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Incidence and Risk of Dementia: The Rotterdam study
Abstract
To assess age-, sex-, and subtype-specific incidence rates of dementia and to calculate the risk of dementia, the authors performed a large, community-based, prospective cohort study on dementia as part of the Rotterdam Study. Participants were recruited among residents of a suburb of Rotterdam, aged 55 years and older. Baseline examinations took place between 1990 and 1993. The average follow-up was 2.1 years. Screening for dementia followed a three-stage protocol. Medical records of subjects who had died or could not be examined in person were evaluated. Of 7,046 subjects who were nondemented at baseline, 162 developed dementia during 15,135 person-years of follow-up, resulting in an overall incidence rate of 10.7 per 1,000 person-years. From the youngest to the oldest 5-year age category, the incidence rate increased from 0.6 to 97.2 per 1,000 person-years. Only in men did the increase level off after age 85. Overall, the incidence rate per 1,000 person-years was 7.7 for Alzheimer's disease and 1.5 for vascular dementia. Dementia incidence rates and dementia-free Kaplan-Meier survival tables were used to calculate age- and sex-specific cumulative risks of dementia. Although the incidence rates of men and women up to age 85 were similar, the lifetime risk of dementia for 55-year-old women was twice as high as for men (0.33 vs. 0.16), reflecting both the higher life expectancy of women and the higher dementia risk at very old age.
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“Aging is a common risk factor for developing AD and cancer (6,7).”
From Alzheimer's Disease–Associated Amyloid-β Precursor Protein Prevents Aging Stress–Induced Mitophagy and Fumarate Depletion to Improve Antitumor Immunity (2025) · cites this paper as [6]
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“A typical patient aged 65-70 might normally expect a period incidence of dementia of around 10% over the next 15 years,36 so this odds ratio would be consistent with an absolute risk increase of 2% (1% to 3%) over that period, corresponding to a number needed to harm of 50 (33 to 100).”
From Anticholinergic drugs and risk of dementia: case-control study (2018) · cites this paper as [36]
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Self-citationSubcortical brain structures and the risk of dementia in the Rotterdam Study
van der Velpen, I. F., Vlasov, V., Evans, T. E., Ikram, M. K., Gutman, B. A., Roshchupkin, G. V., Adams, H. H. H., Vernooij, M. W., & Ikram, M. A. (2022) · Alzheimer s & Dementia · doi:10.1002/alz.12690 · Cited by 40
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“Alzheimer’s disease (AD) is a progressive age-related neurodegenerative disease, which is the most frequent form of dementia [1,2].”
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“In addition, the total cohort was continuously monitored for incident dementia through computerized linkage between the study database and digitalized medical records from general practitioners and the Regional Institute for Outpatient Mental Health Care.21 The diagnoses of dementia and Alzheimer’s disease were made i…”
MethodInfluentialSelf-citationZsoldos, E., Filippini, N., Mahmood, A., Mackay, C. E., Singh‐Manoux, A., Mika Kivimaki, B., Jenkinson, M., & Ebmeier, K. P. (2018) · Scientific Reports · doi:10.1038/s41598-018-24398-9 · Cited by 37
Glucocorticoid receptor variant and risk of dementia and white matter lesions
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Self-citationDiagnosing dementia with confidence by GPs
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Dementia / Alzheimer's Disease
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Treatments for Alzheimer Disease
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“More than 33% of women and 20% of men aged 65 and older will develop dementia during their lifetime.(1) With the aging of the US population, the number of individuals with Alzheimer disease (AD) is expected to quadruple over the next 50 years.”
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Zhang, D., Ou, Y., Liu, Y., Ma, Y., Tan, L., Feng, J., Cheng, W., & Yu, J. (2022) · Alzheimer s Research & Therapy · doi:10.1186/s13195-022-01090-9 · Cited by 36
“This may be explained by the fact that aging is a common risk factor for both dementia [36] and cancer [37].”
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“Ott et al. (1998) note that measured age-specific incidence rates of dementia are scarce.”
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“Assessment of Dementia Participants were screened for dementia at baseline and follow-up examinations using a 3-step protocol (Ott et al., 1998).”
