The Framingham Heart Study assesses residents of Framingham, MA and their offspring over decades and reports on trends in health outcomes. In this report they assessed 5205 people who were 60 years or older and assessed their incidence of developing dementia. From 1977, the incidence of developing dementia has gone down 20% per decade. The bad news, those without a high school diploma did not have a reduction in dementia risk. While this is the best study to date to assess dementia risk, other studies conducted in other Western countries such as Germany confirm that there is a downward trend in dementia incidence occurring there as well.
There is a difference between incidence and prevalence. We have a larger percentage of seniors in the US population than we have ever had before the total number of people with dementia is still going up but your risk as a senior of developing dementia is much less than it was if you were a senior in the 1970s.
A fair amount of people with dementia develop it from cardiovascular diseases like stroke, heart failure, and atrial fibrillation. Reduced rates of smoking, controlling blood pressure and blood cholesterol, getting to the hospital and treating strokes and heart attacks immediately, and using medications to thin the blood if you have heart disease or atrial fibrillation made a major difference in what they call vascular dementia. Those without a high school diploma did not make the same improvements in controlling these risk factors and therefore did not have the same reduction in dementia. The other main type of dementia, Alzheimer’s disease, was not reduced to the same extent as vascular dementia was.
We have a lot to be proud of as a country, we have identified the causes of atherosclerosis, heart attack, and stroke and have developed successful strategies. We have to engage socioeconomically disadvantaged patients in preventative strategies and assure that they see their doctors and comply with treatments.
Dr. Michael White, UConn School of Pharmacy
