Dementia affects More than 57 million people worldwide – And this number should only grow. By 2030It is estimated that 78 million people would suffer from dementia. By 2050, it is expected that this number will reach 139 million people.
Despite this, a New surprising study suggested that the risk of dementia has actually decreased at each generation. However, there are good reasons to be skeptical about this observation.
The researchers analyzed the data of 62,437 people aged 70 and over. The data was collected from three longitudinal cohort studies on aging, including one carried out in the WEone in Europe and one of England.
To conduct their analysis, the researchers compared diagnoses of probable dementia of people born in eight different generation cohorts. The inhabitants of the first cohort were born in 1890-1913, while those of the last cohort were born in 1944-1948.
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Researchers used an algorithm that suggests a probable dementia diagnosis. This was based on the demographic characteristics of the participants, as well as on their cognitive performance and their daily operating skills (including the way in which they were able to fulfill daily functions, such as washing and food, and the way in which they remembered many things).
These are standard evaluation tools used in clinical practice to diagnose dementia.
To then validate the projections of the algorithm on the cases of probable dementia, the predictions were compared to a sub-sample of participants from the United States Aging, demography and memory study which had a clinical diagnosis of dementia.
Participants in this study had undergone a rigorous cognitive assessment of three to four hours. The algorithm used to create dementia projections has shown an agreement of more than 85% with the clinical diagnostic data of this sub-sample data.
Once the status of dementia is calculated, the authors calculated two models to determine the relationship between age, cohort and the start of dementia. They also included gross domestic product (GDP) in their analyzes, because there is a correlation between GDP and health – with research showing that residents of high -income countries tend to be healthier than those who live in low -income nations.
Their results revealed that dementia decreased for each subsequent generation. For example, in the United States, the algorithm said that 25% of people born between 1890-1912 developed dementia, while only 15% of people born in the most recent cohort (1939-1943) developed dementia.
In England, almost 16% of people born between 1924 and 28 were triggered by dementia, against around 15% in people born between 1934 and 38. This effect was also apparently more pronounced for women than for men.
We still do not know why dementia cases have dropped in generations, more recent cohorts having a reduction in dementia.
Projected diagnostics
What does that mean? And how does that do Compare with existing projections?
While the authors used a large sample of three aging cohorts of research established, the results are based solely on high -income countries.
It is well known that dementia can be better diagnosed and neat In high -income countries, where there are more health and more and more health services. Dementia is extremely stigmatized in low and intermediate income countries. As a result, many people are not as aware dementia as people living in high income companies.
This means that people in low -income countries can know less about the associated risk factors of dementia and are less likely to receive a diagnosis and support. This is particularly relevant since Most people with resident dementia in low and intermediate income countries.
With a lack of cohort data on the elderly and cases of dementia in low and intermediate income countries, the results of this study do not provide representative projections on dementia diagnostics worldwide.
It is also important to consider the methods used by the authors in their study. The authors used a prediction model. Although this model has a high agreement with the clinical diagnosis, there are still cases of dementia that will have been missed accordingly.
Likewise, the authors did not distinguish between the dementia subtypes in their modeling. Dementia is just a umbrella term. About 60 to 70% Dementia cases are actually Alzheimer’s disease.
But there are also many Rarer subtypes – like the dementia of Lewy’s body or semantic dementia. Each subtype brings different symptoms. It is unlikely that a generic model properly picks up each case of dementia subtype.
All of these factors can possibly explain how the study has reached their conclusions.
Dementia cases in the world are in fact planned to increase. As such, the results of this study must be taken into account with caution. The prevalence of dementia should not continue to fall for generations born more recently.
Part of the reason for these projections is due to the fact that people live longer and age. Dementia mainly affects people over the age of 65, so with more people living at over 65, it means that more people risk developing disorder.
The world’s population also increases. So, of course, we will see more people living with dementia – especially in low and intermediate income countries, where people can have less knowledge of dementia symptoms and can be less able to treat the Modifiable risk factors linked to a higher risk due to poor health infrastructure.
We know that overall, people from more disadvantaged socio-economicly backgrounds greater health inequalities – and these health inequalities can contribute to increased risk of dementia.
But as this factor has not been taken into account in the study, it is difficult to know if there will be really differences in the planned number of dementia in young generations.
Clarissa GiebelPrincipal researcher at the Institute of Population Health, Nihr Applied Research Collaboration North West Coast, University of Liverpool
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