Background: Updated information on the epidemiology of dementia due to Alzheimer's disease (AD) is needed to ensure that adequate resources are available to meet current and future healthcare needs. We conducted a systematic review and meta-analysis of the incidence and prevalence of AD. Methods: The MEDLINE and EMBASE databases were searched from 1985 to 2012, as well as the reference lists of selected articles. Included articles had to provide an original population-based estimate for the incidence and/or prevalence of AD. Two individuals independently performed abstract and full-text reviews, data extraction and quality assessments. Random-effects models were employed to generate pooled estimates stratified by age, sex, diagnostic criteria, location (i.e., continent) and time (i.e., when the study was done). Results: Of 16,066 abstracts screened, 707 articles were selected for full-text review. A total of 119 studies met the inclusion criteria. In community settings, the overall point prevalence of dementia due to AD among individuals 60 + was 40.2 per 1000 persons (CI 95% : 29.1-55.6), and pooled annual period prevalence was 30.4 per 1000 persons (CI 95% : 15.6-59.1). In community settings, the overall pooled annual incidence proportion of dementia due to AD among individuals 60 + was 34.1 per 1000 persons (CI 95% : 16.4-70.9), and the incidence rate was 15.8 per 1000 person-years (CI 95% : 12.9-19.4). Estimates varied significantly with age, diagnostic criteria used and location (i.e., continent). Conclusions: The burden of AD dementia is substantial. Significant gaps in our understanding of its epidemiology were identified, even in a high-income country such as Canada. Future studies should assess the impact of using such newer clinical diagnostic criteria for AD dementia such as those of the National Institute on Aging-Alzheimer's Association and/or incorporate validated biomarkers to confirm the presence of Alzheimer pathology to produce more precise estimates of the global burden of AD.RÉSUMÉ: Prévalence et incidence de la démence due à la maladie d'Alzheimer : revue systématique et méta-analyse. Contexte: Nous avons besoin d'informations sur l'épidémiologie de la démence due à la maladie d'Alzheimer (MA) afin de nous assurer que des ressources adéquates sont disponibles pour satisfaire les besoins actuels et futurs de la population en soins de santé. Nous avons effectué une revue systématique et une méta-analyse de l'incidence et de la prévalence de la MA. Méthodologie: Nous avons effectué une recherche dans les bases de données MEDLINE et EMBASE de 1985 à 2012 ainsi que dans la liste de références d'articles retenus. Les articles retenus devaient fournir des estimations de l'incidence et/ou de la prévalence populationnelle de la MA. Deux évaluateurs ont revu indépendamment les résumés et le texte intégral ainsi que l'extraction des données des publications et en ont évalué la qualité. Nous avons utilisé des modèles à effets aléatoires pour générer des estimations regroupées stratifiées par â...

The availability, accessibility, and acceptability of services are critical factors in rural health service delivery. In Canada, the aging population and the consequent increase in prevalence of

