggressive behavior has been mixed. The question of the influence of the level of education on the manifestation of aggression in patients with vascular dementia remains completely unexplored. Thus, the above facts dictate the need for further study of these issues.

Significance of Hypouricaemia in the Development of Neurodegenerative Diseases

Abstract Hypouricaemia has received relatively little attention in the literature. As a result, there is less awareness or understanding of the potential risks of low uric acid levels. Emerging research indicates that normal uric acid levels may have an antioxidative and neuroprotective effect. This study aims to investigate possible associations between hypouricaemia and neurodegenerative disease. Data was collected from seventy-seven outpatients and inpatients who underwent routine uric acid testing, who were then stratified into patients with and without neurodegenerative disease. Patients with renal pathologies and patients using uric acid altering medications were excluded from the study. There was a significant difference in the prevalence of Alzheimer’s disease between hypouricemic and normouricemic patients (p = 0.001), however there was no difference in the prevalence of vascular dementia (p = 0.45). This study provides evidence that hypouricaemia has potential effects on health, specifically on the rate of neurodegenerative diseases such as Alzheimer’s disease and gives weight to the potential neuroprotective role of uric acid.

The Prevalence of Vascular Dementia in China: A Systematic Review and Meta-Analysis from 2009-2019.

Background:Vascular dementia (VD), as the second-largest type of dementia, is a serious stage of vascular cognitive impairment. It is significant to conduct retrospective epidemiological studies to characterize further the disease for public health. This study estimated the prevalence of VD among the population aged 18 yr and older in China.Methods:Epidemiological investigations on VD published in journals and covering the period from 1999 to 2019 were identified manually and online by using Chinese databases (such as Chinese BioMedical Literature Database, Chinese National Knowledge Infrastructure database, Chinese science-technology databases, and the Chinese Wan-fang and Chongqing VIP database) and English databases (such as PubMed, Elsevier Science Bibliographic Databases and Cochrane library). Studies were included if the diagnostic criteria for VD are clear and the quality of the included literature was evaluated using the quality evaluation criteria of epidemiological research methods. A random-effects model was employed according to the statistical test of homogeneity.Results:Twenty-six studies met the inclusion criteria, including 100,923 subjects and 977 VD patients. The pooled prevalence of VD was 0.96% (95% [confidence interval, CI] 0.63%∼2.1%). The prevalence of VD increased with increasing age. There was a higher prevalence of VD in the northeast China population, in urban areas and males.Conclusion:We stratified the included studies based on age, location, gender, and geographical distribution for prevalence. The prevalence of VD has slowly risen since 1999. It is obviously different between the North & South and urban &rural districts. While there are many benefits of systematic reviews, the methods presented have inherent limitations.

Epidemiological aspects of vascular dementia in the Northwestern Federal District in 2010-2019

Study design is descriptive epidemiological. We analyzed the data of 11 entities that are part of the North-West Federal District, including in comparison with general indicators for the Russian Federation. There was an increase in the prevalence and a decrease in the incidence of vascular dementia in 2019 compared to 2010. In the Northwestern Federal District, both indicators were higher than all-Russian ones. A small number of cases of vascular dementia can be observed at a young age, but its exponential growth is observed after 60 years. Among previously ill vascular dementia and newly diagnosed, there is an almost twofold predominance of women. The results can be used in solving issues of the organization of psychiatric care and developing prevention algorithms for vascular dementia.

