How will dementia affect us as we age?
31st October
New research has confirmed that despite efforts at prevention more people will develop dementia as we live longer. The ageing population is likely to mean an increase in the number of people dying with dementia and severe cognitive impairment.
Dr Fiona Matthews, at the MRC Biostatistics Unit, and Professor Brayne at the University of Cambridge, have shown in their paper in the journal PLOS Medicine that factors believed to protect against dementia at earlier stages in life may not give protection from dementia at the end of life.
Previous studies had examined risk of dementia over a specified time period or at a particular age but not just before death. It was not known whether factors found to reduce the risk of developing dementia earlier in life would provide protection until the end of life. While it was known that the risk of dementia was reduced for people with higher levels of education and social class, there was up until now no data on whether this risk was reduced right up to the time of death.
The MRC Cognitive Function and Ageing Study followed populations aged 65 years and over for ten years and found that even reducing risk for dementia at a given age, whilst likely to lead to further extension of life, left the cumulative risk of dementia at death still high.
Overall 30% of individuals in the study who died have experienced dementia in their last year of life. There was a strong increasing trend with age from 6% for those aged 65-69 to 58% for those aged 95 and above.
The study also found that women were more likely to develop dementia before death than men. A higher level of education and belonging to a higher social class were associated with only a slightly lower occurrence of dementia before death.
“With increased survival into older age, population levels of dementia immediately preceding death will be a public concern. Policy development and research for dementia must address the needs of individuals who will continue to experience these conditions before death, particularly with regard to long term care, support for informal care givers and appropriate care options," said Dr Matthews.
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