Impact of interventions to reduce Alzheimer's disease pathology on the prevalence of dementia in the oldest-old

Ron Brookmeyer; Claudia H Kawas; Nada Abdallah; Annlia Paganini-Hill; Ronald C Kim; María M Corrada

doi:10.1016/j.jalz.2016.01.004

Impact of interventions to reduce Alzheimer's disease pathology on the prevalence of dementia in the oldest-old

Alzheimers Dement. 2016 Mar;12(3):225-32. doi: 10.1016/j.jalz.2016.01.004. Epub 2016 Feb 17.

Authors

Ron Brookmeyer¹, Claudia H Kawas², Nada Abdallah³, Annlia Paganini-Hill⁴, Ronald C Kim⁵, María M Corrada⁶

Affiliations

¹ Department of Biostatistics, University of California, Los Angeles, CA, USA. Electronic address: rbrookmeyer@ucla.edu.
² Department of Neurology, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.
³ Department of Biostatistics, University of California, Los Angeles, CA, USA.
⁴ Department of Neurology, University of California, Irvine, CA, USA.
⁵ Department of Pathology, University of California, Irvine Medical Center, Orange, CA, USA.
⁶ Department of Neurology, University of California, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Epidemiology, University of California, Irvine, CA, USA.

Abstract

Introduction: The number of persons aged >90 years will grow significantly in coming decades. This group has the highest rates of dementia, most commonly Alzheimer's disease (AD).

Methods: Using The 90+ Study, we developed a statistical model for dementia risk based on brain pathologies. Intervention scenarios which reduce or eliminate AD pathology were considered, and the numbers of dementia cases among the U.S. oldest-old that could be prevented were estimated.

Results: The U.S. dementia prevalence among the oldest-old will increase from 1.35 million in 2015 to 4.72 million in 2050. If interventions eliminate AD pathology, dementia prevalence would be reduced by approximately 50%, averting nearly 2.4 million cases in 2050. However, large numbers of dementia cases would still remain.

Discussion: Reducing AD pathology would significantly decrease the public health burden of dementia. However, other interventions are needed to address the burden associated with other dementing pathologies prevalent in the oldest-old.

Keywords: Alzheimer's disease; Dementia; Intervention; Oldest-old; Pathology; Prediction; Prevalence; Prevention.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged, 80 and over
Aging / pathology*
Alzheimer Disease / epidemiology*
Alzheimer Disease / pathology*
Dementia / epidemiology*
Female
Humans
Longitudinal Studies
Male
Odds Ratio
Prevalence
United States / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding