Incidence and subtypes of dementia in southern Taiwan - Impact of socio-demographic factors

Objective: To determine the incidence rate (IR) and subtypes of dementia in southern Taiwan. Methods: From a cohort of 2,915 community inhabitants aged 65 years and over, 2,507 and 2,175 subjects participated in the first-and second-year follow-up surveys, respectively. A tare-phase study used the Mini-Mental State Examination in phase I and the Consortium to Establish a Registry of Alzheimer's Disease (CERAD) neuropsychological battery and the neurobehavioral examination in phase II. We applied International Classification of Diseases (ICD)-10NA criteria for dementia, National Institute of Neurological and Communication Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) guidelines for Alzheimer's disease (AD), and National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria for vascular dementia (VaD). Results: The annual IR for total dementia was 1.28%, which increased with age from 0.77% for 65- to 74-year-olds to 6.19% for persons aged 85 years or older. AD (25 cases, 41.7%, IR = 0.54%) was the most common cause of dementia, followed by VaD (19 cases, 31.7%, IR = 0.41%) and mixed dementia (9 cases, 15.0%). After adjusting for sex, increasing age was significantly associated with total dementia and AD (p < 0.01). Illiteracy was associated with a marginally increased risk for total dementia (aRR = 1.59, p < 0.1) as was being female for AD (aRR = 1.92, p < 0.1). The a-year mortality rate was high among the demented (48% in total dementia, 38% in AD, and 60% in VaD). Conclusions: The age-specific incidence of dementia in Taiwan is approaching that of developed countries and the low prevalence of dementia (especially VaD) may be mainly due to the high mortality. Age was the major risk factor for total dementia and AD. Being female was probably a risk factor for AD, as was illiteracy for total dementia.