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Dementia a public health priority: online appendix

24 août 2012 Organisation mondiale de la santé

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WHO/NMH/MSD/2012.3

DEMENTIA A Public Health Priority Online appendix Table of contents 1. Methodology for dementia prevalence estimate 2. Full list of studies included and excluded from the systematic review of dementia prevalence 3. The quality of the studies included in the survey 4. Strategies used to generate prevalence estimates within global burden of disease regions 5. Methodology for dementia incidence estimate 6. Full list of studies included and excluded from the systematic review of dementia incidence 2 4 25 27 31 33

1. Methodology for dementia prevalence estimate We conducted a systematic review of the global literature on the prevalence of dementia (1980‐2009) and a meta‐analysis to estimate prevalence and numbers affected, aged 60 years and over in 21 Global Burden of Disease regions. Search strategy: We searched PubMed/ Medline databases using the search terms ("Dementia"[Mesh] AND (("Prevalence"[Mesh]) OR "Epidemiology"[Mesh])). Inclusion criteria: Population‐based studies of the prevalence of dementia among people aged 60 years and over (according to DSM‐IV or ICD‐10 criteria, or similar clinical criteria), for which the field work started on or after 1st January 1980. Exclusion criteria: Studies of prevalence from the follow‐up phase of on an incidence cohort; out‐of‐date population registers (more than three years prior to the survey); nursing home or residential care populations, primary care attendees or other unrepresentative service‐user populations; ascertainment based on help‐seeking and/ or receipt of dementia care services; studies where ‘dementia’ was diagnosed purely on the basis of cognitive impairment; two phase studies, in which screening procedures were inadequate and two phase methodology was not properly applied; studies of the prevalence of Alzheimer’s disease or other subtypes. Technical notes: For China, we relied on a recently published systematic review and meta‐analysis that included both English language and Chinese publications from 1980‐20041, supplemented with studies published in English and not included in that meta‐analysis2‐4. All eligible studies were systematically coded for their study design and quality (sample size, study design, response proportion and diagnostic assessment) Data extraction: We extracted, or calculated from data provided, numerators and denominators for each age and gender group reported. Meta‐analytical methods for estimating dementia prevalence within regions Within each GBD region, where there were sufficient data to conduct a meta‐analysis, we used a random effect exponential (Poisson) model to assess effects of age and sex on dementia prevalence. Age was coded as the mean for each age group reported. Random effects are assumed to have a gamma distribution – the

alpha coefficient is an estimate of overdispersion and an index of between study heterogeneity. For each region we ran two models, one for the effect of age, and one for the main effects of age and sex, and an interaction between age and sex. We then applied the relevant mean ages and sex codings to the coefficients estimated from the models, to estimate prevalence in five year age‐bands from 60‐89 years, and for those aged 90 and over, for both sexes combined (from the age only model), and for men and women separately (from the age and sex model). (1) Gurvit H et al. The prevalence of dementia in an urban Turkish population. American Journal of Alzheimer’s Disease and Other Dementias, 2008, 23 (1): 67–76. (2) World Alzheimer’s Report 2009. London, Alzheimer’s Disease International, 2009. (3) Molero AE, Pino‐Ramirez G, Maestre GE. High prevalence of dementia in a Caribbean population. Neuroepidemiolog, 2007;29(1‐2):107‐12. (4) Canadian Study of Health and Ageing. Canadian study of health and aging: study methods and prevalence of dementia. Canadian Medical Association Journal, 1994, 5, 150 (6): 899–913.

2. Full list of studies included and excluded from the systematic review of dementia prevalence A. INCLUDED STUDIES Table 1 List of studies included in the review, by global disease of burden region and country Asia Pacific Japan Japan Japan Japan Japan Japan Japan Republic of Korea Republic of Korea Republic of Korea Republic of Korea Republic of Korea Singapore Singapore Asia, East China China China China China China China China China China China China China China China China China China China China Paper ID 1.1.5 1.1.7 1.1.10 1.1.11 1.1.15 1.1.17 1.1.18 1.2.2 1.2.3 1.2.4 1.2.5 1.2.6 1.3.1 1.3.2 Paper ID 2.2.1 2.2.2 2.2.3 2.2.4 2.2.7 2.2.10 2.2.11 2.2.12 2.2.13 2.2.14 2.2.15 2.2.16 2.2.17 2.2.18 2.2.19 2.2.20 2.2.21 2.2.22 2.2.23 2.2.24 Author (reference) Ueda K Komahashi T2 Ogura C3 Asada T4 Hatada K5 Yamada T6 Ikeda M7 Woo JI8 Lee DY9 Suh GH10 Kim J11 Jhoo JH12 Kua EH13 Kua EH14 Author (reference) Chen XS15 Gao SR16 Li G17 Zhang MY18 Mao RH19 Wang D20 Xue GH21 Li ZJ22 Chen ZY23 Zhang J24 Tang MN25 Gao ZX26 Xiao ZJ27 Li SR28 Wang TX29 Wang W30 Fan JX31 Zhang ZX32 Tang MN33 Zhou B34 1

Year District 1992 1994 1995 1996 1999 2001 2001 1998 2002 2003 2003 2008 1991 1995 Hisayama Ohiro Okinawa Prefecture Yamanashi Prefecture Nagasaki Prefecture Amino‐cho Nakayama Yonchon County Seoul Yonchon County Busan Seongnam Singapore (Chinese) Singapore (Chinese and Malay) Beijing Beijing Beijing Shanghai Longyan Shanghai Guangdong Dongcheng/ Beijing Shihezi/ Xinjiang Haidian District/ Beijing Sichuan Shanghai Furong District/Changsha Beijing urban

Pubmed ID 1595095 7891413 7635599 8576504 11475427 11235852 11552014 9706887 12133018 14511090 12833306 18841012 1853727 8821351 Pubmed ID 3652848 . 2788352 2353798 . . . . . 10322700 . . . . . 10859498 . . . 11769695

Year District 1987 1989 1989 1990 1993 1995 1997 1997 1998 1998 1999 1999 1999 1999 1999 2000 2000 2000

Anhui province (rural) Beijing urban Nanjing Baoshan district/ Shanghai 2001 Chengdu (rural) 2001 Shanghai (urban and rural)

China China China China China China China China China China Hong Kong SAR Taiwan, China Taiwan, China Taiwan, China Taiwan, China Asia, South India India India India India India India Asia, South East Sri Lanka Thailand Thailand Thailand Malaysia Australasia New Zealand Australia Australia Australia Europe, Central Poland Poland Europe, West Israel Israel France France Netherlands

