The glutamatergic system and neurodegeneration in dementia: preventive strategies in Alzheimer's disease

✍ Scribed by Ramón Cacabelos; Masatoshi Takeda; Bengt Winblad

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 851 KB
• Volume: 14
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/(sici)1099-1166(199901)14:1<3::aid-gps897>3.0.co;2-7

✦ Synopsis

EPIDEMIOLOGY AND COSTS OF DEMENTIA

Alzheimer's disease (AD) is a major health problem in developed countries, accounting for approximately 50±70% of all types of dementia, followed by vascular dementia (VD, 30±40%), mixed dementia (MXD, 10±15%) and other dementing illness (10±15%) (Cacabelos, 1995a(Cacabelos, , 1997a, b), b). The prevalence of AD increases with age, from 0.4±1% at 60±65 years to 20±40% at 85±90 years and 55% in 95-year-old subjects (Fratiglioni, 1998;Gip et al., 1997). Recent studies in Europe showed an incidence rate for dementia in subjects over 50 of 10.7 per 1000 person-years (13.1 per 1000 in women and 6.9 per 1000 in men), with incidence rates of 7.7, 1.5 and 1.3 per 1000 personyears for AD, VD and other dementias, respectively (Ott et al., 1997). The incidence of dementia and AD increases with age even in the oldest age group, and women have a higher risk than men after 80 years of age (Fratiglioni et al., 1997a, b). In a 5-year incidence and prediction survey of dementia in a population sample of women aged 70±79, the incidence of dementia of all severities was 3.1% per annum (Brayne et al., 1997). In most western countries, 50±70% of dementia cases are due to AD and 20±30% to VD (Fratiglioni, 1998).

In older subjects (485 yr) both AD and VD appear with a similar frequency (AD: 43.5%; VD: 46.9%; other types of dementia: 9.5%) (Skoog et al., 1993), suggesting that increasing age leads to