MethodCDH6 and HAGH protein levels in plasma associate with Alzheimer’s disease in APOE ε4 carriers
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Potential role of estrogen in the pathobiology and prevention of Alzheimer's disease.
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“More than 33% of women 65 years or older will develop dementia during their lifetime (29).”
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Consistency of Epidemiologic Estimates
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“From the second round, after an average follow-up of 26 months, an interim incidence estimate was made [12].”
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“14 In RS, cognitive testing 15 was used for referral to a neurologist-led adjudication panel.”
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“particularly one large meta‐analysis, confirmed that females were at greater risk of developing AD and deterioration of cognition (2-10).”
InfluentialSex differences in risk of Alzheimer's disease in adults with Down syndrome
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“Several types of dementia are differentiated by aetiology including 72% Alzheimer, 16% vascular and 11% other types [2].”
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Ruitenberg, A., Kalmijn, S., de Ridder, M. A. J., Redekop, W. K., van Harskamp, F., Hofman, A., Launer, L. J., & Breteler, M. M. B. (2001) · Neuroepidemiology · doi:10.1159/000054786 · Cited by 41
Self-citationFactors Influencing Alzheimer’s Disease Risk: Whether and How They are Related to the APOE Genotype
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“In addition, the higher incidence of AD/dementia in women (Ott et al. 1998) and the higher incidence of PD/dementia in men (Reekes et al.”
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Self-citationDementia-Free Survival Among Centenarians: An Evidence-Based Review
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“However, physical health and cognitive function are closely interrelated in this age group, so it is Notes: The Dutch Aging Study (10), Berlin Aging Study (16,17), Rotterdam Study (26), and Kungsholmen Project (35,36) did not separate data regarding data from 90- to 99-year-old participants from centenarian data.”
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ALZHEIMER'S DISEASE AND VASCULAR FACTORS: FACTS AND THEORIES
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“The incidence rate of all-cause dementia in the present study was 9.8 per 1,000 person-years, which is consistent with the rates reported in previous studies in Japan, China, and Europe [35-37], thus supporting the reliability of this study.”
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“From the epidemiological point of view, the Rotterdam Study showed the age-specific incidence of subtypes of dementia for both sexes in a large prospective study (Ott et al., 1998).”
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Lifetime cumulative incidence of dementia in a community-dwelling elderly population in Japan
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Polymorphisms and haplotypes in the C-reactive protein gene and risk of dementia
van Oijen, M., de Maat, M. P. M., Kardys, I., de Jong, F. J., Albert Hofman, D., Koudstaal, P. J., Witteman, J. C. M., & Breteler, M. M. B. (2006) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2006.06.015 · Cited by 20
Self-citationNormal and Pathological Aging: From Animals to Humans
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Paganini‐Hill, A., & Clark, L. J. (2006) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000097097 · Cited by 19
Won, H., Manaf, Z. A., Ludin, A. F. M., & Shahar, S. (2016) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12753 · Cited by 20
The Demographic Characteristics and the Risk Factors of Dementia in SAUDI Elderly
Albugami, M. M. (2018) · American Journal of Psychiatry and Neuroscience · doi:10.11648/j.ajpn.20180601.11 · Cited by 19
“Older age is strongly associated with dementia and has been reported globally [5, 6].”
BackgroundFactores de riesgo de la enfermedad de Alzheimer
Quintana, J. L. B., Allam, M. F., del Castillo, A. S., & Navajas, R. F. (2005) · Revista de Neurología · doi:10.33588/rn.4010.2004360 · Cited by 20
Turner, S., Iliffe, S., DOWNS, M. G., Bryans, M., Wilcock, J., & Austin, T. (2003) · Aging & Mental Health · doi:10.1080/1360789021000058148 · Cited by 19
Vrijsen, J., Abu–Hanna, A., de Rooij, S. E., & Smidt, N. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049918 · Cited by 18
Qualitative Analysis of Therapeutic Light Effects on Global Function in Alzheimer’s Disease
Etcher, L., & Davis, J. E. (2010) · Western Journal of Nursing Research · doi:10.1177/0193945910386248 · Cited by 19
Cytokine/neurotrophin interaction in the aged central nervous system
Macdonald, N. J., Decorti, F., Pappas, T. C., & Taglialatela, G. (2000) · Journal of Anatomy · doi:10.1046/j.1469-7580.2000.19740543.x · Cited by 18
“Alzheimer’s disease (AD) is the most common agerelated neurodegenerative disease with an incidence in the population aged above 85 y of about 80 cases per 1000 persons per year (Ott et al. 1998).”