2.2.25 2.2.26 2.2.27 2.2.28 2.2.29 2.2.30 2.2.321 2.2.322 2.2.33 2.2.34 2.3.1 2.1.1 2.1.2 2.1.3 2.1.4 Paper ID 3.1.1 3.1.2 3.1.3 3.1.4 3.1.5 3.1.71 3.1.72 Paper ID 4.1.1 4.2.1 4.2.2 4.2.4 4.3.1 Paper ID 5.1.1 5.2.1 5.2.3 5.2.4 Paper ID 7.1.4 7.1.5 Paper ID 9.1.2 9.1.3 9.2.1 9.2.9 9.3.1

Qu QM35 Zhang GC36 Tang Z37 Zou KL38 Li WB39 Zhang ZX40 Llibre Rodrigues J41 Llibre Rodrigues J41 Shen YC42 Dong MJ43 Chiu HF44 Liu HC45 Liu CK46 Liu HC47 Lin RT48 Author (reference) Shaji S Rajkumar S50 Chandra V51 Vas CJ52 Shaji S53 Llibre Rodriguez J41 Llibre Rodriguez J41 Author (reference) de Silva HA Phanthumchinda k55 Senanarong V56 Wangtongkum S57 Krishnaswamy S58 Author (reference) Campbell AJ Kay DW60 Henderson AS61 Smith K62 Author (reference) Gabryelewicz T Bdzan LB64 Author (reference) Bowirrat A Kahana E66 Obadia Y67 Ritchie K68 Heeren TJ69 65 63 59 54 49

2001 2001 2002 2002 2003 2005

Xi'an Shanghai Beijing (urban and rural) Yuzhong/ Chongqing Inner Mongolia Beijing; Xian; Shanghai; Chengdu 2008 Beijing urban 2008 Beijing rural 1994 Beijing 2007 1998 1995 1996 1998 Systematic Review Hong‐Kong urban and rural Saa‐Min/Kaohsiung City Kinmen

. . . . . 15767510 18657855 18657855 8187576 17965036 9566386 7836638 8961673 9772013 9804120 Pubmed ID 8773818 9251930 9781520 12003250 15684237 18657855 18657855 Pubmed ID 12891639 . . 19127790 . Pubmed ID 6846087 4080881 8084942 18799785 Pubmed ID 10786235 17598428 Pubmed ID 11284991 12700906 9258521 8296946 2071805

1998 Kaokaoping Year District 1996 1997 1998 2001 2005 2008 2008 2003 1991 2000 2008 1997 1983 1985 1994 2008 Emakulam (rural) Madras Ballabgarh Mumbai (urban) Emakulam (urban) Chennai Vellore Ragama Bangkok (urban slum) Bangkok Chiang Mai Kuala Lumpur (urban) Gisborne Hobart Canberra/ Queanbeyan Kimberley

Year District

Year District 1999 Mokotol 2007 Gdansk Year District 2001 2003 1997 1994 1991 Wadi Ara Ashkelon Southeastern ‐ Marseille Aquitaine Leiden

Netherlands Netherlands Netherlands Netherlands Sweden Sweden Sweden Sweden Germany Germany Germany Finland Denmark Denmark Spain Spain Spain Spain Spain Spain Spain Spain Spain Italy Italy Italy Italy Italy Italy Italy Italy Italy Italy Italy Italy Italy Italy Belgium Norway San Marino United Kingdom

9.3.2 9.3.5 9.3.6 9.3.7 9.4.1 9.4.2 9.4.4 9.4.6 9.5.2 9.5.3 9.5.4 9.6.6 9.7.2 9.7.3 9.8.1 9.8.2 9.8.3 9.8.5 9.8.6 9.8.7 9.8.9 9.8.10 9.8.11 9.9.1 9.9.3 9.9.4 9.9.6 9.9.7 9.9.9 9.9.10 9.9.11 9.9.12 9.9.13 9.9.15 9.9.16 9.9.17 9.9.18 9.10.1 9.11.1 9.12.1 9.13.1

Ott A70 Thomassen R71 Boersma F72 Blansjaar BA73 Fratiglioni L74 Skoog I75 Borjesson‐Hanson A76 Von Strauss E77 Meller I78 Wernicke TF79 Riedel‐Heller SG80 Juva K81 Andersen K82 Andersen‐Ranberg K83 Coria F84 Lobo A85 Manubens JM86 Pi J87 Vilalta‐Franch J88 Garcia Garcia FJ89 Gascon‐Bayarri J90 Fernandez M91 Lobo A92 Rocca WA93 D'Alessandro R94 Ferini‐Strambi L95 Azzimondi G96 De Ronchi D97 Ravaglia G98 Cristina S99 Ravaglia G100 Benedetti MD101 Tognoni G102 Prencipe M103 Francesconi P104 Francesconi P105 Francesconi P106 Roelands M107 Engedal K108 D'Alessandro R109 O'Connor DW110

1995 1998 1998 2000 1991 1993 2004 1999 1993 1994 2001 1993 1997 2001 1993 1995 1995 1996 2000 2001 2007 2008 2007 1990 1996 1997 1998 1998 1999 2001 2002 2002 2005 1996 2006 2006 2006 1994 1993 1988 1989

Ommoord/ Rotterdam One Dutch town Zwolle Three Dutch Towns Stockholm (Kungsholmen) Gothenburg Gothenburg Stockholm Munich Berlin Leipzig Helsinki Odense Nationally Represented Turegano Zaragoza Pamplona Catalunya Girona Toledo El Prat de Llobregat/ Barcelona Mungialde/ Vizcaya Zaragoza Appignano Troina, Sicily Vescovato S Agata Militello, Sicily Ravenna Bologna; Ravenna Pavia Conselice Buttapietra/ Verona Tuscany, Vecchiano rural villages near L'Aquila Tuscany, Dicomano Tuscany, Impruneta Tuscany, Greve/ Bagno Antwerp Oslo San Marino Cambridge

7728032 9443495 9495684 10713579 1745343 8417380 15623723 10328254 8499498 8309568 11532803 8442392 9272182 11316833 8410037 7771920 7643949 8719047 10904947 11333686 17878737 18247280 17803760 2320236 8982619 9085005 9701834 9595968 10430440 11784344 12145456 11901276 16008529 8648328 17176938 17176938 17176938 8090257 . 3255434 2923012

United Kingdom United Kingdom United Kingdom United Kingdom United Kingdom Switzerland North America Canada

