Role of Improved Vascular Health in the Declining Incidence of Dementia
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As people are living longer, the disease burden is shifting toward diseases of old age, including an increasing prevalence of dementia, most commonly because of Alzheimer disease (AD). The risk of developing dementia doubles every 5 years after the age of 65 years.1 There are currently 5.1 million Americans aged >65 years living with dementia, and this number is expected to reach 13.8 million by the year 2050.2
Despite an increasing prevalence of dementia, the FHS (Framingham Heart Study) recently showed that the age-specific incidence of dementia has steadily declined over the previous 3 decades (Figure).3 In other words, whereas the overall number of people affected by dementia will continue to increase because of population aging, an individual’s risk of developing dementia by a specific age has decreased by as much as 20% each decade over the past 30 years. Other studies have also pointed toward a declining incidence of dementia in the United States and Europe.4–6 The Health and Retirement Study also reported a decline in dementia prevalence in the United States from the year 2000 to 2012.7 Collectively, these studies provide hope that some cases of dementia can be prevented or delayed.
The factors underlying changing temporal trends in dementia are not entirely clear. It is important to understand what …