CORRELATION OF AGGREGATED BETA AMYLOID LEVEL IN PLASMA WITH MOCA AND MMSE AMONG TYPE 2 DIABETIC PATIENTS WITH DEMENTIA

Type 2 Diabetes Mellitus (DM) as a risk factor for Alzheimer's disease (AD) and decline in cognitive functions have been studied in recent years; however, no clear evidence of association has been found yet. As potential biomarker for AD, aggregated beta amyloid level in plasma is likewise under study by some medical researchers. We examined the correlation between plasma beta amyloid levels and cognitive functions of Type 2 DM patients with Dementia as indicated by their neurocognitive assessment scores with the end in view of finding a less invasive early detection of AD among diabetic patients. In this Cross Sectional study, 100 Type 2 DM patients with dementia (39% male, 68.71 ± 6.9 years) underwent plain cranial CT scan, plasma beta amyloid, Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests. Patients were categorized as having Vascular or Non Vascular Dementia with the use of NINDS-AIREN Criteria for Vascular Dementia. Elevated aggregated beta amyloid level in plasma (≥ 1.1 pg/ml) was used as biomarker for AD. Among Type 2 DM patients with dementia, there was an increased prevalence of AD (46.7%) as shown by the elevated beta amyloid level independent of Vascular Dementia. The prevalence of vascular dementia was 6%. Among patients with Non Vascular Dementia, majority (51.3%) had elevated beta amyloid. There was no significant correlation between MMSE score and beta amyloid (r= - 0.0192, p = 0.8557), while no significant correlation between MoCA score and beta amyloid (r=0.0939, p=0.3731) among Type 2 DM patients with Dementia. The results did not show significant correlation between both MMSE (r=−0.0664, p=0.6725) and MoCA scores (r=- 0.0877, p=0.5759) with beta amyloid level among those patients with AD. Using the beta amyloid as a biomarker, the study suggests a link between AD and Type 2 DM; however, we recommend that further researches be conducted to ascertain the use of aggregated beta amyloid level in plasma as a less invasive screening routine for AD among Type 2 DM patients with dementia.

Relationship between dementia and ankylosing spondylitis: A nationwide, population-based, retrospective longitudinal cohort study.

Among a variety of comorbidities of ankylosing spondylitis (AS), the association between dementia and AS by using an extensive dataset from the Korean National Health Insurance System was evaluated in this study. We extracted 15,547 newly diagnosed AS subjects among the entire Korean population and excluded wash-out patients (n = 162) and patients that were inappropriate for cohort match (n = 1192). Finally, 14,193 subjects were chosen as the AS group, and through 1:5 age- and sex-stratified matching, 70,965 subjects were chosen as the control group. We evaluated patient demographics, household incomes, and comorbidities, including hypertension, diabetes, and dyslipidemia. The prevalence of overall dementia (1.37%) and Alzheimer’s dementia (AD) (0.99%) in the AS group was significantly higher than in the control group (0.87% and 0.63%), respectively. The adjusted hazard ratio of the AS group for overall dementia (1.758) and AD (1.782) showed statistical significance also. On the other hand, the prevalence of vascular dementia did not differ significantly between the two groups. Subgroup analyses revealed the following risk factors for dementia in the AS group: male gender, greater than 65 years in age, fair income (household income greater than 20% of the median), urban residency, no diabetes, and no hypertension. From the nationwide, population-based, retrospective, longitudinal cohort study, AS patients showed a significantly higher prevalence of overall dementia and Alzheimer’s dementia. Comprehensive patient assessment using our subgroup analysis could help to prevent dementia in patients suffering from AS.

A0575 Comparison of prevalence and associated risk factors of dementia, mild cognitive impairment among elderly between common communities and nursing homes

Objectives: This study was conducted to estimate the prevalence and associated risk factors of dementia and mild cognitive impairment (MCI) in nursing homes (NHs) and common communities (CCs) among elderly in Zhejiang province of China. Methods: We conducted an investigation in Southern China in 2014. A total of 2,015 subjects (1107 from CCs and 908 from NHs) aged 65 or older participated in the study. Trained nurses carried out relevant assessments, interviews and collected information. Dementia (alzheimer's disease (AD), vascular dementia (VaD)) and MCI were diagnosed according to the NIA-AA criteria in 2011. Results: Dementia prevalence was 42.4% in NHs, significantly higher than that of CCs (5.3%). The prevalence rates of AD, VaD and MCI were 22.0%, 1.9% and 21.6% respectively in NHs, which were significantly higher than that of CCs (3.5%, 0.3% and 11.0% respectively). Dementia was associated with old age, low education level, having a medical history of stroke and living in NHs. While prevalence of VaD among participants having a medical history of stroke, a habit of smoking and heavy drinking were found a sharp rise. Conclusion: More attention should be paid to NH dementia, and more appropriate NH intervention programs are needed.