9.13.2 9.13.3 9.13.4 9.13.5 9.13.7 9.14.1 Paper ID 15.1.2

Brayne C111 Livingston G112 Clarke M113 Saunders PA114 MRC CFAS115 Gostynski M116 Author (reference) Canadian Study of Health and Aging Working Group117 Newman SC118 Pfeffer RI Folstein MF120 Hendrie HC121 Graves AB122 Fillenbaum GG123 Breitner JC124 Haan MN125 Plassman BL126 Author (reference) Galasko D Author (reference) Llibre JJ Llibre Rodrigues J41 Llibre JJ129 Llibre Rodrigues J41 Author (reference) Llibre Rodrigues J41 Llibre Rodrigues J41 Custodio N130 Author (reference) Molero AE131 Llibre Rodrigues J41 128 127 119

1989 1990 1991 1993 1998

East Cambridgeshire London, Gospel Oak Melton Mowbray Liverpool Liverpool, Newcastle, Nottingham, Oxford 2002 Zurich Year District

2597917 2284396 1776585 8282463 9572090 12512226 Pubmed ID

1994 Nationally representative 8131123

Canada United States of America United States of America United States of America United States of America United States of America United States of America United States of America United States of America Oceania

15.1.4 15.2.2 15.2.6 15.2.10 15.2.13 15.2.14 15.2.18 15.2.22 15.2.24 Paper ID

1998 Edmonton/ Alberta 1987 California 1991 Baltimore 1995 Indianapolis

9825162 3812449 2071834 7573588

1996 King County/ Washington 8857825 1998 Piedmont/ North Carolina 9674666 1999 Cache County/ Utah 10430421

2003 Sacramento Valley/ 12558712 California 2007 Nationally representative 17975326 Year District 2007 Indigenous (Chamorros) Year District 1999 2008 2009 2008 Marianao/ Habana Havana/ Matanzas Havana Santo Domingo Pubmed ID 17515539 Pubmed ID 10637837 18657855 . 18657855 Pubmed ID 18657855 18657855 . Pubmed ID 17940342 18657855

Guam, United 16.1.1 States of America Caribbean Cuba Cuba Cuba Dominican Republic Latin America, Andean Peru Peru Peru Latin America, Central Venezuela Venezuela Paper ID 6.1.1 6.1.2 6.1.3 6.2.1 Paper ID 10.1.11 10.1.12 10.1.2 Paper ID 11.1.1 11.1.2

Year District 2008 Urban ‐ Lima 2008 Rural ‐ Canete 2008 Cercado de Lima Year District 2007 Maracaibo 2008 Caracas

Mexico Mexico Latin America, Southern Chile Latin America, Tropical Brazil Brazil Brazil North Africa/ Middle East Turkey Egypt Sub‐Saharan Afrca, West Nigeria

11.3.11 11.3.12 Paper ID 12.1.1 Paper ID 13.1.1 13.1.2 13.1.3 Paper ID 14.1.3 14.2.1 Paper ID 18.1.2

Llibre Rodrigues J41 Llibre Rodrigues J41 Author (reference) Albala C132 Author (reference) Herrera E Jr133 Scazufca M134 Bottino CMC135 Author (reference) Gurvit H136 Farrag A137 Author (reference) Hendrie HC138

2008 Mexico City 2008 Rural ‐ Morelos Year District 1997 Concepcion Year District 2002 Catanduva 2008 Sao Paulo 2008 Sao Paulo Year District 2008 Istanbul 1998 Assiut Year District 1995 Ibadan

18657855 18657855 Pubmed ID . Pubmed ID 12040305 17559708 18843181 Pubmed ID 18276959 9769445 Pubmed ID 7573588

B. EXCLUDED STUDIES We provide details of all studies that were considered for inclusion in the review, on the basis of review of the study abstracts, but were not finally included. This was because, either a) on reading the paper, the study was found not to meet inclusion criteria, or b) the study may have, or did meet inclusion criteria, but we were not able to obtain the required prevalence data for the review (‘pending’ papers). This circumstance arose when i) we could not obtain a copy of the paper, and had only the abstract to go on ii) the required information was not provided in the paper We have collated information about excluded papers (Table 2) and pending papers (Table 3) separately, by region, country and year of publication. Studies excluded, because they did not meet inclusion criteria Ninety‐eight papers were excluded after detailed review of the publication. The most common reasons for exclusion were; duplicate or overlapping publications (45 publications); the outcome was not a clinical diagnosis of dementia syndrome (21 publications); prevalence estimate from the follow‐up phase of a cohort study (12 publications); data collection pre‐1980 (8 publications); not a population‐based representative sample (5 publications); ascertainment of dementia diagnosis from service contact or registers (4 publications). Some studies were excluded for more than one of these reasons. Table 2 Studies excluded because they did not meet the inclusion criteria, with reasons for exclusion, by region and country

Region/ country First Author Year of pub. 1987 1993 1994 1994 1990 1993 1999 1994 2002 2003 2004 2002 1992 1993 1994 1995 2006 2008 Reason for exclusion

ASIA Asia Pacific Japan

Ichinowatari N Ohkuni M Oshiro H Kiyohara Y Kawano H Kawano H Kiyohara Y Kiyohara Y Fujishima M Wakisaka Y Ikeda M Meguro K Chen CH Gao ZH Shen YC Wang Z Zhou DF Lam LC

Asia, East China

Hong Kong SAR Asia South

Data collection pre‐1980 Prevalence estimate in a follow‐up wave of a cohort study Not population based ‐ sample was drawn from hospital services Duplicate publication see study 1.1.5 (Ueda K, et al, 1992) Duplicate publication see study 1.1.5 (Ueda K, et al, 1992) Duplicate publication see study 1.1.5 (Ueda K, et al, 1992) Duplicate publication see study 1.1.5 (Ueda K, et al, 1992) Duplicate publication see study 1.1.5 (Ueda K, et al, 1992) Duplicate publication see study 1.1.5 (Ueda K, et al, 1992) – Incidence study Duplicate publication see study 1.1.5 (Ueda K, et al, 1992) – Incidence study Duplicate publication see study 1.1.18 (Ikeda et al, 2001) Duplicate publication see study 1.1.16 (Ishii H, 1999) Duplicate publication see study 2.1.33 (Shen YC, 1994) Duplicate publication see study 2.1.16 (Gao ZX, 1999) Incidence study AD only Prevalence estimate in a follow‐up wave of a cohort study. AD only. Prevalence of very mild and mild dementia only

India Asia, South East Thailand Australasia Australia EUROPE Europe, Central Poland

Das SK Jitapunkul S Mowry BJ Wender M Bidzan L Parnowski T Sipos K

Neurological disorders study with inadequate screening for dementia 2001 Diagnosis based on cognitive screening test only 1988 Not population‐based. Mild dementia only. 1990 2005 1993 2008