Background: Population-based prevalence and incidence studies are essential for understanding the burden of frontotemporal dementia (FTD). Methods: The MEDLINE and EMBASE databases were searched to identify population-based publications from 1985 to 2012, addressing the incidence and/or prevalence of FTD. References of included articles and prior systematic reviews were searched for additional studies. Two reviewers screened all abstracts and full-text reviews, abstracted data and performed quality assessments. Results: Twenty-six studies were included. Methodological limitations led to wide ranges in the estimates for prevalence (point prevalence 0.01-4.6 per 1000 persons; period prevalence 0.16-31.04 per 1000 persons) and incidence (0.0-0.3 per 1000 person-years). FTD accounted for an average of 2.7% (range 0-9.1%) of all dementia cases among prevalence studies that included subjects 65 and older compared to 10.2% (range 2.8-15.7%) in studies restricted to those aged less than 65. The cumulative numbers of male (373 [52.5%]) and female (338 [47.5%]) cases from studies reporting this information were nearly equal (p = 0.18). The behavioural variant FTD (bvFTD) was almost four times as common as the primary progressive aphasias. Conclusions: Population-based estimates for the epidemiology of FTD varied widely in the included studies. Refinements in the diagnostic process, possibly by the use of validated biomarkers or limiting case ascertainment to specialty services, are needed to obtain more precise estimates of the prevalence and incidence of FTD.RÉSUMÉ: Prévalence et incidence de la démence fronto-temporale : une revue systématique du sujet. Contexte : Les études de population sur la prévalence et l'incidence sont essentielles à la compréhension du fardeau associé à la démence fronto-temporale (DFT). Méthodologie : Nous avons cherché dans les bases de données MEDLINE et EMBASE les articles publiés entre 2000 et 2012 portant sur l'incidence et/ou la prévalence de la DFT dans la population. Nous avons également examiné les références des articles inclus dans notre étude ainsi que celles des revues systématiques antérieures. Deux évaluateurs ont examiné tous les résumés et le texte intégral des publications et l'extraction des données, et ils en ont évalué la qualité. Résultats : Vingt-six études ont été retenues. Des limites méthodologiques expliquent les écarts dans les estimations de prévalence (prévalence ponctuelle de 0,01 à 4,6 par 1 000 ; prévalence d'une période donnée de 0,16 à 31,04 par 1 000) et incidence (0,0 à 0,3 par 1 000 personnes-années). La DFT constituait en moyenne 2,7% (écart de 0 à 9,1%) de tous les cas de démence dans les études de prévalence qui incluaient des sujets de 65 ans et plus par rapport à 10,2% (2,8 à 15,7%) dans les études portant sur des sujets âgés de moins de 65 ans. Les nombres cumulatifs d'hommes (373 [52,5%]) et de femmes (338 [47,5%]) tirés des études dans lesquelles cette information était mentionnée étaient pratiquement égaux (p = 0,18). La variante comporte...

Introduction: Dementia is a common neurological condition affecting many older individuals that leads to a loss of independence, diminished quality of life, premature mortality, caregiver burden and high levels of healthcare utilization and cost. This is an updated systematic review and meta-analysis of the worldwide prevalence and incidence of dementia. Methods: The MEDLINE and EMBASE databases were searched for relevant studies published between 2000 (1985 for Canadian papers) and July of 2012. Papers selected for full-text review were included in the systematic review if they provided an original population-based estimate for the incidence and/or prevalence of dementia. The reference lists of included articles were also searched for additional studies. Two individuals independently performed abstract and full-text review, data extraction, and quality assessment of the papers. Random-effects models and/or meta-regression were used to generate pooled estimates by age, sex, setting (i.e., community, institution, both), diagnostic criteria utilized, location (i.e., continent) and year of data collection. Results: Of 16,066 abstracts screened, 707 articles were selected for full-text review. A total of 160 studies met the inclusion criteria. Among individuals 60 and over residing in the community, the pooled point and annual period prevalence estimates of dementia were 48.62 (CI 95% : 41.98-56.32) and 69.07 (CI 95% : 52.36-91.11) per 1000 persons, respectively. The respective pooled incidence rate (same age and setting) was 17.18 (CI 95% : 13.90-21.23) per 1000 person-years, while the annual incidence proportion was 52.85 (CI 95% : 33.08-84.42) per 1,000 persons. Increasing participant age was associated with a higher dementia prevalence and incidence. Annual period prevalence was higher in North America than in South America, Europe and Asia (in order of decreasing period prevalence) and higher in institutional compared to community and combined settings. Sex, diagnostic criteria (except for incidence proportion) and year of data collection were not associated with statistically significant different estimates of prevalence or incidence, though estimates were consistently higher for females than males. Conclusions: Dementia is a common neurological condition in older individuals. Significant gaps in knowledge about its epidemiology were identified, particularly with regard to the incidence of dementia in low-and middle-income countries. Accurate estimates of prevalence and incidence of dementia are needed to plan for the health and social services that will be required to deal with an aging population.RÉSUMÉ: Prévalence et incidence de la démence : revue systématique et méta-analyse. Contexte: La démence est une maladie neurologique fréquente touchant de nombreuses personnes âgées. Elle est la cause de la perte de l'indépendance, d'une qualité de vie altérée, d'une mortalité prématurée et constitue un fardeau important pour les soignants. Elle entraîne une utilisation et un coût élevé de soins de santé ...

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