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EPIDEMIOLOGY AND PREVENTION OF DEMENTIA

Objective

The general objective of EURODEM is to study the prevalence, incidence and risk factors of dementia in order to detect preventable causes of the dementing illnesses.
EURODEM is a concerted action designed to strengthen, develop, and provide data on the epidemiological study of dementing diseases in Europe. It involved the study of prevalence, incidence and risk factors of dementia in order to detect preventable causes of dementing diseases. The following 3 subprojects were set up to address each of these issues. EURODEM-Prevalence documented the magnitude of the problem: dementia prevalence doubles nearly every 5 years, affecting more than 30% of these 85 years and older. EURODEM-Incidence estimated that approximately 10 cases per 1000 person years develop in individuals 65 years and older. Both the prevalence and incidence data suggests that 60% of the dementia cases are attributable to Alzheimer's disease. EURODEM-Risk factors, the subproject in which 11 existent case control studies were jointly analysed, identified a list of risk factors that are consistently and meaningfully associated with the risk of Alzheimer's disease. These include family medical history of dementia and Parkinson's disease, individual medical history of depression and previous injury, maternal age at respondent's birth, chemical intoxications, and sociodemographic characteristics. Because risk factor studies based on prevalent cases are often flawed by bias, it is generally agreed that these risk factor studies need to be further studied in incidence studies of dementia. The main objective of EURODEM-Incidence was to coordinate the development and initiation of incidence studies in various centres in Europe so that methods of case finding and case definition and the information collected on risk factors is standardized across centres. This was accomplished through a series EURODEM meetings.
The dementing illnesses pose an important public health problem. The prevalence of dementia is, even according to conservative estimates, high. On the basis of the available prevalence figures the total number of patients suffering from severe dementia in the twelve EC countries has been estimated to be 1.5 to 2.0 million. This number is expected to rise by at least 20% until the year 2000. Each year an estimated 150,000 to 250,000 patients are newly hospitalized for dementia in the EC countries. In view of the high prevalence of dementia and the large social and economic costs it inflicts, it is remarkable that so little is known about its epidemiology. The lack of epidemiological research, in Europe as well as in other parts of the world, is even more striking when one considers that what is know emphasizes the need for epidemiological studies. In particular, there is evidence for geographical variation in the occurrence of the dementing illnesses, and its major subtypes Alzheimer's disease and vascular dementia. Based on these considerations, the EC initiated a concerted action on the epidemiology and prevention of dementia (EURODEM).

To achieve its goal, three sub-projects were developed, with the following objectives:

EURODEM - Prevalence
1 to compare the prevalence of dementia in various European countries;
2 to compare the relative contribution that each sub-type of dementia (Alzheimer's disease, vascular dementia, mixed dementia and other dementias) contributes to the overall rate of dementia.

EURODEM - Incidence
1 to estimate the incidence of dementing diseases in Europe;
2 to coordinate the development of standardized approaches to the design of new incidence studies.

EURODEM - Risk factors
1 to study risk factors for dementia in order to detect preventable causes of the dementing illnesses;
2 to identify risk factors to be investigated in the incidence studies.

Funding Scheme

CON - Coordination of research actions

Coordinator

Erasmus University Medical School
Address

3000 DR Rotterdam
Netherlands