2006

Hungary Czech Republic Europe, West Israel France

Netherlands

Sweden

Germany

Alzheimer’s Disease only Study of cognitive functions only and not dementia Validation of MMSE Dementia ascertained by MMSE only Does not describe research carried out in Czech Republic Koukolik F 1986 (EURODEM prevalence applied to Czech population) Treves T 1986 Early onset AD only. Data collection pre‐1980 Campion D 1999 Early onset AD only Dartigues JF 1991 Duplicate publication see study 9.2.9 (Ritchie et al, 1994) Ramaroson H 2003 Prevalence of dementia assessed in a follow‐up phase of a cohort study Salamon R 1999 Duplicate publication see study 9.2.9 (Ritchie et al, 1994) – descriptive paper Barberger‐ 1992 Study of instrumental activities of daily living as screening Gateau P tool for dementia in the PAQUID sample. Duplicate publication see study 9.2.9 (Ritchie et al, 1994) Dartigues JF 1992 Duplicate publication see study 9.2.9 (Ritchie et al, 1994) – descriptive paper Letenneur L 1999 Prevalence of dementia assessed in a follow up phase of a cohort study Helmer C 2006 Prevalence of dementia assessed in a follow‐up phase of a cohort study Letenneur 1993 Article in French and difficult to obtain – primary data obtained from (Ritchie et al AJPH, 1994 – study 9.2.9) Gagnon M 1990 Does not report prevalence data (validation only) ‐ see study 9.2.9 (Ritchie et al AJPH, 1994) for primary publication Eefsting JA 1996 Duplicate publication see study 9.3.6 (Boersma et al JCE,1998) for primary Boersma F 1997 Duplicate publication study 9.3.6 (Boersma 1998) Rosso SM 2003 FTD only Andreasen N 1999 Dementia cases identified only after referral to health services Grut M 1993 Duplicate publication see study 9.4.1 (Fratiglioni et al, 1991) Fratiglioni L 1994 Duplicate publication see study 9.4.1 (Fratiglioni et al, 1991) Von Strauss E 1999 Duplicate publication see study 9.4.1 (Fratiglioni et al, 1991) Guo Z 1996 Duplicate publication see study 9.4.1 (Fratiglioni et al, 1991) Forsell Y 1997 Duplicate publication see study 9.4.1 (Fratiglioni et al, 1991) Aevarsson O 1996 Duplicate publication see study 9.4.2 (Skoog I, 1993) Aevarsson O 1997 Duplicate publication see study 9.4.2 (Skoog I, 1993) Cooper B 1989 Data collection pre‐1980

Finland

Molsa PK Sulkava R Juva K Kuusisto J Rahkonen T Lauritzen LU Andersen K Lopez Pousa S Lobo A Sicras A Corso EA Bonaiuto S Prencipe M

1982 1985 1992 1994 2003 1996 2000 1995 1992 2005 1992 1995 1997

Denmark Spain

Italy

Belgium Norway

Baldereschi M 1998 Kurz X 2001 Engedal K 1988

United Kingdom Newens AJ 1993 Ratnavalli E 2002 Harvey RJ 2003 THE AMERICAS Latin America Central Colombia Pradilla AG 2003 Latin America, Southern Uruguay North America Canada Ketzoian C Hogan DB Erkinjuntti T Newman SC Rockwood K Graham JE Robertson D Ebly EM 1997 1995 1997 1999 2000 1997 1989 1994 2003 1981 2004 1985 1987 1989 1989 1991 1992 1995

Data collection pre‐1980. Ascertainment on the basis of service contact Data collection pre‐1980 Duplicate publication ‐ see study 9.6.6 (Juva et al Acta N Scand, 1993) for primary data Prevalence from follow‐up phase of cohort study Lewy Body Dementia only Dementia ascertained by MMSE only Duplicate publication see study 9.7.2 (Andersen K, 1997) Apparently a pilot on the same sample as paper 9.8.6 (Vilalta Franch et al) Duplicate publication see study 9.8.2 (Lobo et a, 1995) Dementia case ascertainment from health service contact Register 9 years out of date (1981 for 1989/1990 survey) Duplicate publication see study 9.9.1 (Rocca WA, 1990) Duplicate publication ‐ see study 9.9.15 (Prencipe JNNP, 1996) AD prevalence only, by HRT use Not population‐based – primary health care consultees only Duplicate publication ‐ see study 9.11.1 (Engedal et al IJGP, 1993) for primary Early onset dementia only Early onset dementia only Early onset dementia only Neurological disorders study with inadequate screening for dementia Neurological disorders study with inadequate screening for dementia Duplicate publication see study 15.1.2 (CSHA, 1994) Duplicate publication see study 15.1.2 (CSHA, 1994) Duplicate publication see study 15.1.2 (CSHA, 1994) Duplicate publication see study 15.1.2 (CSHA, 1994) Duplicate publication see study 15.1.2 (CSHA, 1994) Cognitive screening only Duplicate publication – part of the wider CSHA study (see study 15.1.2) AD only. Prevalence calculated indirectly from incidence. Duplicate publication see study 15.2.1 (Schoenberg, 1985) Prevalence estimate in a follow‐up wave of a cohort study. Data collection pre‐1980. Severe dementia only Data collection pre‐1980 Dementia ascertainment based on clinical records. Data collection pre‐1980 AD only Prevalence estimate in a follow‐up wave of a cohort study. Prevalence estimate in a follow‐up wave of a cohort study. Duplicate publication, see study 15.2.19 (Demirovic J, 2003)

United States of Herbert LE America Schoenberg BS Fitzpatrick AL Schoenberg BS Copeland J Kokmen E Evans DA Aronson MK Bachman DL Prineas RJ

White L Holder J Albert SM

1996 1998 1999

Pressley JC Lopez OL Corrada MM Gureje O Baker FM Ogunniyi A Harmanci H Keskinoglu P

2003 2003 2008 2006 1995 1997 2003 2006

AFRICA West Africa Nigeria

North Africa/ Middle East Turkey

Prevalence estimate in a follow‐up wave of a cohort study Amish community only. Dubious validity of phase 1 screening procedure. Not population based and recruitment was based on health care finance administration files and case reporting health system for the elderly Comparison of dementia diagnosis based on self‐reported diagnosis, Medicare claims or cognitive screening only Prevalence estimate in a follow‐up wave of a cohort study. Prevalence estimate in a follow‐up wave of a cohort study. Duplicate publication see study 18.1.2 (Hendrie et al, 1995) Duplicate publication see study 18.1.2 (Hendrie et al, 1995) Duplicate publication see study 18.1.2 (Hendrie et al, 1995) Duplicate publication see study 14.1.3 (Gurvit H, 2008) Dementia ‘diagnosis’ by MMSE cutpoint only