BackgroundShen, Q. X., Patten, K. T., Valenzuela, A. E., Lein, P. J., & Taha, A. Y. (2022) · Neuroscience Letters · doi:10.1016/j.neulet.2022.136921 · Cited by 17
[The prevalence of dementia three months after stroke and its risk factors].
Tamam, B., Taşdemir, N., & Tamam, Y. (2008) · PubMed · Cited by 17
Arai, A., Katsumata, Y., Konno, K., & Tamashiro, H. (2004) · Care management journals · doi:10.1891/cmaj.2004.5.3.159 · Cited by 17
Sex-specific transcriptional rewiring in the brain of Alzheimer’s disease patients
Santiago, J. A., Quinn, J. P., & Potashkin, J. A. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.1009368 · Cited by 16
Alzheimer’s Disease: Current Trends in Wales
Opeyemi, J. A. G. (2014) · Oman Medical Journal · doi:10.5001/omj.2014.73 · Cited by 16
Impact of gender on platelet membrane functions of Alzheimer's disease patients
Vignini, A., Giusti, L., Raffaelli, F., Giulietti, A., Salvolini, E., Luzzi, S., Provinciali, L., Mazzanti, L., & Nanetti, L. (2012) · Experimental Gerontology · doi:10.1016/j.exger.2012.11.015 · Cited by 16
Impact of Neuroprotection on Incidence of Alzheimer's Disease
de la Fuente‐Fernández, R. (2006) · PLoS ONE · doi:10.1371/journal.pone.0000052 · Cited by 18
Epidemiology of major age-related diseases in women compared to men
Giampaoli, S. (2000) · Aging Clinical and Experimental Research · doi:10.1007/bf03339896 · Cited by 16
The long-term relation between physical activity and executive function in the Rotterdam Study
Galle, S. A., Liu, J., Bonnechère, B., Amin, N., Milders, M. M., Deijen, J. B., Scherder, E., Drent, M. L., Voortman, T., Ikram, M. A., et al. (2022) · European Journal of Epidemiology · doi:10.1007/s10654-022-00902-4 · Cited by 15
Welch, D., Ndanyo, L. S., Brown, S., Agyapong‐Badu, S., Warner, M. B., Stokes, M. J., & Samuel, D. (2017) · Aging Clinical and Experimental Research · doi:10.1007/s40520-017-0800-1 · Cited by 15
“1 3 It is important to consider that 80% of people living in care homes have some form of dementia or severe memory problems [26].”
BackgroundKarch, A., Raddatz, L. M., Ponto, C., Hermann, P., Summers, D. M., & Zerr, I. (2014) · Journal of Neurology · doi:10.1007/s00415-014-7283-1 · Cited by 15
Pimentel, É. M. L. (2009) · Dementia & Neuropsychologia · doi:10.1590/s1980-57642009dn30300007 · Cited by 15
Gubbels, S. M., Bacci, S., Laursen, H. B., Høgenhaven, H., Cowan, S. A., Mølbak, K., & Christiansen, M. (2012) · Eurosurveillance · doi:10.2807/ese.17.15.20142-en · Cited by 15
Palta, P., Snitz, B. E., & Carlson, M. C. (2016) · Handbook of clinical neurology · doi:10.1016/b978-0-12-802973-2.00007-0 · Cited by 18
Dermaut, B., Roks, G., Theuns, J., Rademakers, R., Houwing‐Duistermaat, J. J., Serneels, S., Albert Hofman, D., Breteler, M. M. B., Cruts, M., Broeckhoven, C. V., et al. (2001) · Journal of Neurology · doi:10.1007/s004150170044 · Cited by 15
Self-citationCourse of minimal dementia and predictors of outcome
Visser, P. J., Verhey, F. R. J., JOLLES, J., & Jonker, C. (2002) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.680 · Cited by 15
How cognition has been assessed in research with people with aphasia: a systematic scoping review
Tessaro, B., Salis, C., Hameau, S., & Nickels, L. (2024) · Speech Language and Hearing · doi:10.1080/2050571x.2024.2315801 · Cited by 14
“Secondly, monitoring cognitive change is crucial when considering the linguistic abilities of older adults, given the increased incidence of mild cognitive impairment and dementia in this cohort (Ott, Breteler, Harskamp, Stijnen, & Hofman, 1998).”