The involvement of neuroinflammation and necroptosis in the hippocampus during vascular dementia

The prevalence of vascular dementia is increasing at an alarming rate. The Confirmation of the clinical diagnosis of vascular dementia depends on post-mortem examination of the brain. In our study, we investigated the vascular disease and neuroinflammation during vascular dementia. Our results showed a β-amyloid deposits, neovascularization, neuronal hypertrophy and neuroinflammation in the hippocampus tissue. Interestingly, the neuroinflammation was characterized by a higher expression of TNF-α, IL-1β, TGF-β and iNOS which are TLR4/RelA pathway dependent. Finally, the finding of necroptosis by impaired blood supply and inflammation state suggests that the cognitive impairment was caused by vascular disease and neuroinflammation.

Vyresnių pacientų, pirmą kartą besikreipiančių į atminties sutrikimų kabinetą, kognityvinių funkcijų sutrikimų ypatumai

Įvadas. Pastaraisiais dešimtmečiais Lietuvoje nustatoma vis daugiau demencijos atvejų. Senstanti populiacija ir kraujagysliniai rizikos veiksniai gali būti susiję su šia tendencija, tačiau tikslus Alzheimerio ligos (AL) ir kraujagyslinės demencijos (KD) paplitimas tarp vyresnių pacientų nėra žinomas. Tyrimo tikslas. Įvertinti vyresnių pacientų, pirmą kartą besikreipiančių į Atminties sutrikimų kabinetą, kognityvinių funkcijų sutrikimų (KFS) ypatumus bei nustatyti sąsajas tarp KFS ir rizikos veiksnių, gretutinių ligų. Tyrimo metodika. Atliktas populiacinis retrospektyvinis kohortinis tyrimas, naudojant ambulatorinių kortelių duomenis. Į tyrimą įtraukti 60 m. ir vyresnio amžiaus 202 pacientai, kurie 2015 metais pirmą kartą kreipėsi į Atminties sutrikimų kabinetą, esantį VšĮ Kauno klinikinės ligoninės I konsultacinėje poliklinikoje. Duomenų analizei naudota Microsoft Excel 2010 ir SPSS 22.0 programos. Pasirinktas sta�- tistinio reikšmingumo lygmuo α=0,05. Kintamųjų skirtumai lyginant kelias tiriamųjų grupes ar ryšys tarp kintamųjų laikomi statistiškai reikšmingais, kai p<α (p<0,05). Duomenų analizėje naudoti chi-kvadratu, Student‘o t kriterijai, dispersinė analizė Anova, Spearmen‘o ir Kendall tau-b koreliacijos koeficientai, aprašomoji statistika. Tyrimo rezultatai. Išanalizuoti 202 pacientų (≥ 60 m. amžiaus) ambulatorinių kortelių duomenys. 82,7 proc. pacientų (n=167) buvo nustatyti KFS: 81,4 proc. (n=136) demencija, 18,6 proc. (n=31) lengvas kognityvinis sutrikimas (LKS). Demencijų pasis�- kirstymas pagal sunkumo formą: sunki 15,4 proc., vidutinio sunkumo 72,1 proc., lengva 12,5 proc. Dažniausiai nustatyta KD - 41,9 proc. (subkortikinė 64,9 proc. atvejų), antra pagal dažnį - mišri demencija, kuri diagnozuota 34,6 proc. atvejų, trečia – demencija sergant Alzheimerio liga, 15,4 proc. LKS sutrikimas buvo susijęs su menkesniu išsilavinimu (p<0,001), išemine širdies liga (IŠL) (p=0,030), hipertenzija (p=0,001). Demencija buvo susijusi su vyresniu amžiumi (p=0,001) ir menkesniu išsilavinimu (p<0,001). KD buvo susijusi su smegenų infarktais (p<0,001), IŠL (p=0,001), hipertenzija (p=0,01), lėtine išemine lakūnarine būkle (p<0,001), šlapimo nelaikymu (p=<0,001) ir griuvimais (p=0,001). Mišri demencija buvo susijusi su IŠL (p=0,026), hipertenzija (p=0,007), šlapimo nelaikymu (p<0,001). Išvados. Tarp pirmą kartą besikreipiančių pacientų į Atminties sutrikimų kabinetą KFS paplitimas siekė 82,7 proc. o dažniausiai nustatyta KD. Aukštas KD ir mišrios demencijos paplitimas buvo susijęs su kraujagysliniais rizikos veiksniais: smegenų infarktais, IŠL, hipertenzija, lėtine išemine lakūnine būkle. Ankstyvos bendruomeninės intervencijos, kontroliuojant kraujagyslinius rizikos veiksnius, atliekant atrankines kognityvinių sutrikimų patikras bei nukreipiant pacientus į specializuotus Atminties sutrikimų kabinetus turėtų tapti prioritetu KFS prevencijai pagyvenusių žmonių populiacijoje.

