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Is dementia incidence declining in high-income countries? A systematic review and meta-analysis

PURPOSE: To perform a systematic review and quantitative synthesis of studies on recent trends in dementia incidence in high-income countries (HIC), considering study quality. METHODS: PubMed and Web of Science were searched for eligible studies, that is, population-based/community-based prospective...

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Autores principales: Roehr, Susanne, Pabst, Alexander, Luck, Tobias, Riedel-Heller, Steffi G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149863/
https://www.ncbi.nlm.nih.gov/pubmed/30271219
http://dx.doi.org/10.2147/CLEP.S163649
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author Roehr, Susanne
Pabst, Alexander
Luck, Tobias
Riedel-Heller, Steffi G
author_facet Roehr, Susanne
Pabst, Alexander
Luck, Tobias
Riedel-Heller, Steffi G
author_sort Roehr, Susanne
collection PubMed
description PURPOSE: To perform a systematic review and quantitative synthesis of studies on recent trends in dementia incidence in high-income countries (HIC), considering study quality. METHODS: PubMed and Web of Science were searched for eligible studies, that is, population-based/community-based prospective cohort studies investigating dementia incidence with similar methods over time, published after 1990. Study selection, data extraction, and quality assessment were performed independently by two investigators. Random-effect meta-analysis and meta-regression were used to estimate incidence change (IC) and to explore associations with study attributes. PRISMA standards were followed. RESULTS: The systematic review included seven studies (42,485 individuals), and the meta-analysis included five studies of sufficient quality. Relating dementia incidence of later cohorts to earlier cohorts (reference) yielded a nonsignificant decrease across HIC (IC =0.82; 95% CI 0.51–1.33), with high heterogeneity (I(2)=94.9%, P<0.001) and without publication bias (Egger’s t=–1.77; P=0.18). Excluding the Japanese Hisayama study, the only study suggesting an increase, indicated borderline evidence for a decrease across Western HIC (IC =0.69; 95% CI 0.47–1.00; I(2)=88.1%, P<0.001; Egger’s t=–0.34, P=0.77), again with high heterogeneity. Meta-regression did not reveal an association of incidence rate with calendar year or study attributes; however, analyses were low powered. CONCLUSION: There is evidence of favorable trends in dementia incidence in Western HIC (stabilizing/decreasing). Reverse trends may occur in HIC of other regions, as exemplified by Japan. However, study number was small and heterogeneity was high. Further cohort studies using consistent methods are needed to draw definite conclusions. Our work may inform such future studies.
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spelling pubmed-61498632018-09-28 Is dementia incidence declining in high-income countries? A systematic review and meta-analysis Roehr, Susanne Pabst, Alexander Luck, Tobias Riedel-Heller, Steffi G Clin Epidemiol Review PURPOSE: To perform a systematic review and quantitative synthesis of studies on recent trends in dementia incidence in high-income countries (HIC), considering study quality. METHODS: PubMed and Web of Science were searched for eligible studies, that is, population-based/community-based prospective cohort studies investigating dementia incidence with similar methods over time, published after 1990. Study selection, data extraction, and quality assessment were performed independently by two investigators. Random-effect meta-analysis and meta-regression were used to estimate incidence change (IC) and to explore associations with study attributes. PRISMA standards were followed. RESULTS: The systematic review included seven studies (42,485 individuals), and the meta-analysis included five studies of sufficient quality. Relating dementia incidence of later cohorts to earlier cohorts (reference) yielded a nonsignificant decrease across HIC (IC =0.82; 95% CI 0.51–1.33), with high heterogeneity (I(2)=94.9%, P<0.001) and without publication bias (Egger’s t=–1.77; P=0.18). Excluding the Japanese Hisayama study, the only study suggesting an increase, indicated borderline evidence for a decrease across Western HIC (IC =0.69; 95% CI 0.47–1.00; I(2)=88.1%, P<0.001; Egger’s t=–0.34, P=0.77), again with high heterogeneity. Meta-regression did not reveal an association of incidence rate with calendar year or study attributes; however, analyses were low powered. CONCLUSION: There is evidence of favorable trends in dementia incidence in Western HIC (stabilizing/decreasing). Reverse trends may occur in HIC of other regions, as exemplified by Japan. However, study number was small and heterogeneity was high. Further cohort studies using consistent methods are needed to draw definite conclusions. Our work may inform such future studies. Dove Medical Press 2018-09-18 /pmc/articles/PMC6149863/ /pubmed/30271219 http://dx.doi.org/10.2147/CLEP.S163649 Text en © 2018 Roehr et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Roehr, Susanne
Pabst, Alexander
Luck, Tobias
Riedel-Heller, Steffi G
Is dementia incidence declining in high-income countries? A systematic review and meta-analysis
title Is dementia incidence declining in high-income countries? A systematic review and meta-analysis
title_full Is dementia incidence declining in high-income countries? A systematic review and meta-analysis
title_fullStr Is dementia incidence declining in high-income countries? A systematic review and meta-analysis
title_full_unstemmed Is dementia incidence declining in high-income countries? A systematic review and meta-analysis
title_short Is dementia incidence declining in high-income countries? A systematic review and meta-analysis
title_sort is dementia incidence declining in high-income countries? a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149863/
https://www.ncbi.nlm.nih.gov/pubmed/30271219
http://dx.doi.org/10.2147/CLEP.S163649
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