‘Pending’ studies Twenty studies were potentially eligible, but could not be used in this review. In three cases we were not able to obtain the publication referred to in the abstract. In one case, a prevalence study appeared to have been conducted, but we were not able to identify the index publication containing prevalence data. In one case we were not able to determine eligibility from information contained in the publication. For the remaining 15 studies, the data presented was not in the form that allowed us to extract and use it, usually because no age‐specific estimates were provided. In all of thee cases we have attempted to contact authors for further information. Table 3 List of ‘Pending’ studies (potentially eligible studies, but data could not be used in the review), by region and country Region/ country Study First Author Year Reason for inability to use data code of pub. ASIA Asia Pacific Japan 1.1.16 Ishii H 1999 ‘Analysis 3’ may be eligible as a very small subsample survey with extensive clinical ascertainment. Otherwise dementia diagnosed on the basis of cognitive impairment only. More information needed on sampling (representativeness) 1.1.1 Shibayama H 1986 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided 1.1.3 Mutou T 1989 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided 1.1.4 Fukunishi I 1989 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided 1.1.12 Nakajima K 1998 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided 1.1.13 Urakami K 1998 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided 1.1.14 Shiba M 1999 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided Republic of 1.2.1 Kim E 1993 Have not been able to obtain publication Korea EUROPE Europe, Central Poland Albania Europe, East Russian Federation Europe, West Israel Netherlands 7.1.3 7.4.1 8.1.1 9.1.4 9.3.4 Rossa G Kruja J Gavrilova SI Wertman E 1997 2002 1987 Insufficient information to extract data. Have not been able to obtain publication Have not been able to obtain publication

Sweden

9.4.5

2007 Insufficient information to estimate precision. No numerators, denominators, 95% CI or SE Schmand B 1997 AMSTEL study. Prevalence survey apparently conducted, but no prevalence publication yet identified Wancata J 2007 Overall prevalence estimates only; neither age‐

Italy

9.9.19

THE AMERICAS North America United States of 15.2.8 America 15.2.17 Gurland BJ

Italian Longitudinal Study on Aging Working Group Heyman A

nor gender‐ specific prevalence provided 1997 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided . 1991 Overall prevalence estimates by gender only; no age‐specific prevalence provided 1999 Overall prevalence estimates by gender only; no age‐specific prevalence provided 2003 Overall prevalence estimates by gender only; no age‐specific prevalence provided 1992 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided 1983 Overall prevalence estimates only; neither age‐ nor gender‐ specific prevalence provided

15.2.19 Demirovic J AFRICA Sub‐Saharan Africa, West Nigeria Sub‐Saharan Africa, South South Africa 18.1.1 17.1.1 Ogunniyi AO Ben‐Arie O

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3. The quality of the studies included in the survey a. Study design. 70% of dementia prevalence studies used two or more phases. Unfortunately, most did not sample screen negatives, and those that did often did not weight back appropriately. For 79% of multiphase studies (49% of all studies) the design was not correctly applied and/ or analysed appropriately. b. Scope of diagnostic assessment. Dementia diagnosis requires cognitive impairment (and decline) in memory and other domains of intellectual function, with consequent social or occupational impairment. Other causes including psychosis, depression and delirium should be excluded. Only 43% of studies included multidomain cognitive testing, disability assessment, clinical interview and informant interview. Informant interviews were most likely to be omitted. c. Sample size. A study of 500 participants could estimate a true prevalence of 6% with a precision of +/‐ 2.1%. Precision increases to +/‐ 1.2% for a sample size of 1500 and to +/‐ 0.8% for a sample size of 3000. Most studies had sample sizes smaller than 1500. Nearly a third of Western European studies had sample sizes smaller than 500. Sample sizes tended to be larger in East Asia and in LMIC studies generally. d. Response proportion. Participation in studies of dementia prevalence was generally adequate to good; only six studies (4%) reported fewer than 60% of eligible participants responding, while more than half reported 80% or more responding. However, 15% of studies did not report response rates. e. Overall quality. Mean scores for the ad hoc quality index varied significantly between regions. Overall study quality was high for the Latin American region, and particularly poor for Asia Pacific High Income and South East Asia studies. Study quality did not differ significantly between HIC and LMIC. Study had improved over time – from a mean of 7.3 for studies conducted in the 1980s, to 7.8 for the 1990s, to 9.0 for studies conducted this century.

Prevalence study characteristics, by region (for those regions within which meta‐analyses were conducted), and by country income level

Europe

North Ameri ca

Latin Ameri ca and Caribb ean 15 0 3 (20%) 12 (80%) 0 5 (36%) 8 (57%) 1 (7%)

Asia Australa Asia, Pacific sia East High Incom e 20 7 (35%) 10 (50%) 3 (15%) 3 (16%) 7 (37%) 5 (26%) 4 (21%) 4 2 (50%) 1 (25%) 1 (25%) 2 (50%) 2 (50%) 0 0 34 5 (15%) 25 (74%) 4 (12%) 0 10 (29%) 10 (29%) 14

Asia, South

Asia, High‐ South incom East e countri es 5 1 (20%) 2 (40% 2 (40%) 1 (20%) 4 (80%) 0 0 93 25 (27%) 59 (63%) 9 (10%) 21 (23%) 34 (37%) 21 (23%) 16

Low‐ All and regions middle‐ income countri es 64 8 (13%) 32 (50%) 24 (38%) 3 (5%) 24 (38%) 22 (34%) 15 157 33 (21%) 91 (58%) 33 (21%) 24 (16%) 58 (37%) 43 (28%) 31

Number of studies1 Year of research 1980‐1989 1990‐1999 After 2000 Sample size <500 500‐1499 1500‐2999 >=3000

51 13 (26%) 34 (67%) 4 (8%) 16 (31%) 19 (37%) 9 (18%) 7 (14%)

13 3 (23%) 9 (69%) 1 (8%) 0 4 (31%) 5 (39%) 4 (31%)

7 0 4 (57%) 3 (43%) 1 (14%) 3 (43%) 2 (29%) 1 (14%)

Outcome ICD‐10 DSM‐IV/ IIIR GMS/ AGECAT CAMDEX Other Design One phase Two or more phases Multiphase design applied and analysed correctly 2 Response proportion <60% 60‐79% 80‐100% Not specified Assessment quality Comprehensiv e diagnostic assessment 3 Overall quality score 4 Mean (SD)