Post-mortem assessment in vascular dementia: advances and aspirations.

BackgroundCerebrovascular lesions are a frequent finding in the elderly population. However, the impact of these lesions on cognitive performance, the prevalence of vascular dementia, and the pathophysiology behind characteristic in vivo imaging findings are subject to controversy. Moreover, there are no standardised criteria for the neuropathological assessment of cerebrovascular disease or its related lesions in human post-mortem brains, and conventional histological techniques may indeed be insufficient to fully reflect the consequences of cerebrovascular disease.DiscussionHere, we review and discuss both the neuropathological and in vivo imaging characteristics of cerebrovascular disease, prevalence rates of vascular dementia, and clinico-pathological correlations. We also discuss the frequent comorbidity of cerebrovascular pathology and Alzheimer’s disease pathology, as well as the difficult and controversial issue of clinically differentiating between Alzheimer’s disease, vascular dementia and mixed Alzheimer’s disease/vascular dementia. Finally, we consider additional novel approaches to complement and enhance current post-mortem assessment of cerebral human tissue.ConclusionElucidation of the pathophysiology of cerebrovascular disease, clarification of characteristic findings of in vivo imaging and knowledge about the impact of combined pathologies are needed to improve the diagnostic accuracy of clinical diagnoses.

Discovery of Acupoints and Combinations with Potential to Treat Vascular Dementia: A Data Mining Analysis.

The prevalence of vascular dementia (VaD) is high among the elderly. Acupuncture, a popular therapeutic method in China, can improve memory, orientation, calculation, and self-managing ability in VaD patients. However, in clinical acupuncture and acupuncture research, the selection of acupoints to treat VaD remains challenging. This study aimed to discover acupoints and acupoint combinations with potential for VaD based on data mining. After database searching and screening for articles on clinical trials evaluating the effects of acupuncture on VaD, 238 acupuncture prescriptions were included for further analysis. Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Shuigou (GV 26), and Shenting (GV 24) appeared most frequently in the modern literature and are potential acupoints for VaD. Combinations between Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Shenting (GV 24), Shuigou (GV 26), and Zusanli (ST 36) were most frequent and represent potential combinations for VaD treatment. These results provide a reference for the selection and combination of acupoints to treat VaD in clinical acupuncture and acupuncture research.

Vascular Cognitive Disorders and Depression After First-Ever Stroke: The Fogarty-Mexico Stroke Cohort

Background and Purpose: Stroke is the major cause of vascular behavior and cognitive disorders worldwide. In developing countries, there is a dearth of information regarding the public health magnitude of stroke. The aim of the Fogarty-Mexico cohort was to assess the prevalence of vascular behavioral and cognitive disorders, ranging from mild vascular cognitive impairment (VCI) to vascular dementia (VaD), in a cohort of acute first-ever symptomatic stroke patients in Mexico. Methods: A total of 165 consecutive, first-ever stroke patients admitted to the National Institute of Neurology and Neurosurgery in Mexico City, were included in the cohort. Patients were eligible if they had an ischemic stroke, primary intracerebral hemorrhage, or cerebral venous thrombosis (CVT). Stroke diagnosis required the presence of an acute focal deficit lasting more than 24 h, confirmed by a corresponding lesion on CT/MRI. Stroke severity was established with the NIH Stroke Scale. The pre-stroke functional status was determined by the IQCODE. Three months after the occurrence of stroke, 110 survivor patients returned for follow-up and were able to undergo functional outcome (modified Rankin scale, Barthel index), along with neurological, psychiatric, neuropsychological, laboratory, and imaging assessments. We compared depression, demographic, and clinical and imaging features between patients with and without dementia, and between patients with VCI and those with intact cognition. Results: Of the 110 patients (62% men, mean age 56 ± 17.8, education 7.7 ± 5.2 years) 93 (84%) had ischemic strokes, 14 (13%) intracerebral hemorrhage, and 3 (3%) CVT. The main risk factors were hypertension (50%), smoking (40%), hypercholesterolemia (29%), hyperhomocysteinemia (24%), and diabetes (22%). Clinical and neuropsychological evaluations demonstrated post-stroke depression in 56%, VCI in 41%, and VaD in 12%; 17% of the latter had pre-stroke functional impairment (IQCODE >3.5). Cognitive deficits included executive function in 69%, verbal memory in 49%, language in 38%, perception in 36%, and attention in 38%. Executive dysfunction occurred in 36% of non-demented subjects, 65% of them with mild-moderate deficits in daily living activities. Female gender (p ≤ 0.054), older age (mean age 65.6 years vs. 49.3, p < 0.001), diabetes (p ≤ 0.004), illiteracy and lower education (p ≤ 0.001), and PSD (p = 0.03) were significantly higher in VCI-VaD compared with cognitively intact post-stroke subjects. We could not demonstrate an association with lesion site and distribution of the cognitive deficits. Conclusions: The Fogarty-Mexico cohort recruited relatively young acute stroke patients, compared with other Mexican stroke cohorts. PSD and VCI occurred frequently but prevalence of VaD (12%) was lower than expected. A high prevalence of treatable stroke risk factors suggests that preventive interventions are advisable.

