Prevalence of senile dementia in a rural community in Japan: the Tajiri project

Ishii, Hiroshi; Meguro, Kenichi; Ishizaki, Junichi; Shimada, Masumi; Yamaguchi, Satoshi; Sano, Iwao; Ambo, Hideo; Ohtake, Hiroto; Shimada, Youichi; Someya, Kyoko; Sato, Masato; Shibuya, Yasuyuki; Kato, Masami; Sekita, Yasuyoshi; Yamadori, Atsushi

doi:10.1016/s0167-4943(99)00038-2

Cited by 25 publications

(38 citation statements)

References 54 publications

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“…7) Briefly, 2516 elderly residents of the town aged over 65 years were targeted initially. In the first phase, a total of 2352 respondents completed a health questionnaire that included questions about past medical history and activities of daily living.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Idiopathic Normal-Pressure Hydrocephalus in the Elderly Population of a Japanese Rural Community

Hiraoka

Meguro

Mori

2008

Neurol. Med. Chir.(Tokyo)

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110

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The prevalence of idiopathic normal-pressure hydrocephalus (NPH) in a community was investigated by retrospective analysis of data from a previous community-based study of 170 randomly selected elderly residents aged 65 years or older. Magnetic resonance (MR) images of the subjects were reviewed for the specific structural features of idiopathic NPH, i.e. ventricular enlargement and narrow cerebrospinal fluid (CSF) space at high convexity and high midline areas. The clinical features of idiopathic NPH, gait disturbance, urinary incontinence, and cognitive impairment, were evaluated on the basis of records of the subjects' neurological examinations, a health questionnaire, the Mini-Mental State Examination, and Clinical Dementia Rating. Thirteen of the 170 subjects showed lateral ventricular enlargement greater than 0.3 on Evans' index. Five subjects (2.9%) demonstrated both ventricular enlargement and narrow CSF space at the high convexity/midline. All five subjects with these MR imaging signs had cognitive impairment, one had gait disturbance, and one had urinary incontinence. The present study found 2.9% of community-dwelling elderly subjects showed radiological and clinical features consistent with idiopathic NPH.

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Section: Methodsmentioning

confidence: 99%

Prevalence of Idiopathic Normal-Pressure Hydrocephalus in the Elderly Population of a Japanese Rural Community

Hiraoka

Meguro

Mori

2008

Neurol. Med. Chir.(Tokyo)

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110

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“…37 Further evidence of the validity of CDR staging can be indirectly accrued from other Asian neuropathological, 38 genetic 39,40 and neuroimaging studies. 6,41,42 Dementia Diagnosis Because the CDR also defines non-demented aging (CDR=0), it additionally has, in practice, the diagnostic capacity of distinguishing no dementia from dementia even in its mildest stages (i.e., CDR=0.5). 17 The CDR has been demonstrated to be congruent with the DSM-IV approach of identifying dementia in a multi-racial Asian population.…”

Section: Evidence Of Cdr Use In Asian Populations Validation Studiesmentioning

confidence: 99%

“…The CDR has been employed as part of a multi-pronged strategy for the detection of dementia in Asian epidemiological studies in urban [43][44][45] and rural settings (e.g., the Tajiri Project 6 and the US-Indo study 8,13 ). Although primarily used as a staging instrument in these studies, the CDR complements the DSM criteria for the purpose of dementia diagnosis, and it has the added advantage of being able to evaluate both Alzheimer and non-Alzheimer forms of dementia.…”

Section: Evidence Of Cdr Use In Asian Populations Validation Studiesmentioning

confidence: 99%

“…2 Existing disease burden can be estimated by cross sectional prevalence studies. The prevalence rate of dementia among persons aged 65 years and older has been variously reported as 1.8% to 6.3% in Chinese, [3][4][5] 3.3% to 8.0% in Japanese, 6,7 1.4% to 4.0% in Indian, 8,9 8.2% to 10.8% in Korean 10 and 2.5% to 7.7% in South-East Asian 11,12 populations. The wide range can be explained by the different sample characteristics, screening strategies and dementia ascertainment methods.…”

mentioning

confidence: 99%

“…2 In Japan, for example, the prevalence of dementia patients is expected to triple from 1 million in 1990 to 2.9 million by the year 2020. 6 This defining demographic trend raises the clarion call for reliable and valid methods of dementia diagnosis and staging that are applicable to Asian populations. Challenges abound in the transcultural adaptation of dementia rating scales that are mainly derived from Caucasian populations.…”

mentioning

confidence: 99%

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Utility of the Clinical Dementia Rating in Asian Populations

Lim¹,

Chong²,

Sahadevan³

2007

Clinical Medicine & Research

115

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Consistent with the worldwide demographic trend of population aging, dementia is expected to become a burgeoning public health problem in Asian populations.Thus, there is a pressing need for reliable and valid methods of dementia diagnosis and staging that are applicable in heterogeneous Asian populations. The Clinical Dementia Rating (CDR) is an informant-based global assessment scale with established reliability and validity that has been widely utilized as a severity-ranking scale in many studies of Asian populations. From a diagnostic standpoint, the CDR is congruent with the Diagnostic and Statistical Manual of Mental Disorders approach of dementia diagnosis. It exhibits excellent discriminatory ability in the very mild stages of dementia, a useful property that is germane to the surging interest in mild cognitive impairment and related concepts. Limitations of the CDR include its length of administration, reliance on clinical judgment and collateral source information, and relative insensitivity as a measure of change in interventional studies. Since the exercise of clinical judgment is inherent in scoring, CDR raters should be mindful of the influence of cultural factors on premorbid lifestyle, informant reliability and performance in certain CDR test items (especially those pertaining to the categories of judgment and problem solving, community, and home and hobbies). Thus, in future studies that involve the nascent use of the CDR in Asian populations, it is recommended that any transcultural adaptation of CDR items be described in detail and appropriate validation studies be carried out before adopting the CDR as a yardstick measure of assessment. The potential of adapted versions of the CDR in chronic care settings and advanced cases should be explored.An integrative approach, combining brief informant interview in conjunction with brief objective cognitive testing, could be a viable strategy for dementia screening in the clinical and research setting that warrants further evaluation in Asian populations.

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