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One in Seven Older Adults Has Dementia


Approximately one in seven, or 3.4 million, Americans age 71 and older has dementia, and 2.4 million have Alzheimer’s disease, according to a new analysis supported by the National Institutes of Health (NIH). It is the latest in a series of analyses attempting to assess the prevalence of dementia and Alzheimer’s, the most common form of dementia.


One in Seven Older Adults Has Dementia

Approximately one in seven, or 3.4 million, Americans age 71 and older has dementia, and 2.4 million have Alzheimer’s disease, according to a new analysis supported by the National Institutes of Health (NIH). It is the latest in a series of analyses attempting to assess the prevalence of dementia and Alzheimer’s, the most common form of dementia.

The study is the first to estimate rates of dementia and Alzheimer’s using a nationally representative sample of older adults across the United States.

Brenda Plassman, PhD, of Duke University Medical Center, in Durham, NC, worked with Kenneth Langa, MD, PhD, and David Weir, PhD, of the University of Michigan, in Ann Arbor; Robert Wallace, PhD, of the University of Iowa, in Iowa City; and others to conduct the analysis as part of the Aging, Demographics and Memory Study, which is a substudy of the Health and Retirement Study (HRS).

HRS is the leading resource for data on the combined health and economic circumstances of Americans over age 50. The substudy and HRS are sponsored by the National Institute on Aging (NIA) under a cooperative agreement with the University of Michigan.

The study highlights the nationwide reach of dementia, which affects not only those with the disease but their families and communities as well.

“As the population ages during the next few decades, the prevalence of Alzheimer’s will increase several-fold unless effective interventions are discovered and implemented,” said NIA director Richard Hodes, MD. “These data underscore the urgency of research in this area.”

The study included 856 HRS participants age 71 and older from 42 states in 2001-2003. Duke researchers conducted home evaluations to gather information about each participant’s cognitive and functional status and symptoms, neuropsychiatric symptoms, medications, medical history, and family history of memory problems. Prior neuroimaging and laboratory results also were obtained.

A team of clinicians reviewed the evaluation information and made a preliminary assessment of cognitive status. A consensus panel of medical experts used diagnostic criteria to determine if the participant had normal cognitive function, cognitive impairment without dementia, or dementia. The criteria also were used to discern the type of dementia, such as Alzheimer’s or vascular dementia, the second most common cause of dementia in older adults.

Based on the experts’ classifications, the researchers estimated the national prevalence and total numbers of people age 71 and older, by age group, with any dementia and with Alzheimer’s or vascular dementia. They determined that 13.9 percent of Americans age 71 and older have some type of dementia, 9.7 percent of people in that age group have Alzheimer’s, and 2.4 percent have vascular dementia. Alzheimer’s accounted for about 70 percent of all dementia cases among people 71 and older.

The substudy analysis showed that the prevalence of dementia increases significantly with age: 5 percent for ages 71-79, 24.2 percent for ages 80-89, and 37.4 percent for 90 or older. The estimated rate of Alzheimer’s also rose greatly with older age, from 2.3 percent for ages 71-79 to 18.1 percent for ages 80 to 89 and 29.7 percent for age 90 and older.

Fewer years of education and the presence of at least one APOE e4 allele, a genetic risk factor for Alzheimer’s, were found to be strong predictors of dementia.

The substudy data will be valuable in assessing the impact of dementia, said Richard Suzman, PhD, director of the NIA Behavioral and Social Research Program, which jointly directs the HRS. The information about the health, economic and family resources of individuals in the study “will help us to characterize more fully the burden of dementia on individuals, caregivers and the nation’s health care system.”

Previous studies included lower age ranges than the substudy, broader characterizations of dementia, or participants in a specific community as a base for national extrapolations. A 1998 study combined data from four community-based studies, estimating that the national prevalence of Alzheimer’s in individuals age 60 or older would rise from 2.3 million in 1997 to 8.6 million in 2047.2 Widely cited estimates based on the prevalence of Alzheimer’s in a Chicago-based community and an earlier comparable study using data from East Boston forecast the number of those age 65 or older with Alzheimer’s to be 5.1 million in 2010.3,4

References

1.Plassman, B.L., et al. (2007). Prevalence of dementia in the United States: The Aging, Demographics and Memory Study. Neuroepidemiology, 29: 125-32.

2.Brookmeyer, R., et al. (1998). Projections of Alzheimer’s disease in the United States and the public health impact of delaying disease onset. American Journal of Public Health, 88: 1337-42.

3.Hebert, L.E., et al. (2003). Alzheimer disease in the U.S. population. Archives of Neurology, 60: 1119-22.

4.Evans, D.A., et al. (1990). Estimated prevalence of Alzheimer’s disease in the United States. Milbank Quarterly, 68: 267-89.

 

Catching the first signs of dementia (Alzheimer’s)

Looking back, there is little doubt in my mind that if I had had the proper education or information I would have realized my mother was suffering from dementia sooner. Most people like me tend to ignore the symptoms at first believing they are simply signs of “old age”. Anyone who ends up in my shoes knows and understands that a person in the early stages of dementia or Alzheimer’s can function with normality–even drive a car. It is not until they deteriorate or until some “event” takes place that we wake up to reality.