1 (2%) 37 (73%) 2 (4%) 6 (12%) 5 (10%) 16 (31%) 36 (69%) 22%

0 (0%) 9 (69%) 1 (8%) 0 (0%) 3 (23%) 2 (15%) 11 (85%) 55%

0 8 (53%) 0 0 7 (47%) 10 (67%) 5 (33%) 20%

1 (5%) 17 (85%) 0 (0%) 0 (0%) 2 (10%) 3 (15%) 17 (85%) 12%

0 2 (67%) 0 0 1 (33%) 3 (75%) 1 (25%) 100%

(41%) 1 (7%) 10 (71%) 0 0 3 (21%) 3 (21%) 11 (89%) 9%

1 (14%) 4 (57%) 0 (0%) 0 2 (29%) 3 (43%) 4 (57%) 0%

0 4 (80%) 1 (20%) 0 0 0 5 (100%) 0%

(17%) 3 (3%) 69 (75%) 3 (3%) 6 (7%) 11 (12%) 25 (27%) 69 (73.%) 25%

(23%) 2 (5%) 25 (60%) 1 (2%) 1 (2%) 13 (31%) 16 (36%) 20 (46%) 11%

(20%) 5 (4%) 94 (70%) 4 (3%) 7 (5%) 24 (18%) 41 (30%) 97 (70%) 21%

5 (10%) 16 (31%) 28 (54%) 3 (6%) 28 (55%)

0 6 (46%) 5 (39%) 2 (15%) 5 (39%)

0 2 (13%) 10 (67%) 3 (20%) 11 (73%)

0 3 (15%) 10 (50%) 7 (35%) 2 (10%)

0 2(50%) 2 (50%) 0 0

0 4 (29%) 10 (71%) 0 4 (31%)

0 1 (14%) 5 (71%) 1 (14%) 3 (43%)

0 1 (20%) 1 (20%) 3 (60%) 1 (20%)

5 (5.3%) 29 (31%) 48 (51%) 12 (13%) 36 (39%)

1 (2%) 8 (18%) 26 (59%) 9 (21%) 21 (51%)

6 (4%) 37 (27%) 74 (54%) 21 (15%) 57 (43%)

8.2 (1.8)

8.2 (1.7)

9.7 (2.0)

6.6 (1.6)

8.3 (0.9)

8.0 (1.9)

8.4 (2.2)

5.5 (0.7)

7.8 (1.8)

8.3 (2.5)

7.9 (2.0)

1. These numbers differ from the totals listed elsewhere, as we were not able to ascertain some or all study characteristics for some of the ‘pending’ studies, about which we were seeking further information from authors. Also full details on methodology were not available from several of the Chinese language publications, summarised in a previous published meta‐analysis1 2. As a proportion of all studies using a multiphase design (i.e. with two or more phases, with screening performed on all in the first phase, and definitive diagnostic assessment on a sub‐sample based on screening score) 3. Defined as a multidomain cognitive battery, an informant interview, a formal assessment of disability, and a clinical interview 4. Derived from sample size, design, response proportion and assessment quality (see text for details)

(1) Dong MJ et al. The prevalence of dementia in the People's Republic of China: a systematic analysis of 1980–2004 studies. Age and Ageing, 2007, 36 (6): 619–264.

4. Strategies used to generate prevalence estimates within global burden of disease regions Table 1 Strategies used within regions in which it was possible to carry out a quantitative meta‐analysis GBD Region Countries (those with one or more studies Relationship to Approach used to underlined) WHO regions generate regional used for ADI/ prevalence and Lancet estimates numbers ASIA Asia Pacific, High Brunei Darussalam, Japan, Republic of WPRO A except Apply estimates from Income Korea, Singapore for Republic of meta‐analysis. Korea (WPRO B) Apply estimates from Asia, East China, (including Hong Kong Special WPRO B except meta‐analysis. Administrative Region and Taiwan), for Democratic Democratic People’s Republic of Korea People’s Republic of Korea (SEARO D) Asia, South Afghanistan, Bangladesh, Bhutan, India, SEARO D except Apply estimates from Nepal, Pakistan for Afghanistan meta‐analysis. and Pakistan (EMRO D) Asia, Southeast Cambodia, Christmas Island, Cocos Islands, Mainly SEARO B Apply estimates from and WPRO B. meta‐analysis. Indonesia, Lao People's Democratic Republic, Malaysia, Maldives, Mauritius, Myanmar, Philippines, Reunion, Seychelles, Sri Lanka, Thailand, Timor‐Leste, Viet Nam Australasia Australia, New Zealand WPRO A Apply estimates from meta‐analysis. EUROPE Europe, Akrotiri and Dhekelia, Aland Islands, EURO A Apply estimates from Western Andorra, Austria, Belgium, Channel Islands, meta‐analysis. Cyprus, Denmark, Faeroe Islands, Finland, France, Germany, Gibraltar, Greece, Greenland, Holy See, Iceland, Ireland, Isle of Man, Israel, Italy, Jersey, Liechtenstein, Luxembourg, Malta, Monaco, Netherlands, Norway, Portugal, San Marino, Spain, Svalbard, Sweden, Switzerland, United Kingdom THE AMERICAS North America Canada, Saint Pierre et Miquelon, United AMRO A Conduct meta‐analysis States of America for United States of America. Apply CSHA data for Canada, then aggregate Latin America, AMRO D Bolivia, Ecuador, Peru Apply estimates from Andean meta‐analysis conducted across all four regions. There Latin America, Colombia, Costa Rica, El Salvador, AMRO B except were insufficient Central Guatemala, Honduras, Mexico, Nicaragua, for Guatemala studies in any of the Panama, Venezuela and Nicaragua

Latin America, Southern

Latin America, Tropical

Argentina, Chile, Falkland Islands (Malvinas), Uruguay Brazil, Paraguay

(AMRO D) AMRO B

AMRO B

individual regions. Our judgment was that compositional and contextual variation was unlikely to be marked, and the heterogeneity observed in the meta‐ analysis was less than for any other GBD region.

List is relevant as of January 2009.

