Lifetime Risk Estimates for Dementia, MCI: New Data

 Your risk is definitely higher post stroke; BUT YOUR COMPETENT? DOCTOR HAS EXACT PROTOCOLS TO PREVENT THAT, RIGHT?

Nope! You got one of the incompetent? ones, didn't you!

Lifetime Risk Estimates for Dementia, MCI: New Data

TOPLINE:

Lifetime risk for dementia and mild cognitive impairment (MCI) was 43% and 62%, respectively, in adults aged 55 years or older, new research showed. Additionally, the onset of MCI occurred 10 years earlier than the onset of dementia, women had a higher lifetime risk for both conditions, and Black individuals had an earlier age of onset.

METHODOLOGY:

• Researchers pooled data from five cohort studies at Rush Alzheimer’s Disease Center for more than 4600 community-dwelling event-free adults aged 55-105 years (mean age at baseline, 77 years; 75% female; 28% Black individuals) for dementia analyses. Nearly 4000 of these participants were also assessed for MCI.
• At annual standardized clinical evaluations, participants reported their medical histories and underwent neurologic examinations and neuropsychological testing.
• Researchers assessed lifetime risk for incident dementia and incident MCI, accounting for the competing risk for death, with participants stratified by age, sex, race, and history of stroke.

TAKEAWAY:

• From age 55 to 105 years, the lifetime risk was 43% for incident dementia and 62% for incident MCI — with the risk increasing sharply after age 75 and 65 years, respectively. Approximately 84% of cases for both conditions were diagnosed between 75 and 95 years of age.
• Women had a higher lifetime risk than men for dementia (45% vs 39%) and MCI (63% vs 59%), and their diagnoses occurred approximately 2 years later (P < .05).
• Black participants had a slightly higher overall risk for dementia than White participants (45% vs 43%) and were diagnosed about 5 years earlier (P < .001). The overall risk for MCI was lower in Black participants than in White participants (59% vs 64%), but Black participants had a higher cumulative incidence at age 55-75 years (15% vs 10%) and were diagnosed a median of about 6 years earlier (P < .001).
• Exploratory analyses showed a significant association between stroke and increased risk for both dementia (hazard ratio [HR], 1.4; P < .001) and MCI (HR, 1.3; P < .003).

IN PRACTICE:

“These findings extend lifetime risk estimation beyond age 90 and highlight the need for equitable, culturally informed dementia prevention and monitoring strategies,” the investigators of the study wrote.

SOURCE:

The study was led by Lianlian Du, PhD, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago. It was published online on February 03 in Alzheimer’s & Dementia.

LIMITATIONS:

The study population primarily comprised Black, White, and urban-dwelling individuals, with a limited number of Latino participants and no Asian American participants, which potentially affected generalizability. Genetic and cohort effects were not examined. Additionally, the apparent plateau in the cumulative incidence analysis after age 95 years warrants careful interpretation because analyses indicated continued increases in risks for dementia or MCI and mortality.

DISCLOSURES:

The study was funded by the National Institute on Aging. The investigators reported having no relevant conflicts of interest.

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