Nutrition and vascular dementia.

The objective of this review was to elucidate the relationship between VaD and various nutritional factors based on epidemiological studies. Vascular dementia (VaD) is the second most common type of dementia. The prevalence of VaD continues to increase as the US population continues to grow and age. Currently, control of potential risk factors is believed to be the most effective means of preventing VaD. Thus, identification of modifiable risk factors for VaD is crucial for development of effective treatment modalities. Nutrition is one of the main modifiable variables that may influence the development of VaD. A systematic review of literature was conducted using the PubMed, Web of Science, and CINAHL Plus databases with search parameters inclusive of vascular dementia, nutrition, and vascular cognitive impairment (VCI). Fourteen articles were found that proposed a potential role of specific nutritional components in VaD. These components included antioxidants, lipids, homocysteine, folate, vitamin B12, and fish consumption. Antioxidants, specifically Vitamin E and C, and fatty fish intake were found to be protective against VaD risk. Fried fish, elevated homocysteine, and lower levels of folate and vitamin B12 were associated with increased VaD. Evidence for dietary lipids was inconsistent, although elevated midlife serum cholesterol may increase risk, while late-life elevated serum cholesterol may be associated with decreased risk of VaD. Currently, the most convincing evidence as to the relationship between VaD and nutrition exists for micronutrients, particularly Vitamin E and C. Exploration of nutrition at the macronutrient level and additional long term prospective cohort studies are warranted to better understand the role of nutrition in VaD disease development and progression. At present, challenges in this research include limitations in sample size, which was commonly cited. Also, a variety of diagnostic criteria for VaD were employed in the studies reviewed, indicating the need for constructing a correct nosological definition of VaD for consistency and conformity in future studies and accurate clinical diagnosis of VaD.

The cohort study of dementia: the Hisayama study

An accurate population-based cohort study of dementia was begun in 1985 in the town of Hisayama, Japan. To examine secular trends in the prevalence of dementia and its subtypes, four cross-sectional surveys were conducted among Hisayama residents aged 65 years or older in 1985, 1992, 1998, and 2005. The prevalence of Alzheimer's disease (AD) significantly increased with time, while the prevalence of vascular dementia (VaD) decreased from the 1985 survey to the 1998 survey and then increased in the 2005 survey. In a 17-year prospective study of a total of 668 elder residents without dementia, elevated midlife and late-life blood pressure were significant risk factors for the late-life onset of VaD, but not for that of AD. A 15-year prospective study of 1,017 elder subjects, who underwent a 75-g oral glucose tolerance test, revealed that the age- and sex-adjusted incidence of VaD and AD significantly increased in subjects with diabetes than in those with normal glucose tolerance. Moreover, 2-hour post-load plasma glucose levels were closely associated with increased risk of VaD and AD. In a pathological study of Hisayama residents, higher levels of 2-hour post-load plasma glucose, fasting insulin, and HOMA-IR were significantly associated with increased likelihood of neuritic plaques.