Table 2 ‐ Strategies used within regions in which it was not possible to carry out a quantitative meta‐ analysis Region Countries (those with one or more Relationship to Approach studies underlined) WHO regions used in ADI/ Lancet ASIA Asia, Central Armenia, Azerbaijan, Georgia, EURO B, except for Apply relevant Kazakhstan, Kyrgyzstan, Mongolia, Kazakhstan (EURO Lancet/ ADI Tajikistan, Turkmenistan, Uzbekistan C) estimates to each country and aggregate WPRO B Data from one study Oceania American Samoa, Cook Islands, Fiji, in Guam only French Polynesia, Guam, Kiribati, (indigenous Marshall Islands, Micronesia, Nauru, New Chamorros islanders. Caledonia, Niue, Norfolk Island, Northern Therefore use Mariana Islands, Palau, Papua New Lancet/ ADI WPRO B Guinea, Pitcairn, Samoa, Solomon Islands, for all countries Tokelau, Tonga, Tuvalu, Vanuatu, Wallis and Futuna Islands EUROPE EURO B, except for Apply relevant Europe, Central Albania, Bosnia and Herzegovina, Lancet/ ADI Croatia, Czech Bulgaria, Croatia, Czech Republic, estimates to each Hungary, Montenegro, Poland, Romania, Republic and Slovenia (EURO A) country and Serbia, Slovakia, Slovenia, The former aggregate Yugoslav Republic of Macedonia Europe, Eastern Belarus, Estonia, Latvia, Lithuania, EURO C Apply Lancet/ ADI Republic of Moldova, Russian Federation, EURO C estimates Ukraine THE AMERICAS AMRO B, other Use 10/66 Cuba and Caribbean Anguilla, Antigua and Barbuda, Aruba, than Haiti (AMRO Bahamas, Barbados, Belize, Bermuda, Dominican Republic D) and Cuba British Virgin Islands, Cayman Islands, prevalence for those (AMRO A) Cuba, Dominica, Dominican Republic, countries. Apply relevant Lancet/ ADI French Guiana, Grenada, Guadeloupe, estimates to other Guyana, Haiti, Jamaica, Martinique, countries and Montserrat, Netherlands Antilles, Puerto aggregate Rico, Saint Barthelemy, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, Turks and Caicos Islands, US Virgin Islands AFRICA North Africa / Algeria, Bahrain, Egypt, Iran, Iraq, Jordan, EMRO B, except for Apply Turkey study estimates to Turkey. Egypt, Iraq, Middle East Kuwait, Lebanon, Libya, Morocco, Apply Egypt study Morocco and Occupied Palestinian Territory, Oman, estimates to Egypt Qatar, Saudi Arabia, Syrian Arab Republic, Yemen (EMRO D), and other EMRO D Algeria (AFRO D) Tunisia, Turkey, United Arab Emirates, and Turkey (EURO countries. Western Sahara, Yemen Apply relevant B) Lancet/ ADI estimates to other countries and

Sub‐Saharan Africa, Central

Angola, Central African Republic, Congo, Democratic Republic of the Congo, Equatorial Guinea, Gabon

A mixture of AFRO D and AFRO E

Sub‐Saharan Africa, East

Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mayotte, Mozambique, Rwanda, Somalia, Sudan, Uganda, United Republic of Tanzania, Zambia Sub‐Saharan Botswana, Lesotho, Namibia, South Africa, Southern Africa, Swaziland, Zimbabwe Sub‐Saharan Benin, Burkina Faso, Cameroon, Cape Africa, West Verde, Chad, Côte d'Ivoire, Gambia, Ghana, Guinea, Guinea‐Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Saint Helena, Sao Tome and Principe, Senegal, Sierra Leone, Togo List is relevant as of January 2009.

AFRO E except for Comoros (AFRO D) and Somalia and Sudan (EMRO D) AFRO E AFRO D

aggregate Apply relevant Lancet/ ADI estimates to each country and aggregate Apply relevant Lancet/ ADI estimates to each country and aggregate Apply Lancet/ ADI AFRO E estimates Apply Nigeria (Hendrie) prevalence estimates to all countries in this region

5. Methodology for dementia incidence estimate We conducted a systematic review of the global literature on the incidence of dementia (1980‐2011) and a meta analysis to estimate the incidence and numbers of new cases, aged 60 years and over in 21 Global Burden of Disease regions. Search strategy: We updated a search conducted in 2009 for the revision of the Global Burden of Disease report to 15th November 2011, using PubMed/ Medline databases and the following search terms ‐ ("Dementia"[Mesh] AND (("Incidence"[Mesh]) OR "Epidemiology"[Mesh])). Inclusion criteria: Population‐based studies of the incidence of dementia among people aged 60 years and over (according to DSM‐IV or ICD‐10 criteria, or similar clinical criteria), for which the baseline cohort recruitment started on or after 1st January 1980. Exclusion criteria: Studies of incidence from the follow‐up phase of on an incidence cohort; out‐of‐date population registers (more than three years prior to the survey); nursing home or residential care populations, primary care attendees or other unrepresentative service‐user populations; ascertainment based on help‐seeking and/ or receipt of dementia care services; studies where ‘dementia’ was diagnosed purely on the basis of cognitive impairment; two phase studies, in which screening procedures were inadequate and two phase methodology was not properly applied; studies of the incidence of Alzheimer’s disease or other subtypes. Technical notes: Five potentially eligible studies had to be excluded, because case (numerator) and person years (denominator) data could not be extracted1‐5. Data extraction: We extracted, or attempted to calculate from the data provided, number of incident cases and person years denominators for each age group reported. Meta‐analytical methods for estimating dementia prevalence within regions As for the meta‐analysis of prevalence data we used a random effect exponential (Poisson) model to assess the effect of age on the incidence of dementia. We conducted separate meta‐regressions on all studies combined, and then separately for HIC, LMIC, and for regions where there was sufficient data to attempt a meta‐analysis (Western Europe, North America and Latin America and the Caribbean combined). We then applied relevant mean ages to the coefficients estimated from the models, to estimate incidence in five year age‐bands from 60‐95 years, and for those aged 95 and over. We further estimated the effect of region and of HIC vs. LMIC location. Estimating numbers of incident cases for each GBD world region We estimated the numbers of annual incident cases by first estimating the numbers at risk (total population in each age group, minus numbers with prevalent dementia), and then by applying the appropriate annual incidence rate (we used the Western Europe rate for the European regions, the North American rate for the North American region and the Latin American rate for the Latin American and Caribbean regions, and the HIC or LMIC rates as appropriate for other regions).

(1) Acosta et al. The epidemiology of dependency among urban‐dwelling older people in the Dominican Republic; a cross‐sectional survey. BMC Public Health, 2008, 8: 285. (2) Kokmen E et al. Prevalence of medically diagnosed dementia in a defined United States population: Rochester, Minnesota, January 1, 1975. Neurology, 1989, 39 (6): 773–776. (3) Ott A et al. Prevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam study. British Medical Journal, 1995, 310 (6985): 970–973. (4) Knapp M, Prince M. Dementia UK – A report into the prevalence and cost of dementia prepared by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and the Institute of Psychiatry at King's College London, for Alzheimer's Society. London, Alzheimer's Society, 2007. (5) Ratnavalli E et al. The prevalence of frontotemporal dementia. Neurology, 2002, 58 (11): 1615–1621.

