Dementia Incidence Dropping In Those With At Least High School Education Interview with:

Claudia L. Satizabal, PhD Instructor in Neurology Boston University School of Medicine The Framingham Heart Study Boston, MA 02118-2526

Dr. Claudia Satizabal

Claudia L. Satizabal, PhD
Instructor in Neurology
Boston University School of Medicine
The Framingham Heart Study
Boston, MA 02118-2526

MedicalResearch: What is the background for this study? What are the main findings?


Dr. Satizabal: Our societies are expected to face an increasing burden of dementia in the next decades due to increasing life expectancies and the aging of a big proportion of the population, the so called “baby boomers”. However, some studies conducted in high-income countries have suggested a decline in the total number of cases (prevalence) as well as new cases (incidence) of dementia at any given age. Yet the findings of these studies were not seen as definitive, either because results were of borderline significance or because they were based on survey data, and stronger evidence was lacking.

We used information collected since 1975 in the Framingham Heart Study to estimate the trends in dementia incidence. One of the strengths of this study is that investigators have been careful to use the same diagnostic criteria for over the past 30 decades, which allows us to provide more robust evidence of dementia trends over time.

We found that there has been a progressive decline in the incidence of dementia at any given age over the past 30 decades. Compared to the late 1970s, we observed a decline of 22% in the late 1980s, 38% in the 1990s and 44% in the 2000s. This beneficial trend was only seen among persons with at least a high school diploma. We also explored trends in vascular risk factors such as blood pressure, smoking, diabetes, and others; however, these trends did not completely explain the decline in dementia incidence. One interesting finding was that the risk of dementia associated with cardiovascular diseases, such as stroke or atrial fibrillation, decreased dramatically over the course of time from the late 1970s to the 2000s.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Satizabal: The findings of our study are encouraging because they suggest that some dementia cases may be delayed or even preventable. Although the studied vascular risk factors did not completely explain the observed trends, our results suggest that earlier detection and better management of cardiovascular diseases may offer a possibility to help diminish new cases of dementia.

Patients need to be aware that improved cardiovascular health often translates into improved brain health. Their adherence to primary and secondary prevention is therefore key to decrease the burden of dementia in the next decades.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Satizabal: Our study has shown a decrease in the incidence of dementia and encourages new research to identify which are the factors contributing with this decline, so that public health policies can be implemented to accelerate this beneficial trend. Although we considered several vascular risk factors, we were not able to study the impact of other lifestyle aspects such as diet, exercise, environmental pollution, and others, which could have contributed to the observed trends.

MedicalResearch: Is there anything else you would like to add?

Dr. Satizabal: This study required an enormous amount of quality data and it was only possible thanks to the exceptional dedication of Framingham participants, who have contributed their information for more than 60 years across three generations. It was also thanks to the work previous and current Framingham investigators who continue gathering quality information.


Incidence of Dementia over Three Decades in the Framingham Heart Study 

Claudia L. Satizabal, Ph.D., Alexa S. Beiser, Ph.D., Vincent Chouraki, M.D., Ph.D., Geneviève Chêne, M.D., Ph.D., Carole Dufouil, Ph.D., and Sudha Seshadri, M.D.

N Engl J Med 2016; 374:523-532
February 11, 2016 DOI: 10.1056/NEJMoa1504327

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Claudia L. Satizabal, PhD (2016). Dementia Incidence Dropping In Those With At Least High School Education

Last Updated on February 11, 2016 by Marie Benz MD FAAD