Prevalence of Alzheimer's Dementia and Its Risk Factors in Community-Dwelling Elderly Koreans

Abstract

ObjectiveWe estimated the prevalence of Alzheimer's dementia (AD) and mild cognitive impairment (MCI) and their risk factors in an urban community setting, focusing especially on metabolic syndrome.MethodsA two-phase investigation based on a door-to-door survey was performed. In Phase I, we administered the Korean version of the Mini-Mental State Examination (MMSE-KC) of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K). Assessment Packet and the Korean version of the Geriatric Depression Scales (GDS-K) to all 706 participants aged 65 years or older. In Phase II of the study, 175 persons underwent physical and neurological examinations according to the protocol of the CERAD-K clinical assessment battery [CERAD-K (C)] and the neuropsychological assessment battery [CERAD-K (N)]. We also examined the association between cognitive decline and metabolic syndrome. AD and MCI were defined using the DSM-IV-TR criteria and the Clinical Dementia Rating (CDR) scales.ResultsThe mean age (±SD) of the subjects was 74.3±16.7 years and the ratio of males to females was 53.2 to 46.8. The prevalence of Alzheimer's dementia was 9.0%, while that of MCI was 32.9%. Old age and lower educational level had significant associations with cognitive decline in the elderly, but gender, years of alcohol intake or smoking, and metabolic syndrome were not associated with AD or MCI.ConclusionIn this study, metabolic syndrome was not associated with Alzheimer's AD or MCI. Information regarding an association between Alzheimer's dementia and metabolic syndrome in this study will be helpful in formulating future public health policy and prevention strategies in Korea.

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

“…For some evidences, an atrial fibrillation was relevant to cognitive impairment and hippocampal atrophy with no symptomatic stroke or silent infarction. 34,35 The previous studies 26,30,31,[36][37][38][39] and the results of our study have shown that atrial fibrillation was associated with an increased risk of poststroke dementia. Moreover, the result of this study found that stroke patients with atrial fibrillation risk of dementia were 1.68 times compared with stroke patients without atrial fibrillation statistically significant.…”

“…11,18,22 A study on frequency and predictors of dementia after ischemic stroke showed that prior stroke was independent predictors of dementia (OR 2.53, 95%CI; 1.42 to 4.51). 26 Recurrence stroke risk factors were significantly associated with post-stroke dementia. 11,22,25 In systematic review and meta-analysis, it was found that recurrence stroke was associated with dementia (OR 2.3, 95%CI; 1.5-3.5).…”

“…10,19,24 Cohort study found that smoker associated with potential covariates and diagnosis of post-stroke dementia (OR 1.51, 95%CI; 0.89-2.58) 10 and alcohol consumption risk factors were more frequent in demented patients than no demented patients (OR 1.87, 95%CI; 1.02-3.44). 26 Third, stroke factors such as the previous stroke has been indicated as a risk factor for poststroke dementia. 11,18,22 A study on frequency and predictors of dementia after ischemic stroke showed that prior stroke was independent predictors of dementia (OR 2.53, 95%CI; 1.42 to 4.51).…”

“…Fifteen abstracts were excluded because the result no associated with poststroke dementia, thirteen articles cannot calculate the data for the relative risks of dementia in stroke patients. The remaining 8 articles 20,21,23,[26][27][28][29][30] selected by the selection criteria can be calculated to identify the relative risks of dementia, as shown in Figure 1. Table 1 shows the demographic details of hospital-based and population-based studies of dementia after stroke such as study design, and methods used to measure dementia in all the publications that were relevant to the eligible hospital-based and population-based studies of dementia after stroke.…”

“…40 The authors suggested that infarcts in several locations cause intracerebral circuit interruption, and infarcts and functional cortical disconnection can be caused by extensive white matter lesions and/or pre-existing neuronal damage. Prior or recurrent stroke has been indicated as a risk factor for post-stroke dementia 26,28,31,41 Kokmen et al 42 's study in population-based found that second stroke was significant independent predictors of dementia in a multivariate Cox proportional hazards model. Tatemichi et al 14 concluded that prior stroke was considered as the most important predictor of dementia.…”