The prevalence of cognitive impairment in an elderly Canadian population

Robertson, Duncan; Rockwood, Kenneth; Stolee, Paul

doi:10.1111/j.1600-0447.1989.tb02984.x

Cited by 32 publications

(14 citation statements)

References 19 publications

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“…For the institutional sample, all selected residents ( N = 1817) were invited to take part in the clinical component of the CSHA without undergoing the screening examination. This approach was adopted because the high prevalence of dementia in institutions made screening unnecessary (Bland, Newman, & Orn, 1988;Robertson, Rockwood, & Stolee, 1989).…”

Section: Methodsmentioning

confidence: 99%

Neuropsychological detection of dementia: An overview of the neuropsychological component of the canadian study of health and aging

Tuokko¹,

Kristjansson

Miller

1995

Journal of Clinical and Experimental Neuropsychology

102

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As part of the Canadian Study of Health and Aging (CSHA), a battery of neuropsychological measures was administered to 1879 participants. Participants who received neuropsychological evaluations were selected from an age-stratified random sample on the basis of scores on a cognitive screening tool, the Modified Mini-Mental State Examination (3MS). Seventy-five percent of the sample seen for neuropsychological evaluation scored between 50 and 77 on the 3MS and 25% of the sample scored 78 or over. This paper provides a descriptive summary of the methodological basis of the neuropsychological component of the CSHA. The findings indicated that differences existed between participants administered the battery in English or French in terms of refusal rates and diagnoses of dementia. Cursory examination of the utility of the battery indicated that the battery was tolerated well by both the participants and the psychologists involved with the study and that measures of memory functioning were central to diagnostic decision-making. The relations between neuropsychological, preliminary medical and consensus diagnoses were examined and indicated that neuropsychological information influenced diagnostic decision-making. The neuropsychology component of the CSHA is a rich source of information on persons aged 65 years and older in Canada.

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Section: Methodsmentioning

confidence: 99%

Neuropsychological detection of dementia: An overview of the neuropsychological component of the canadian study of health and aging

Tuokko¹,

Kristjansson

Miller

1995

Journal of Clinical and Experimental Neuropsychology

102

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“…Unfortunately, data on such subjects are usually not easy to access. In several studies, information regarding these subjects is missing, 23 and often response rates are calculated after subtracting those not participating for reasons other than refusal, [24][25][26] thus possibly yielding an underestimate of the true prevalence. In fact, higher mortality rates are reported among cognitively impaired [27][28][29] or demented subjects.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of non-responders and the impact of non-response on prevalence estimates of dementia

Boersma

Eefsting²,

Brink³

et al. 1997

International Journal of Epidemiology

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During the last decade much attention has been paid to methodological differences as an important source of variability in the results of prevalence studies of dementia.1-3 Application of internationally accepted criteria for dementia and standardized diagnostic procedures have indeed been effective in diminishing the variation in prevalence rates of studies conducted recently. Based on meta-analysis of such studies the prevalence of dementia among the Dutch population age 65 and over can be estimated to range from 5.1% to 6.7%. [4][5][6] However, the issue of non-response, a potentially important source of variation, has attracted relatively little attention. Most studies show that non-responders do not differ from responders in terms of sociodemographic characteristics. However, a similar distribution of demographic variables in responders and nonresponders does not preclude the possibility of an unequal distribution of cognitive status, 2,7-9 which is not unlikely to affect response. 10,11 Under-or overrepresentation of cognitively impaired subjects among responders may have important implications for prevalence estimates. This is especially true in studies with low response rates, but it can also be a serious problem in studies with high response rates and large differences in cognitive status between responders and non-responders. Moreover, non-responders do not necessarily constitute a homogeneous group.12 With regard to cognitive functioning, it is unlikely that refusers, those not responding due to health problems or those moving out of the study region, are comparable. Next to response rates it can thus be hypothesized that the impact of non-response on prevalence estimates of dementia depends on the type of non-response. Background. Differential distributions of sociodemographic characteristics and cognitive impairment in responders and non-responders may result in a biased prevalence estimate of dementia based on responders only. Methods. Responders (n = 2191) to a cross-sectional, two-stage community study were compared with regard to sociodemographic characteristics and cognition with three subgroups of non-responders: (A) subjects who refused to participate (n = 369), (B) subjects who were too ill or who had died prior to the screening (n = 72) and (C) subjects who had moved out of the study region or were not traceable (n = 23). Prevalence estimates specific for age and housing situation in responders and physicians' ratings of cognitive impairment were used to estimate the prevalence of dementia among non-responders.Results. Group A differed from responders in age and housing situation, group B in age, housing and cognition, and group C only in age. Separate prevalence estimates of dementia based on age, housing and cognition yielded figures for group A between 4.9% and 7.2%, for group B between 13.1% and 19.1%, and for group C between 2.6% and 4.2%. Joined with the prevalence rate among responders (6.5%) the best possible point estimate of the prevalence of dementia in the target population lies...

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“…In older age categories, severe dementia with the need for institutionalization has the highest prevalence [16,20,32]. Obviously, there is a need for strategies to reduce both the prevalence and the severity of dementia in order to lighten the burden on society in terms of health care, disability, hospital and institutional care.…”

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confidence: 99%

The Dutch Vascular Factors in Dementia Study: rationale and design

Kooten¹,

Bots²,

Breteler³

et al. 1997

Journal of Neurology

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Dementia is a rapidly increasing health problem in the industrialized countries. With the ageing of the population the number of demented persons increases both in relative and absolute terms. Obviously, there is a need for prevention and intervention strategies. We describe the methods and baseline findings of a large study aimed at identifying potentially modifiable vascular, thrombogenic, and metabolic determinants of dementia. The study population consists of subjects 55 years of age or older. Since the vascular wall of the cerebral vessels is different from that of the coronary or peripheral vessels, we formed three subgroups in which vascular risk factors for dementia are studied. Subjects with stroke were distinguished from subjects with coronary or peripheral artery disease, and from subjects without stroke or coronary or peripheral artery disease. To obtain a large enough number of subjects with stroke, cases and controls from a stroke registry were combined with cases and controls of a population-based study from the same region. For the diagnosis of dementia the DSM-III-R criteria were used. Extensive information on cardiovascular risk factors was collected, including indicators of atherosclerosis. Blood and urine were sampled to study platelet function and thrombogenic and metabolic factors. The study population consists of 7,466 subjects, of whom 300 were recruited from a hospital-based stroke registry. Coronary or peripheral artery disease was present in 956 subjects and stroke in 617. Dementia was present in 434 (5.8%) of all subjects. The prevalence of dementia was 3.0, 24.0, and 4.4% in subjects with a history of coronary or peripheral artery disease, a history of stroke, and subjects without a history of coronary or peripheral artery disease or stroke, respectively. The study will allow us to investigate the role of vascular factors in dementia, irrespective of its cause.

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The prevalence of cognitive impairment in an elderly Canadian population

Cited by 32 publications

References 19 publications

Neuropsychological detection of dementia: An overview of the neuropsychological component of the canadian study of health and aging

Neuropsychological detection of dementia: An overview of the neuropsychological component of the canadian study of health and aging

Characteristics of non-responders and the impact of non-response on prevalence estimates of dementia

The Dutch Vascular Factors in Dementia Study: rationale and design

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