Date Published:
3 November 2006 |
New Cambridge Univ study shows increased risk of dementia before death
As the number of older people increases, the number of people who experience
dementia before they die is also likely to increase, according to a new study.
The research, lead by Professor Carol Brayne at the University of
Cambridge, has shown that factors believed to protect against dementia at
earlier stages
in life may not provide protection from dementia at the end of life.
Previous studies examined risk of dementia over a specified time period or
at a particular age but not just before death. Thus it was not known whether
factors found to reduce the risk of developing dementia earlier in life would
provide protection until the end of life. For example, previous research
studies have consistently suggested the risk of dementia is reduced for people
with higher levels of education and social class, but whether this affects
the risk of having dementia by time of death had not been investigated (partly
because most studies do not follow individuals over very lengthy periods).
The study followed populations aged 65 years and over for ten years and found
that reducing risk for dementia at a given age is likely to lead to further
extension of life, thus the cumulative risk of dementia at death (even in
populations at lower risk for given ages) will remain high. Ageing of populations,
due to better nutrition and improved health care, is likely to result in
an increase in the number of people dying with dementia and severe cognitive
impairment even in the presence of preventative programmes.
For this study, funded by the Medical Research Council, the prevalences of
dementia and severe cognitive impairment were estimated by age, sex, social
class and education to examine whether any different patterns emerged. Overall
30% of individuals who died have experienced dementia in their last year
of life. There was a strong increasing trend with age from 6% for those aged
65-69 to 58% for those aged 95 and above.
The study also found that women were more likely to develop dementia before
death than men (even after taking into account that women live longer than
men). A higher level of education and belonging to a higher social class
were associated with only a slightly lower prevalence of dementia before
death.
Professor Brayne, from the Department of Public Health and Primary Care at
the Institute of Public Health, said,
“ Policy development and research
for dementia must address the needs of individuals who will continue to experience
these conditions before death, particularly with regard to long term care,
support for informal care givers and appropriate palliative care options.”
Dr Fiona Matthews, at the MRC Biostatistics Unit, said,
“ With increased
survival into older age, population levels of dementia immediately preceding
death will be a public concern".
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