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Epidemiology of Dementia in Canada: Information from the Canadian Study of Health and Aging

Epidemiology of Dementia in Canada: Information from the Canadian Study of Health and Aging. Prevalence of Dementia Canada 1991-92. Rate per 1,000. Source: Can Med Assoc J 1994;150:899-913. Prevalence of Cognitive Disorder by severity and gender, ages 65+.

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Epidemiology of Dementia in Canada: Information from the Canadian Study of Health and Aging

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  1. Epidemiology of Dementia in Canada:Information from the Canadian Study of Health and Aging

  2. Prevalence of DementiaCanada 1991-92 Rate per 1,000 Source: Can Med Assoc J 1994;150:899-913

  3. Prevalence of Cognitive Disorderby severity and gender, ages 65+ Cognitively Cog. Dementia normal Impaired Mild Mod. Severe Male % 72.6 21.3 2.1 2.6 1.4 Female % 77.1 13.5 2.4 3.6 3.5 M + F % 75.2 16.8 2.3 3.1 2.6 Source: Lancet 1997;349:1793

  4. Prevalence of Cognitive Disorderby severity and age Cognitively Impaired Dementia normal Mild Mod. Severe 65-74 % 86.6 11.0 1.0 0.9 0.5 75-84 % 64.7 24.0 3.4 4.6 3.2 85+ % 35.0 30.3 7.2 12.9 14.6

  5. Estimated Numbers of Canadians, 65+, with Dementia, 1991 Source: Can Med Assoc J 1994;150:899-913

  6. Projected Prevalence of Dementia (x 1,000)Canada, 1991 - 2031 All Dementias AD x 3 x 2 Vascular

  7. Age-Specific Incidence of Dementia in Canada, per thousand (whole population) Women Men Source: Neurology 2000; 55: 66-73

  8. Annual Numbers of New Cases of DementiaCanada, 1991 85+ 65 - 74 75 - 84 All Ages: 60,150 Source: Neurology 2000; 55: 66-73

  9. Probability of Becoming DementedCanada, 1991 % probability Women Men Undemented at age

  10. Annual Incidence of Dementia in selected studies, by age, per thousand (whole population) CSHA Kungsholmen Bordeaux Rotterdam New York Framigham Mannheim Rochester Turku

  11. Age-Specific Incidence of Alzheimer’s Disease, per thousand E. Boston Bordeaux CSHA Baltimore Framingham Rotterdam Lund

  12. Age-Specific Incidence of Alzheimer’s Disease, per thousand Canada

  13. CSHA Incidence of Alzheimer’s Disease, per thousand (log scale)

  14. Expectation of Life With and Without Dementia: Canadian Women Years undemented demented Age

  15. Expectation of Life With and Without Dementia: Canadian Men Years undemented demented Age

  16. Age-adjusted Mortality Ratios Mortality Ratio Residence Cognitive status Women Men Community Normal 1 1 Impaired 2.17 1.95 Demented 2.67 2.84 Institution Normal 3.06 2.11 Impaired 3.52 3.09 Demented 6.03 5.02 (reference group) Source: Can. J. Public Health 1997;88:303

  17. Progression of Dementia:Survival by Age Category years of survival

  18. Net Annual Costs of Dementia, 1991 cost per No. of Annual net Source patient, $ patients cost x 1,000$ Community 10,100 123,900 1,250,900 - paid services 4,970 123,900 615,200 - unpaid services 5,130 123,900 635,700 Institutions 19,100 114,000 2,177,500 Drugs 240 252,600 60,600 Hospital 0 252,600 0 Diagnosis 250 54,100 13,500 People < 65 yrs 28,100 389,200 Total 3,901,500 Source: CanMedAssocJ 1994;151:1457-64

  19. Dementia and Functional Ability Community Institutions Normal Demented Normal Demented % % % % Good function 65.8 6.6 7.1 0.0 Mild disability 20.2 14.8 10.8 0.3 Moderate 12.1 30.8 39.5 2.5 Severe 1.3 21.2 27.3 12.3 Total disability 0.6 26.5 15.3 84.9

  20. Risk Factors for AD(CSHA-1 Case-Control Study) • One or more relatives with AD: O.R. 2.6 • 0-6 yrs education: O.R. 4.0 • Occupational exposure to glues: O.R. 2.2 • Head injury: O.R. 1.7 • Arthritis: O.R. 0.5 • Use of NSAID drugs: O.R. 0.5 • Age of onset for smokers 80 yrs; nonsmokers 84 yrs. Source: Neurology 1994;44:2073-80

  21. Risk Factors for Alzheimer’s Disease (Cohort Study) OR 95% CI • Any Apolipoprotein E4 3.3 2.0 – 5.4 • 0-8 yrs. education 1.9 1.3 - 2.9 • Head injury 0.6 0.3 - 1.2 • Family history of dementia 1.0 0.6 – 1.8 • Depression 2.8 1.3 - 6.1 • Smoking 1.04 0.6 - 1.8

  22. Risk Factors for Alzheimer’s Disease (continued) OR 95% CI • Vigorous exercise x3 / wk 0.7 0.5 - 1.0 • Use of NSAID drugs 0.7 0.4 – 1.0 • Ulcer 1.8 0.9 - 3.3 • History of hypertension 0.8 0.5 - 1.3

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