The basic underlying premise in this article is that behavior changes slowly in the elderly and if they begin to suffer cognitive impairment it will be evidenced in behavioral changes. Sometimes these changes can be quite subtle but if detected could raise a “red flag”.

If my mother had been enrolled in any of these studies I feel certain she would have been diagnosed with dementia sooner. This would have allowed me to get her in an exercise program, get her proper nutrition, and insure that she was taking her medicines as prescribed. I learned in the last three years how important these three factors are in the quality of her life.

My mother (in the photo) turned 91 years old in June and she suffers from Alzheimer’s disease. I am her CarGiver.

Sensors could help catch first signs of dementia
Monitors and online tests track subtle changes in daily mobility, behavior

Source Associated Press and MSNBC

WASHINGTON – Tiny motion sensors are attached to the walls, doorways and even the refrigerator of Elaine Bloomquist’s home, tracking the seemingly healthy 86-year-old’s daily activity.

It’s like spying in the name of science — with her permission — to see if round-the-clock tracking of elderly people’s movements can provide early clues of impending Alzheimer’s disease.

“Now it takes years to determine if someone’s developing dementia,” laments Dr. Jeffrey Kaye of Oregon Health & Science University, which is placing the monitors in 300 homes of Portland-area octogenarians as part of a $7 million federally funded project.

The goal: Shave off that time by spotting subtle changes in mobility and behavior that Alzheimer’s specialists are convinced precede the disease’s telltale memory loss.

Simple early signs

Early predictors may be as simple as variations in speed while people walk their hallways, or getting slower at dressing or typing. Also under study are in-home interactive “kiosks” that administer monthly memory and cognition tests, computer keyboards bugged to track typing speed, and pill boxes that record when seniors forget to take their medicines.

More than 5 million Americans, and 26 million people worldwide, have Alzheimer’s, and cases are projected to skyrocket as the population ages. Today’s medications only temporarily alleviate symptoms. Researchers are desperately hunting new ones that might at least slow the relentless brain decay if taken very early in the disease, before serious memory problems become obvious.

So dozens of early diagnosis methods also are under study, from tests of blood and spinal fluid to MRI scans of people’s brains. Even if some pan out, they’re expensive tests that would require lots of doctor intervention, when getting someone to visit a physician for suspicion of dementia is a huge hurdle. And during routine checkups, even doctors easily can miss the signs.

Bloomquist, of Milwaukie, Ore., knows the conundrum all too well. She volunteered for Kaye’s research because her husband died of Alzheimer’s, as did his parents and her own mother.

“It’s hard to know when people begin Alzheimer’s,” she reflects. “Alzheimer people do very well socially for short periods of time. If it’s just a casual conversation, they rise to the occasion.”

‘Typical’ days monitored

Measuring how people fare at home — on bad days as well as good ones, not just when they’re doing their best for the doctor — may spot changes that signal someone’s at high risk long before they’re actually demented, Kaye told the Alzheimer’s Association’s international dementia-prevention meeting last week.

“If you only assess them every once-in-a-blue-moon, you really are at a loss to know what they are like on a typical day,” Kaye explains.

High-tech monitors under study:

Researchers at New York’s Mount Sinai School of Medicine are heading a study that ultimately plans to recruit 600 people over age 75 to help test in-home “kiosks” that turn on automatically to administer monthly cognitive exams. A video of a smiling scientist appears on-screen to talk participants through such classic tests as reading a string of words and then, minutes later, repeating how many they recall, or seeing how quickly they complete connect-the-dot patterns.
An Oregon pilot study of the motion sensors tracked 14 participants in their upper 80s for almost a year. Half had “mild cognitive impairment,” an Alzheimer’s precursor, and half were healthy. Impaired participants showed much greater variation in such day-to-day activities as walking speed, especially in the afternoons.

Why? The theory is that as Alzheimer’s begins destroying brain cells, signals to nerves may become inconsistent — like static on a radio — well before memories become irretrievable. One day, signals to walk fire fine. The next, those signals are fuzzy and people hesitate, creating wildly varying activity patterns.

Study receives unique grant

The pilot study prompted a first-of-its-kind grant from the National Institutes of Health to extend the monitoring study to 300 homes; 112 are being monitored already, mostly in retirement communities like Bloomquist’s. They’re given weekly health questionnaires to make sure an injury or other illness that affects activity doesn’t skew the results.

In addition, participants receive computer training so they can play brain-targeted computer games and take online memory and cognition tests. The keyboards are rigged to let researchers track changes in typing speed and Internet use that could indicate confusion.

Finally, a souped-up pill dispenser called the MedTracker is added to some of the studies, wirelessly recording when drugs are forgotten or taken late.
Electronics giants already sell various medical warning technologies for the elderly, including dementia patients, such as pill boxes that sound reminder alarms at dose time. And the Alzheimer’s Association and Intel Corp. are jointly funding research into how to use television, cell phones and other everyday technology to do such things as guide dementia patients through daily activities.

The next step of companies selling early symptom monitoring isn’t far off, and unbiased data on what really helps will be crucial, Kaye warns.

 
 
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