Diagnosing dementia in the oldest-old
Open accessAbstract
The "oldest-old" comprise the fastest growing segment of the population in much of the world. Rates of dementia are extremely high in this age group and will present a major public health burden as the numbers of these individuals quadruple by the middle of the century. Studies in this age group are rare and frequently have small numbers of participants. In research studies and the clinic, the diagnosis of dementia and determination of the etiology of the disorder are challenging. In this review, we include some of our experiences in a population-based longitudinal investigation, The 90+ Study. Oldest-old individuals are more likely to suffer from medical comorbidities and have high rates of sensory loss, psychoactive medication usage, frailty and fatigue. Moreover, social and cultural expectations affect the reporting and interpretation of behavioral changes. These and other factors make it difficult to determine the relative contributions of cognitive losses and non-cognitive losses in the development of functional disability. Contributing further to the complexities of diagnosis, current research suggests that dementia in the oldest-old, compared to younger people, is more likely to be related to mixed disease pathologies. Frequent cerebral neuropathologies include Alzheimer's disease neurodegeneration, small and large vessel vascular disease, and hippocampal sclerosis. More research is necessary in the oldest-old to better understand the etiologies of dementia in this age group, and factors that may affect the expression of disease as we age.
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In the oldest old, the prevalence of concomitant non-AD brain diseases, including CVD and hippocampal sclerosis, begins to mimic the effects of AD pathologic diagnosis.
“Thus, in the oldest old, the prevalence of concomitant non-AD brain diseases, including CVD and hippocampal sclerosis, begins to mimic the effects of AD pathologic diagnosis (154, 221, 222).”
From Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature (2012) · cites this paper as [221]
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- [6]Corrada MM Brookmeyer R Paganini-Hill A Berlau D Kawas CH Dementia incidence continues to increase with age in the oldest old: the 90+ study Ann Neurol 2010 Jan 67 1 114 121 20186856 PMC3385995
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- Authors
- Brumback-Peltz, C., Balasubramanian, A. B., Corrada, M. M., & Kawas, C. H.
- Affiliations
- University of California, Irvine (US)
- Venue
- Maturitas
- Publisher
- Elsevier BV
- Published
- 2011-10
- Volume
- 70
- Issue
- 2
- Pages
- 164-168
- ISSN
- 0378-5122 (ISSN-L)
- PMC
- PMC3171568
- OpenAlex
- W1965447880
- Cited by
- 49
- References
- 56
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 1 · 2023: 7 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 5 · 2015: 2 · 2014: 5 · 2013: 4 · 2012: 5
- FWCI
- 0.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Maturitas (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- National Institute on Aging (R01 AG21055, R01AG021055, R01-AG21055-2S1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- dementia diagnosis, oldest old, Alzheimer's disease, cerebral small vessel disease, hippocampal sclerosis, functional disability, frailty, comorbidities, sensory impairment, psychotropic drugs, dementia etiology
- MeSH terms
- Activities of Daily Living, Aged, 80 and over, Dementia, Diagnosis, Differential, Hippocampus, Humans, Longitudinal Studies, Sclerosis, Vascular Diseases, Neurodegenerative Diseases
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