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ICAD 2009 – The Stories201113123037

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ICAD 2009 – The Stories201113123037 Powered By Docstoc
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Contact: Alzheimer’s Association media line: 312-335-4078, media@alz.org
ICAD 2009 press room, July 11-16: +43 (0)1 931020 7501

 NEW CASES OF ALZHEIMER’S AND DEMENTIA CONTINUE TO RISE, EVEN
                     IN THE “OLDEST OLD”

- New Research Shows that the Proportion of People with Alzheimer’s and Dementia
                     also Rises in the Oldest Age Groups -

Vienna, July 13, 2009 – The number of people with Alzheimer’s and dementia – both new cases
and total numbers with the disease – continues to rise among the very oldest segments of the
population in contradiction of the conventional wisdom, according to research reported today at
the Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease (ICAD 2009)
in Vienna.

Previous epidemiological studies have suggested that the number of people with Alzheimer’s and
dementia begins to level off and perhaps even go down a bit in people age 90 and above, known
as the “oldest old.” This is the fastest growing segment of the population in western countries.

“The number of people affected by Alzheimer’s and dementia is growing at an epidemic pace,
and the skyrocketing financial and personal costs will devastate the world’s economies and
healthcare systems, and far too many families,” said William Thies, Ph.D., Chief Medical &
Scientific Officer at the Alzheimer's Association. “We must make the fight against Alzheimer’s a
priority before it’s too late.”

“However there is hope. There are many drugs in late stage clinical trials for Alzheimer’s that
show promise to slow or stop the progression of the disease. This, combined with advancements
in early detection, has the potential to change the landscape of Alzheimer’s in our lifetimes. But
we need more funding for research to see these possibilities through to completion,” Thies said.

The research reported at ICAD 2009 includes a study of more than 2,100 individuals age 80 years
or older in eight municipalities of Varese province, Italy, and a systematic review and
collaborative analysis of studies reporting the prevalence of dementia in Europe.
The Monzino 80-plus Study – Dementia Risk Continues to Rise in the “Oldest Old”
Ugo Lucca, head of the Laboratory of Geriatric Neuropsychiatry at the Mario Negri Institute for
Pharmacological Research in Milano, Italy, and colleagues conducted a prospective, door-to-
door, population-based study of all people age 80 years or older in eight municipalities of Varese
province, Italy, roughly 30 kilometers (20 miles) north of Milan (known as the Monzino 80-plus
Study). Their goal was to estimate the prevalence (total number with the disease) and incidence
(new cases of the disease) of dementia in this population.

The researchers were able to gather information and an initial dementia evaluation for 2,138
individuals. The mean age of the population at that first evaluation was 87.5 years; 74.1% were
women. Mean education was 5.1 years, and mean MMSE score was 21.4. After an average
follow-up period of three years, of the 1,085 survivors non-demented at baseline, 995 were re-
evaluated for dementia.

Prevalence of dementia standardized on the 2008 Italian population was 22.9% and was higher in
women (25.8%) than in men (17.1%). Prevalence increased with advancing age:
• 13.5% at 80-84 years
• 30.8% at 85-89
• 39.5% at 90-94
• 52.8% over 94

The estimated annual incidence of dementia standardized on the 2008 Italian population was 8.6%
and was higher in women (9.2%) than in men (7.2%). Incidence also rose with increasing age:
• 6.0% at 80-84 years
• 12.4% at 85-89
• 13.1% at 90-94
• 20.7% over 94

“Gathering reliable information on such a large number of the ‘oldest old’ makes this one of the
largest studies investigating dementia in this age segment of the population,” Lucca said. “This
study’s results confirm that Alzheimer’s and dementia are very common among the oldest people
in society. We believe this strengthens the need to shift more of the focus of clinical research to
this segment of the elderly population.”

According to the researchers, though the rate of women who developed dementia during the
follow-up period was higher than in men in this study, no definite conclusion can be drawn about
this difference because the number of men in the oldest ages became very small.

Systematic Review of Dementia in Europe – Higher Prevalence in Female “Oldest
Old”
The goal of Dr. Emma Reynish, a consultant geriatrician and coordinator of the European
Alzheimer’s Disease Consortium from the Victoria Hospital, Kirkcaldy, Scotland, UK, and
colleagues at the EuroCoDe (European Collaboration on Dementia) project, was to determine
the prevalence of dementia in Europe based on up to date research findings and including data
from Eastern Europe. They conducted an extensive literature search using Cochrane review
methodologies and compiled a database of all European epidemiological studies in the field up to
the present date. 194 articles were identified by the review and 26 studies met inclusion criteria to
participate with raw data in the collaborative analysis.

According to the researchers, while dementia prevalence rates for all men and for women up to
age 85 confirmed previous findings, age-specific prevalence rates were higher than previously
documented in the female “oldest old” age groups, rising to over 50% in those over 95 years.

“Our key findings confirmed that age remains as the single most important risk factor for
dementia,” Reynish said. “Nevertheless, due to the lack of data in the oldest old in previous
prevalence studies, the prevalence of dementia of women over the age of 85 had been
underreported.”

About ICAD 2009
The 2009 Alzheimer’s Association International Conference on Alzheimer's Disease (ICAD 2009) brings
together more than 3,000 researchers from 70 countries to share groundbreaking research and information
on the cause, diagnosis, treatment and prevention of Alzheimer’s disease and related disorders. As a part of
the Association’s research program, ICAD 2009 serves as a catalyst for generating new knowledge about
dementia and fostering a vital, collegial research community. ICAD 2009 will be held in Vienna, Austria at
Messe Wien Exhibition and Congress Center from July 11–16.

About the Alzheimer’s Association
The Alzheimer’s Association is the leading voluntary health organization in Alzheimer care, support and
research. Our mission is to eliminate Alzheimer’s disease through the advancement of research, to provide
and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of
brain health. Our vision is a world without Alzheimer’s. For more information, visit www.alz.org.


                                                  ###

•   Ugo Lucca, et al – Risk of dementia continues to rise in the oldest old: The Monzino 80-plus Study
    (Funder: Fondazione Italo Monzino (Milano, Italy))
•   Emma Reynish, et al – Systematic Review and Collaborative Analysis of the Prevalence of Dementia
    in Europe (Funder: European Commission, coordinated by Alzheimer Europe)


              EMBARGOED FOR RELEASE UNTIL MONDAY, JULY 13, 2009
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                                                                                                          3
All materials to be presented at the 2009 Alzheimer’s Association International Conference on Alzheimer’s Disease (ICAD
2009) are embargoed for publication and broadcast until the date and time of presentation at the International Conference on
Alzheimer’s Disease, unless the Alzheimer’s Association provides written notice of change of embargo date/time in advance.

                            EMBARGOED FOR RELEASE
            UNTIL MONDAY, JULY 13, 2009, 8:30 a.m. (Vienna) / 2:30 a.m. ET (U.S.)

Control #: 09-A-1144-ALZ
P3 - Tuesday Posters - Presentation #P3-168; Speaking Time: 7/14/2009, 12:30 - 3:00 PM

Risk of dementia continues to rise in the oldest old: The Monzino 80-plus Study

Ugo Lucca, Mariateresa Garrì, Alessandro Nobili, Luca Pasina, Francesca Gandini, Emma Riva, Mauro Tettamanti
Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
Contact e-mail: lucca@marionegri.it

Disclosure Block: U. Lucca, None; M. Garrì, None; A. Nobili, None; L. Pasina, None; F. Gandini, None; E. Riva,
None; M. Tettamanti, None.

Background: Most dementia sufferers are eighty years or older, the fastest growing segment of
the elderly population in western countries. Because of the small number of persons in this age
class usually included in population-based studies, prevalence and incidence estimates fluctuate
widely in the oldest old, making it hard to establish whether the risk of dementia (and Alzheimer’s
disease) continues to rise also at very high ages.

Objective: To estimate the prevalence and incidence of dementia (mild+) in a prospective, door-
to-door population-based study of all eighty years or older residents in eight municipalities of
Varese province, Italy (the Monzino 80-plus Study).

Methods: Among the 2,436 eligible residents, information could be gathered for 2,138
individuals (response rate: 87.8%). Of the 1,085 survivors non-demented at baseline, 995 (91.7%)
were re-evaluated after an average follow-up period of 3 years. Diagnosis of dementia was based
on DSM-IV criteria.

Results: Mean age of the population at baseline evaluation was 87.5 (SD: 4.8) years and 74.1%
were women. Some 32% lived alone and 11.5% in an institution. In the whole population, mean
education was 5.1 (2.5) years, mean MMSE score 21.4 (7.6), and mean percentage of dependence
on IADL 48.5% (36.9%). Prevalence of dementia standardized on the 2008 Italian population was
22.9% (95% CI: 21.1-24.7) and was higher in women 25.8% (95% CI: 23.7-28.1) than in men
17.1% (95% CI: 14.0-20.5). Prevalence increased with advancing age: 13.5% at 80-84 years,
30.8% at 85-89, 39.5% at 90-94, and 52.8% over 94. The number of person-years of observation
was 3,110. The estimated annual incidence of dementia standardized on the 2008 Italian
population was 8.6% (95%CI: 7.6-9.7) and was higher in women 9.2% (95% CI: 8.0-10.6) than in
men 7.2% (95% CI: 5.5-9.2). Incidence as well rose with increasing age: 6.0% at 80-84 years,
12.4% at 85-89, 13.1% at 90-94, and 20.7% over 94.

Conclusions: Although not exponentially, the overall prevalence and incidence rates of dementia
continue to rise also in very old age.
All materials to be presented at the 2009 Alzheimer’s Association International Conference on Alzheimer’s Disease (ICAD
2009) are embargoed for publication and broadcast until the date and time of presentation at the International Conference on
Alzheimer’s Disease, unless the Alzheimer’s Association provides written notice of change of embargo date/time in advance.

                            EMBARGOED FOR RELEASE
            UNTIL MONDAY, JULY 13, 2009, 8:30 a.m. (Vienna) / 2:30 a.m. ET (U.S.)

Control #: 09-A-1781-ALZ
P3 - Tuesday Posters - Presentation #P3-168, Speaking Time: 7/14/2009, 12:30 - 3:00 PM

Systematic Review and Collaborative Analysis of the Prevalence of Dementia in
Europe

Emma Reynish1,2, Horst Bickel3, Laura Fratiglioni4, Andrzej Kiejna5, Martin Prince6, Jean Georges7,
EUROCODE Prevalence Group
1Victoria Hospital, Kirkcaldy, United Kingdom; 2Toulouse University Hospital, Toulouse, France; 32 Klinik und
Poliklinik für Psychiatrie und Psychotherapie der Technischen, Munich, Germany; 4Karolinska Institute, Stockholm,
Sweden; 5Department of Psychiatry, Wroclaw, Poland; 6Institute of psychiatry, London, United Kingdom;
7Alzheimer Europe, Luxembourg, Luxembourg.
Contact e-mail: emmareynish@ednet.co.uk

Disclosure Block: E. Reynish, None; H. Bickel, None; L. Fratiglioni, None; A. Kiejna, None; M. Prince, None; J.
Georges, None.

Background: An accurate estimate of the numbers of individuals affected with dementia is
essential. Previous collaborative work from Europe is based on studies performed 20 years ago.
This current project aims to determine the prevalence of dementia in Europe based on up to date
research findings and includes data from Eastern Europe.

Methods: A systematic review followed by collaborative analysis of studies reporting the
prevalence of dementia in Europe. Medline and Embase searches were performed using the search
terms “Dementia / Prevalence / Incidence / Epidemiology” and/or “Alzheimer’s Disease /
Vascular dementia, Lewy-body disease / Fronto-temporal dementia / Incidence / Prevalence /
Epidemiology. A database of studies was compiled and those fulfilling predetermined quality
criteria were invited to submit data for collaborative analysis. Age and sex specific prevalence’s
were calculated using the total number of prevalence cases from all studies as the numerator and
total population examined as the denominator.

Results: A total of 194 articles were identified by the review and 26 studies met inclusion criteria
to participate with raw data in the collaborative analysis. Calculated age specific prevalence rates
for men confirmed previous findings with rates rising from 1.8% in the 65-69 years age range up
to 30% in the over 90 years age group. For women confirmation of previous findings was also
true for the 65 to 85 years age ranges with 5 year age specific rates rising from 1.5% to 30%
respectively. Age specific prevalence rates were however higher than previously documented in
the female oldest old age groups rising to over 50% in those over 95 years.

Conclusions: Epidemiological studies of dementia prevalence in Europe continue to show
constant rates in all age ranges with the female oldest old being the exception. Here estimates
show a higher than previously reported prevalence in females.

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