Davanipour, Z., Tseng, C.-C., Lee, P.-J., Markides, K. S., & Sobel, E. L. (2013) · Journal of Advances in Medicine and Medical Research · doi:10.9734/bjmmr/2014/7317 · Cited by 14
Protective effect of Daming capsule against chronic cerebral ischemia
Song, X., Zhu, W., An, R., Li, Y., & Du, Z. (2015) · BMC Complementary and Alternative Medicine · doi:10.1186/s12906-015-0668-6 · Cited by 14
Hokkanen, L., Launes, J., & Michelsson, K. (2013) · F1000Research · doi:10.12688/f1000research.2-50.v1 · Cited by 17
Pomponi, M. F. L., Gambassi, G., Pomponi, M., Gioia, A. D., & Masullo, C. (2010) · Ageing Research Reviews · doi:10.1016/j.arr.2010.09.003 · Cited by 13
“1) and incidence (Ott et al., 1998; Kukull et al., 2002) (Fig.”
Long-Term Prognosis of Patients with Major Depression and Silent Cerebral Infarction
Yamashita, H., Fujikawa, T., Takami, H. E., Yanai, I., Okamoto, Y., Morinobu, S., & Yamawaki, S. (2010) · Neuropsychobiology · doi:10.1159/000319359 · Cited by 14
“One possibility is that previous or current episodes of depression may affect preexisting SCI and thereby increase the risk of dementia.Incidence rates of dementia in the general population aged from 60 to 70 years old have been reported as 1–6 persons per 1,000 person-years [”
BackgroundSmid, J., Nitríni, R., Bahia, V. S., & Caramelli, P. (2001) · Arquivos de Neuro-Psiquiatria · doi:10.1590/s0004-282x2001000300015 · Cited by 14
Late-onset depressive symptoms increase the risk of dementia in small vessel disease
van Uden, I. W. M., van der Holst, H. M., van Leijsen, E. M. C., Tuladhar, A. M., van Norden, A. G. W., de Laat, K. F., Claassen, J. A. H. R., van Dijk, E. J., Kessels, R. P. C., Richard, E., et al. (2016) · Neurology · doi:10.1212/wnl.0000000000003089 · Cited by 13
“This could be explained by the approximately 10 years younger mean age of our population and also the less severe WMH at baseline; both factors are known to be related to the incidence of dementia.(32,33) Our findings that DS are associated with all-cause dementia are accounted for by those participants with LODS.”
ResultCarving the senescent phenotype by the chemical reactivity of catecholamines: An integrative review
Golubev, A. G. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101570 · Cited by 12
Arai, H., Sumitomo, K., Sakata, Y., Daidoji, K., Takase, T., & Toyoda, T. (2015) · Psychogeriatrics · doi:10.1111/psyg.12130 · Cited by 12
Metadata
- Authors
- Ott, A., Breteler, M. M. B., Harskamp, F. V., Stijnen, T., & Hofman, A.
- Affiliations
- Erasmus MC (NL)
- Corresponding author
- Ott, A.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-03-15
- Volume
- 147
- Issue
- 6
- Pages
- 574-580
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2039379003
- Cited by
- 455
- References
- 16
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 4 · 2023: 9 · 2022: 16 · 2021: 9 · 2020: 36 · 2019: 9 · 2018: 16 · 2017: 11 · 2016: 10 · 2015: 14 · 2014: 10 · 2013: 16 · 2012: 18
- FWCI
- 15.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- dementia incidence, dementia risk, Alzheimer's disease, vascular dementia, age-specific incidence, sex differences, lifetime risk, older adults, Rotterdam Study
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Female, Humans, Male, Middle Aged, Netherlands, Prospective Studies, Risk, Incidence, Age Distribution, Sex Distribution
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