Dataset Information

Estimating the lifetime risk of dementia in the Canadian elderly population using cross-sectional cohort survival data.

ABSTRACT: Dementia is one of the world's major public health challenges. The lifetime risk of dementia is the proportion of individuals who ever develop dementia during their lifetime. Despite its importance to epidemiologists and policy-makers, this measure does not seem to have been estimated in the Canadian population. Data from a birth cohort study of dementia are not available. Instead, we must rely on data from the Canadian Study of Heath and Aging, a large cross-sectional study of dementia with follow-up for survival. These data present challenges because they include substantial loss to follow-up and are not representatively drawn from the target population because of structural sampling biases. A first bias is imparted by the cross-sectional sampling scheme, while a second bias is a result of stratified sampling. Estimation of the lifetime risk and related quantities in the presence of these biases has not been previously addressed in the literature. We develop and study nonparametric estimators of the lifetime risk, the remaining lifetime risk and cumulative risk at specific ages, accounting for these complexities. In particular, we reveal the fact that estimation of the lifetime risk is invariant to stratification by current age at sampling. We present simulation results validating our methodology, and provide novel facts about the epidemiology of dementia in Canada using data from the Canadian Study of Health and Aging.

SUBMITTER: Carone M

PROVIDER: S-EPMC4485460 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Estimating the lifetime risk of dementia in the Canadian elderly population using cross-sectional cohort survival data.

Carone Marco M Asgharian Masoud M Jewell Nicholas P NP

Journal of the American Statistical Association 20140101 505

Dementia is one of the world's major public health challenges. The lifetime risk of dementia is the proportion of individuals who ever develop dementia during their lifetime. Despite its importance to epidemiologists and policy-makers, this measure does not seem to have been estimated in the Canadian population. Data from a birth cohort study of dementia are not available. Instead, we must rely on data from the Canadian Study of Heath and Aging, a large cross-sectional study of dementia with fol ...[more]

PMID: 26139951

Similar Datasets

Project description:BackgroundScreening for hepatitis C virus (HCV) is recommended in patients born between 1945 and 1965 ("baby boomers") in the United States. Because these patients are often screened for colorectal cancer, dual screening for HCV may enhance case identification. Our objectives were to assess the acceptability and yield of screening for HCV among patients undergoing screening for colorectal cancer.MethodsPatients referred for a colonoscopy to screen for colorectal cancer completed an anonymous survey regarding the acceptability of screening for HCV, risk factors and prior testing. The impacts of demographics and risk factors for HCV on willingness to be screened were determined using logistic regression, and the stored sera of 483 patients who had undergone screening for colorectal cancer between February 2011 and August 2012 were tested for HCV antibodies.ResultsAmong 1012 survey respondents (median age 56 yr; 911 [90.0%] were baby boomers, 880 [87.0%] were white and 223 [22.0%] were born outside Canada), 123 patients (12.2%) reported prior testing for HCV. HCV was previously diagnosed in 9 of these patients (0.9%, representing 1.0% of the patients who were baby boomers): 5 (55.6% of those diagnosed) reported risk factors. Excluding patients diagnosed with HCV, 903 (90.0%) respondents indicated that they would consent to testing of blood or saliva for HCV. After adjusting for age, sex and status of immigration, patients who were white (odds ratio [OR] 3.38, 95% confidence interval [CI] 1.81-6.32) and patients with risk factors (> 1 v. 0: OR 3.67, 95% CI 1.12-12.02) had a greater acceptance of screening. Among 483 patients screened for colorectal cancer, 3 were anti-HCV positive (0.6%, 95% CI 0.1%-1.8%), representing 0.8% (95% CI 0.2%-2.4%) of the patients who were baby boomers.InterpretationAcceptance of screening for HCV is high among patients undergoing screening for colorectal cancer in the Calgary area. However, the low prevalence of HCV suggests that the cost-effectiveness of birth-cohort screening in this population warrants evaluation.

Project description:Studies have suggested that the prevalence of dementia is lower in developing than in developed regions. We investigated the prevalence and severity of dementia in sites in low-income and middle-income countries according to two definitions of dementia diagnosis.We undertook one-phase cross-sectional surveys of all residents aged 65 years and older (n=14 960) in 11 sites in seven low-income and middle-income countries (China, India, Cuba, Dominican Republic, Venezuela, Mexico, and Peru). Dementia diagnosis was made according to the culturally and educationally sensitive 10/66 dementia diagnostic algorithm, which had been prevalidated in 25 Latin American, Asian, and African centres; and by computerised application of the dementia criterion from the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). We also compared prevalence of DSM-IV dementia in each of the study sites with that from estimates in European studies.The prevalence of DSM-IV dementia varied widely, from 0.3% (95% CI 0.1-0.5) in rural India to 6.3% (5.0-7.7) in Cuba. After standardisation for age and sex, DSM-IV prevalence in urban Latin American sites was four-fifths of that in Europe (standardised morbidity ratio 80 [95% CI 70-91]), but in China the prevalence was only half (56 [32-91] in rural China), and in India and rural Latin America a quarter or less of the European prevalence (18 [5-34] in rural India). 10/66 dementia prevalence was higher than that of DSM-IV dementia, and more consistent across sites, varying between 5.6% (95% CI 4.2-7.0) in rural China and 11.7% (10.3-13.1) in the Dominican Republic. The validity of the 847 of 1345 cases of 10/66 dementia not confirmed by DSM-IV was supported by high levels of associated disability (mean WHO Disability Assessment Schedule II score 33.7 [SD 28.6]).As compared with the 10/66 dementia algorithm, the DSM-IV dementia criterion might underestimate dementia prevalence, especially in regions with low awareness of this emerging public-health problem.

Dataset Information

Estimating the lifetime risk of dementia in the Canadian elderly population using cross-sectional cohort survival data.

Publications

Estimating the lifetime risk of dementia in the Canadian elderly population using cross-sectional cohort survival data.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets