A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012
Langa, Kenneth M., Eric Larson, Eileen Crimmins, Jessica Faul, Deborah Levine, Mohammed Kabeto, and David Weir. 2017. "A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012." JAMA Internal Medicine, 177(1): 51-58.
The aging of the US population is expected to lead to a large increase in the number of adults with dementia, but some recent studies in the US and other high-income countries suggest that the age-specific risk of dementia may have declined over the past 25 years. Clarifying current and future population trends in dementia prevalence and risk has important implications for patients, families, and government programs.
Here we compare the prevalence of dementia in the US in 2000 and 2012, using data from the Health and Retirement Study (HRS), a nationally representative, population-based longitudinal survey of individuals in the United States 65 years or older from the 2000 (n = 10,546) and 2012 (n = 10,511) waves of the HRS.
Dementia was identified in each year using HRS cognitive measures and validated methods for classifying self-respondents, as well as those represented by a proxy. Logistic regression was used to identify socioeconomic and health variables associated with change in dementia prevalence between 2000 and 2012.
The study cohorts had an average age of 75.0 in 2000 and 74.8 years in 2012 (P = .24); 58.4% of the 2000 cohort was female compared with 56.3% of the 2012 cohort. Dementia prevalence among those 65 years or older decreased from 11.6% in 2000 to 8.8% (8.6% with age- and sex-standardization) in 2012. More years of education was associated with a lower risk for dementia, and average years of education increased significantly (from 11.8 years to 12.7 years between 2000 and 2012. The decline in dementia prevalence occurred despite a significant age- and sex-adjusted increase between years in the cardiovascular risk profile (eg, prevalence of hypertension, diabetes, and obesity) among older US adults.
The prevalence of dementia in the US declined significantly between 2000 and 2012. An increase in educational attainment was associated with some of the decline in dementia prevalence, but the full set of social, behavioral, and medical factors contributing to the decline is still uncertain. Continued monitoring of trends in dementia incidence and prevalence will be important for better gauging the full future societal impact of dementia as the number of older adults increases in the decades ahead.
Country of focus: United States of America.