Aspectos de comorbilidad en pacientes ancianos con demencia. Diferencias por edad y género

Prevalence of dementia in elderly patients is high. The goal of the study was to assess some aspects of comorbidity in the patients with dementia. We also analyzed comorbidity differences according to age and gender. A total of 311 patients older than 64 years old with dementia were prospectively evaluated. Data were collected on sociodemographic endpoints, type of dementia, Barthel Index (BI), Lawton Index (LO), Mini-Mental State Examination (MMSE), Charlson Index, total number of drugs, history of high blood pressure (HT), diabetes (DM), dyslipidemia (DL), heart failure (HF), chronic obstructive pulmonary disease (COPD) and cancer. The sample consisted of 222 women (71.4%) and 89 men. Mean age (standard deviation [SD]) was 80.6 (6) years. Patients were taking an average of 5.8 (2.6) drugs. The mean of Charlson Index was of 2.1 (1.3). Fifty-one percent had HT, 24% DM, 24% DL, 13% HF, 11% COPD and 8% cancer. We found better scores in the MMSE, higher comorbidity and percentage of married people and prevalence of vascular dementia in men with respect to women, who had higher percentage of Alzheimer disease, and widowers. When differences were analyzed according to age, we found a higher percentage of widowers and HF diagnosis, a lower LI values and DL percentage in the patients older than 84 years with respect to younger subjects. Our results showed the presence of high comorbidity and chronic drugs prescription in elderly people with dementia. There are some differences in comorbidity according to age and gender that must be taken into account.

The prevalence of dementia in the People's Republic of China: a systematic analysis of 1980–2004 studies

Dementia has been a major public health problem. However, there has not yet been a nationwide investigation or systematic analysis of the prevalence of dementia in China from 1980 to 2004. The aim of this study was to analyse the prevalence of dementia and its major subtypes [Alzheimer disease (AD), vascular dementia (VD)] among the population aged 60 years and older in China from 1980 to 2004. Epidemiological investigations on dementia in China published in journals and covering the period from 1980 to 2004 were identified manually and on-line by using CBMDISK, Chongqing VIP database and CNKI database. Those reported in English journals were identified using MEDLINE. Selected studies had to describe an original study defined by strict screening and diagnostic criteria. The fixed effects model or random effects model was employed according to statistical test for homogeneity. Twenty-five studies were selected, the statistical information of which was collected for systematic analysis. Our results showed that AD and VD were the two major subtypes of dementia in China, and the pooled prevalence of AD and VD for the population aged 60 years and older was 1.6 and 0.8%, respectively. There was a higher prevalence of AD in the illiterate elderly population (3.2%) than in those who received years of education. The chronological prevalence of AD increased significantly from 1980 to 2004. In southern and northern China, the prevalence of AD was 2.0 and 1.2%, respectively, while VD was 0.6 and 1.1%, respectively. In the last 24 years, AD and VD were the two major subtypes of dementia in China. The prevalence of AD may be affected by sex, education, occupation or age. The prevalence of VD, which was higher in northern than in southern China, seems not to be affected by age, sex or education.

Prevalence of Dementia Subtypes in El Prat de Llobregat, Catalonia, Spain: The PRATICON Study

Background: Studies on dementia subtypes show a wide variation in the prevalence of Alzheimer’s disease (AD) and vascular dementia (VD) worldwide. However, studies reporting on Lewy body dementia (LBD) and frontotemporal dementia (FTD) are sparse. Aims: To describe the prevalence ofdementia and subtypes. Method: A 34% sample of 5,150 subjects aged 70 years and over in El Prat de Llobregat (Barcelona) were screened by the Mini-Mental State Examination. When scoring <24, participants were assessed to establish a diagnosis. Results: There were 165 subjects diagnosed with dementia (prevalence of 9.4%). Subtypes of dementia were: AD 69.1%, VD 12.7%, LBD 9.1%, FTD 3% and secondary dementia 1.8%. Prevalences were: AD 6.5%, VD 1.2%, LBD 0.9% and FTD 0.3%. Conclusions: AD and VD were the most common type of dementia. Prevalence of dementia, AD and FTD were similar to those reported, while prevalence of VD and LBD were lower.