This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (150)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Alzheimer Disease  • Dementias  • Evidence-Based Medicine  • Alert me on articles by topic

A Meta-analysis

Sujuan Gao, PhD; Hugh C. Hendrie, MB, ChB; Kathleen S. Hall, PhD; Siu Hui, PhD

Arch Gen Psychiatry. 1998;55:809-815.

Background  Prevalence studies on dementia and Alzheimer disease (AD) have reported a positive association with age. However, the trend of the association in the oldest-old categories has been the subject of discussion. The relationship between sex and AD has been inconsistent with these studies. Prevalence rates are influenced by the survival and disease incidence. Incidence rates provide a better measure of disease risk.

Methods  English-language articles identified through a MEDLINE search on "incidence dementia" and "incidence Alzheimer's disease" were examined and references from identified articles were reviewed. Population-based studies using personal interviews, standard clinical diagnosis criteria (DSM-III for dementia, National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorder Association for AD) and reporting age-specific incidence rates were included in the meta-analysis. Data from the selected studies were extracted and verified. Mixed-effect models were used in the meta-analysis to accommodate the heterogeneity of the studies.

Results  Incident dementia and AD are associated with a significant quadratic age effect indicating that the increase in incidence rates slows down with the increase in age, although there is no sign of a decline in the incidence rates themselves. The odds ratios for women to develop incidence of dementia and AD relative to men are 1.18 (95% confidence interval, 0.95-1.46) and 1.56 (95% confidence interval, 1.16-2.10), respectively.

Conclusions  The acceleration of incidence rates for AD and dementia slows down with the increase in age, although we find no evidence of a rate decline. Women are at higher risk of developing AD than men.

From the Departments of Medicine (Drs Gao and Hui) and Psychiatry (Drs Hendrie and Hall), Indiana University School of Medicine, Indianapolis.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Increased Frequency of Learning Disability in Patients With Primary Progressive Aphasia and Their First-Degree Relatives
Rogalski et al.
Arch Neurol 2008;65:244-248.
ABSTRACT | FULL TEXT  

Clinical predictors of progression to Alzheimer disease in amnestic mild cognitive impairment
Fleisher et al.
Neurology 2007;68:1588-1595.
ABSTRACT | FULL TEXT  

Estrogen, Menopause, and the Aging Brain: How Basic Neuroscience Can Inform Hormone Therapy in Women
Morrison et al.
J. Neurosci. 2006;26:10332-10348.
FULL TEXT  

Dementia-free survival among centenarians: an evidence-based review.
Calvert et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2006;61:951-956.
ABSTRACT | FULL TEXT  

Lessons Learned From International Comparative Crosscultural Studies on Dementia.
Hendrie
AJGP 2006;14:480-488.
ABSTRACT | FULL TEXT  

Familial risk for Alzheimer's disease alters fMRI activation patterns
Bassett et al.
Brain 2006;129:1229-1239.
ABSTRACT | FULL TEXT  

The different paths to 100
Perls
Am. J. Clin. Nutr. 2006;83:484S-487S.
ABSTRACT | FULL TEXT  

A unique gene expression signature discriminates familial Alzheimer's disease mutation carriers from their wild-type siblings
Nagasaka et al.
Proc. Natl. Acad. Sci. USA 2005;102:14854-14859.
ABSTRACT | FULL TEXT  

Dementia incidence may increase more slowly after age 90: Results from the Bronx Aging Study
Hall et al.
Neurology 2005;65:882-886.
ABSTRACT | FULL TEXT  

Participation in Novelty-Seeking Leisure Activities and Alzheimer's Disease
Fritsch et al.
J Geriatr Psychiatry Neurol 2005;18:134-141.
ABSTRACT  

Meta-Analysis of the Association of the Cathepsin D Ala224Val Gene Polymorphism with the Risk of Alzheimer's Disease: A HuGE Gene-Disease Association Review
Ntais et al.
Am J Epidemiol 2004;159:527-536.
ABSTRACT | FULL TEXT  

Gender, cognitive decline, and risk of AD in older persons
Barnes et al.
Neurology 2003;60:1777-1781.
ABSTRACT | FULL TEXT  

People with Dementia in a Rural Community: Issues of Prevalence and Community Care Policy
Gilmour et al.
Dementia 2003;2:245-263.
ABSTRACT  

Sex Differences in the Risk of Schizophrenia: Evidence From Meta-analysis
Aleman et al.
Arch Gen Psychiatry 2003;60:565-571.
ABSTRACT | FULL TEXT  

Estrogen and Cognitive Functioning in Women
Sherwin
Endocr. Rev. 2003;24:133-151.
ABSTRACT | FULL TEXT  

White Matter Structural Integrity in Healthy Aging Adults and Patients With Alzheimer Disease: A Magnetic Resonance Imaging Study
Bartzokis et al.
Arch Neurol 2003;60:393-398.
ABSTRACT | FULL TEXT  