6. Full list of studies included and excluded from the systematic review of dementia incidence A. INCLUDED STUDIES Table 1 – List of studies included in the review, by region and country Study Setting Country Mid‐ year of baseline survey Not given 1991 Follow‐ up period Lower age limit 65 Criterion Institutions Cohor Person included in t at years sampling? risk Yes 3086 4916

Western Europe 1. Odense study; Andersen et al 1999 (1) 2. Helsinki; Polvikoski et al 2006 (2) 3. PAQUID; Letenneur et al 1999 (3) 4. LEILA 75+; Riedel‐Heller et al, 2001 (4) 5. Munich; Fichter et al 1996 (5) 6. ILSA; Di et al, 2002 (6) Odense

Denmark

DSM‐III‐R

Vantaa

Finland

Up to 85 10 years 5.0 65

DSM‐III‐R

Not stated 328

1242

Gironde and Dordogne Leipzig

France

1987

DSM‐III‐R

3675

11989

Germany

1997

1.6

ICD10 and DSM‐III‐R DSM‐III‐R DSM‐III‐R

Yes

1187

1310

Munich

Germany

7. Conselice; Ravaglia et al 2005 (7) 8. Leiden; Leiden Gussekloo et al 1995 (8) 9. Rotterdam study;Rotterdam Ott et al, 1998 (9) 10. NEDICES; Las Margaritas, Bermejo‐Pareja et Lista, Arevalo al 2008 (10) 11. Girona cohort Girona study; Lopez‐Pousa et al 2004 (11) 12. ZARADEMP; Zaragoza Lobo et al, 2011 (12) 13. Kungsholmen Kungsholmen project; Fratiglioni et al 1997 (13) 14. MRC Alpha; Liverpool Copeland et al 1999 (14) 15. Cambridge; Cambridge

Genoa, Italy Segrate, Selvazzano‐ Rubia, Impruneta, Fermo, Naples, Casamassima, and Catania Conselice Italy

1990‐ 1991 1992

85 65

Not stated 358 Yes 3208

181 9524

1999

DSM‐IV

Not stated Yes

937

3044

Netherlan ds Netherlan ds Spain

1986

4.1

DSM‐III

618

808

1991 1994

2.1 3.2

55 65

DSM‐III‐R DSM‐IV

Yes Not stated

7046 4972

15135 12552

Spain

1990‐ 1995 1994

DSM‐III‐R

1260

5257

Spain

4.5

DSM‐IV

15353

Sweden

1987

3.0

DSM‐III‐R

Yes

1473

3697

United Kingdom United

1989

ICD‐10

Yes

4778

7202

1986

2.4

DSM‐III‐R

Yes

1778

2809

Paykel et al 1994 Kingdom (15) 16. MRC CFA Study; Cambridgeshir United Matthews et al, e, North Kingdom 2005 (16) Wales, Nottingham, Newcastle, Oxford North America 1,2. EPESE; Piedmont United Fillenbaum et al county, North States of 1998 (17) Carolina. America White and African American sub‐ samples 3. Cache County Cache County, United States of study; Miech et al, Utah America 2002 (18) 4. The 90+ study Laguna Woods, United (19) California States of America 5. Canadian Study Nationally Canada of Health and representative Aging; Canadian Study of Health and Aging Working Group, 2000 (20) Latin America 1. Brazil; Nitrini et Catanduva, Sao Brazil al, 2004 (21) Paulo 2. 10/66 Cuba Havana, Cuba Matanzas

1992

DSM‐III‐R

Yes

17627

1986

DSM‐IV

4136

6867

1995

DSM‐III‐R

Not stated 4614

10541

2003

2.3

DSM‐IV

Yes

330

769

1991

5.0

DSM‐III‐R

Yes, but excluded for this analysis

7733

27352

1997 2004

3.3 4.5

65 65

DSM‐IV 10/66 Dementia / DSM‐IV 10/66 Dementia / DSM‐IV 10/66 Dementia / DSM‐IV 10/66 Dementia / DSM‐IV 10/66 Dementia / DSM‐IV DSM‐IV

Not stated 1538 No 2517

3649 8679

3. 10/66 Dominican Santo Domingo Dominica 2005 Republic n Republic 4. 10/66 Peru Lima, Canete Peru 2005

5.1

1769

5561

2.9‐3.7

1767

3913

5. 10/66 Mexico

Mexico City, Morelos

Mexico

2006

3.0

1823

4164

6. 10/66 Venezuela Caracas

Venezuela 2005

4.3

1820

5269

Australasia 1. Sydney Older Persons Study; Waite et al 2001 (22) Sydney

Australia

1992

3.2

383

1052

East Asia 1. Beijing; Li et al 2007 (23) 2. Beijing; Li et al 1991 (24) 3. 10/66 China Beijing Beijing

China China

1997 1986 2004

2.0 3.0 5.0

60 70 65

ICD10/ DSM‐IV DSM‐III 10/66 Dementia / DSM‐IV

No No No

1553 825 2022

2781 2309 7109

Xicheng, Daxin China

4. Taiwan, China; Kaohsiung, Liu et al, 1998 (25) Pingtung

Asia Pacific 1. Yonchon County Yonchon Survey; Lee et al County 2008 (26)

Taiwan, China Republic of Korea Nigeria

Not given 1996

2.0 7.0

65 65

ICD‐10NA DSM‐III‐R

2807 658

4679 3526

Sub‐Saharan Africa (West) 1. Ibadan Study of Ibadan Aging (27)

2004

3.3

Clinical/ NS

1225

3890

B. EXCLUDED STUDIES Table 2 ‐ List of ‘Pending’ studies Potentially eligible studies had to be excluded, because case (numerator) and person years (denominator) data could not be extracted (28‐32).

Study West Europe Rural Cambridgeshire study Brayne et al 1997 (31) The MRC Alpha Study Copeland et al, 1999 (32) North America United States of America / Nigeria study Hendrie et al 2001 (30) Manitoba Study of Health and Aging Tyas et al, 2006 (29) Asia Pacific Hisayama Study Fujishima et al 2002 (28) Sub‐Saharan Africa West United States of America / Nigeria study Hendrie et al 2001 (30)

Setting Rural Cambridgeshire Liverpool Indianapolis Manitoba Hisayama Ibadan

Country United Kingdom United Kingdom United States of America Canada Japan Nigeria

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Informations clés

Organisation Organisation mondiale de la santé (OMS)

Type de document Technical Documents

Date d'adoption 24 août 2012

Source Organisation mondiale de la santé