Dementia before death in ageing societies--the promise of prevention and the reality.

<h4>Background</h4>Dementia and severe cognitive impairment are very closely linked to ageing. The longer we live the more likely we are to suffer from these conditions. Given population increases in longevity it is important to understand not only risk and protective factors for dementi...

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Main Authors: Carol Brayne, Lu Gao, Michael Dewey, Fiona E Matthews, Medical Research Council Cognitive Function and Ageing Study Investigators
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2006-10-01
Series:PLoS Medicine
Online Access:https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0030397&type=printable
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author Carol Brayne
Lu Gao
Michael Dewey
Fiona E Matthews
Medical Research Council Cognitive Function and Ageing Study Investigators
author_facet Carol Brayne
Lu Gao
Michael Dewey
Fiona E Matthews
Medical Research Council Cognitive Function and Ageing Study Investigators
author_sort Carol Brayne
collection DOAJ
description <h4>Background</h4>Dementia and severe cognitive impairment are very closely linked to ageing. The longer we live the more likely we are to suffer from these conditions. Given population increases in longevity it is important to understand not only risk and protective factors for dementia and severe cognitive impairment at given ages but also whether protection affects cumulative risk. This can be explored by examining the effect on cumulative risk by time of death of factors found consistently to reduce risk at particular ages, such as education and social status.<h4>Methods and findings</h4>In this analysis we report the prevalence of dementia and severe cognitive impairment in the year before death in a large population sample. In the Medical Research Council Cognitive Function and Ageing Study (a 10-y population-based cohort study of individuals 65 and over in England and Wales), these prevalences have been estimated by age, sex, social class, and education. Differences have been explored using logistic regression. The overall prevalence of dementia at death was 30%. There was a strong increasing trend for dementia with age from 6% for those aged 65-69 y at time of death to 58% for those aged 95 y and above at time of death. Higher prevalences were seen for severe cognitive impairment, with similar patterns. People with higher education and social class had significantly reduced dementia and severe cognitive impairment before death, but the absolute difference was small (under 10%).<h4>Conclusions</h4>Reducing risk for dementia at a given age will lead to further extension of life, thus cumulative risk (even in populations at lower risk for given ages) remains high. Ageing of populations is likely to result in an increase in the number of people dying with dementia and severe cognitive impairment even in the presence of preventative programmes. Policy development and research for dementia must address the needs of individuals who will continue to experience these conditions before death.
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spelling doaj-art-2b0f0ef767444eb4b6ae559e78daf70c2025-08-20T02:02:44ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762006-10-01310e39710.1371/journal.pmed.0030397Dementia before death in ageing societies--the promise of prevention and the reality.Carol BrayneLu GaoMichael DeweyFiona E MatthewsMedical Research Council Cognitive Function and Ageing Study Investigators<h4>Background</h4>Dementia and severe cognitive impairment are very closely linked to ageing. The longer we live the more likely we are to suffer from these conditions. Given population increases in longevity it is important to understand not only risk and protective factors for dementia and severe cognitive impairment at given ages but also whether protection affects cumulative risk. This can be explored by examining the effect on cumulative risk by time of death of factors found consistently to reduce risk at particular ages, such as education and social status.<h4>Methods and findings</h4>In this analysis we report the prevalence of dementia and severe cognitive impairment in the year before death in a large population sample. In the Medical Research Council Cognitive Function and Ageing Study (a 10-y population-based cohort study of individuals 65 and over in England and Wales), these prevalences have been estimated by age, sex, social class, and education. Differences have been explored using logistic regression. The overall prevalence of dementia at death was 30%. There was a strong increasing trend for dementia with age from 6% for those aged 65-69 y at time of death to 58% for those aged 95 y and above at time of death. Higher prevalences were seen for severe cognitive impairment, with similar patterns. People with higher education and social class had significantly reduced dementia and severe cognitive impairment before death, but the absolute difference was small (under 10%).<h4>Conclusions</h4>Reducing risk for dementia at a given age will lead to further extension of life, thus cumulative risk (even in populations at lower risk for given ages) remains high. Ageing of populations is likely to result in an increase in the number of people dying with dementia and severe cognitive impairment even in the presence of preventative programmes. Policy development and research for dementia must address the needs of individuals who will continue to experience these conditions before death.https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0030397&type=printable
spellingShingle Carol Brayne
Lu Gao
Michael Dewey
Fiona E Matthews
Medical Research Council Cognitive Function and Ageing Study Investigators
Dementia before death in ageing societies--the promise of prevention and the reality.
PLoS Medicine
title Dementia before death in ageing societies--the promise of prevention and the reality.
title_full Dementia before death in ageing societies--the promise of prevention and the reality.
title_fullStr Dementia before death in ageing societies--the promise of prevention and the reality.
title_full_unstemmed Dementia before death in ageing societies--the promise of prevention and the reality.
title_short Dementia before death in ageing societies--the promise of prevention and the reality.
title_sort dementia before death in ageing societies the promise of prevention and the reality
url https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0030397&type=printable
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