Familial Patterns of Risk in Very Late-Onset Alzheimer Disease
Silverman et al.
Arch Gen Psychiatry 2003;60:190-197.
ABSTRACT | FULL TEXT  

Racial Differences in the Diagnosis of Dementia and in Its Effects on the Use and Costs of Health Care Services
Husaini et al.
Psychiatr. Serv. 2003;54:92-96.
ABSTRACT | FULL TEXT  

Coffee Consumption and Cognitive Function among Older Adults
Johnson-Kozlow et al.
Am J Epidemiol 2002;156:842-850.
ABSTRACT | FULL TEXT  

The Role of Hormone Replacement Therapy in the Prevention of Alzheimer Disease
Fillit
Arch Intern Med 2002;162:1934-1942.
ABSTRACT | FULL TEXT  

Primary care expenditures before the onset of Alzheimer's disease
Albert et al.
Neurology 2002;59:573-578.
ABSTRACT | FULL TEXT  

Alzheimer Disease
Cummings and Cole
JAMA 2002;287:2335-2338.
FULL TEXT  

Independent Predictors of Cognitive Decline in Healthy Elderly Persons
Marquis et al.
Arch Neurol 2002;59:601-606.
ABSTRACT | FULL TEXT  

Incidence of AD may decline in the early 90s for men, later for women: The Cache County study
Miech et al.
Neurology 2002;58:209-218.
ABSTRACT | FULL TEXT  

Risk of Dementia Among White and African American Relatives of Patients With Alzheimer Disease
Green et al.
JAMA 2002;287:329-336.
ABSTRACT | FULL TEXT  

Predictors of Healthy Brain Aging
McNeal et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2001;56:B294-301.
ABSTRACT | FULL TEXT  

Advising relatives of risk of Alzheimer's diseaseAuthors' reply
Blansjaar et al.
Br. J. Psychiatry 2001;179:73-74.
FULL TEXT  

Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology
Petersen et al.
Neurology 2001;56:1133-1142.
ABSTRACT | FULL TEXT  

Early-onset Alzheimer's disease in Scotland: environmental and familial factors
WHALLEY
Br. J. Psychiatry 2001;178 :s53-s59.
ABSTRACT | FULL TEXT  

Incidence of Dementia and Alzheimer Disease in 2 Communities: Yoruba Residing in Ibadan, Nigeria, and African Americans Residing in Indianapolis, Indiana
Hendrie et al.
JAMA 2001;285:739-747.
ABSTRACT | FULL TEXT  

Is the Risk of Developing Alzheimer's Disease Greater for Women than for Men?
Hebert et al.
Am J Epidemiol 2001;153:132-136.
ABSTRACT | FULL TEXT  

Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan
Tang et al.
Neurology 2001;56:49-56.
ABSTRACT | FULL TEXT  

Risk factors for dementia
McCullagh et al.
Adv. Psychiatr. Treat. 2001;7:24-31.
FULL TEXT  

Childhood mental ability and dementia
Whalley et al.
Neurology 2000;55:1455-1459.
ABSTRACT | FULL TEXT  

The biphasic pattern of age-specific malignant brain tumor mortality rates
Riggs
Neurology 2000;55:750-753.
ABSTRACT | FULL TEXT  

Prevalence of AD among whites: A summary by levels of severity
Hy and Keller
Neurology 2000;55:198-204.
ABSTRACT | FULL TEXT  

The incidence of dementia in Canada
Neurology 2000;55:66-73.
ABSTRACT | FULL TEXT  

Ten-year incidence of dementia in a rural elderly US community population: The MoVIES Project
Ganguli et al.
Neurology 2000;54:1109-1116.
ABSTRACT | FULL TEXT  

In Vivo Evaluation of Brain Iron in Alzheimer Disease Using Magnetic Resonance Imaging
Bartzokis et al.
Arch Gen Psychiatry 2000;57:47-53.
ABSTRACT | FULL TEXT  

Other Articles Noted
Evid. Based Nurs. 1999;2:105-112.
FULL TEXT  

APOE-{epsilon}4 count predicts age when prevalence of AD increases, then declines: The Cache County Study
Breitner et al.
Neurology 1999;53:321-321.
ABSTRACT | FULL TEXT  

Review: incidence of dementia and Alzheimer's disease increases with increasing age
Hatcher
Evid. Based Ment. Health 1999;2:60-60.
FULL TEXT  

Neurosyphilis in Elderly Patients
Castilla-Guerra et al.
J. Neuropsychiatry Clin. Neurosi. 1999;11:287-287.
FULL TEXT  

Women Are at Higher Risk for Alzheimer's
JWatch Women's Health 1998;1998:14-14.
FULL TEXT