J Korean Med Sci.  2014 Jul;29(7):913-918. 10.3346/jkms.2014.29.7.913.

The Recent Decline in Prevalence of Dementia in Developed Countries: Implications for Prevention in the Republic of Korea

• Lee Y

• KMID: 1789949
• DOI: http://doi.org/10.3346/jkms.2014.29.7.913

Abstract

With the rapid aging of the population in Korea, the number of older people with dementia is projected to increase, forecasting an epidemic of dementia. Recent trends in dementia in several western countries, however, depict a gradual decline in prevalence and incidence. This decrease has been attributed to an improvement in education and living environments, engagement in healthy behaviors, and reduction in the prevalence of vascular risk factors. In Korea, however, trends in modifiable risk factors do not favor an optimistic outlook due to the continuous increase in the prevalence of hypertension, diabetes mellitus, and obesity. Given these observations, there is much to be gained through the promotion of healthy lifestyles. Moreover, public health resources need to be directed toward the provision of health promotion and preventive services, control and management of vascular risk factors, and improvement in the standard of living. Nationwide initiatives to develop and implement policies and strategies to protect cognitive health throughout the lifespan should be considered a public health priority.

Keyword

Dementia; Prevalence; Incidence; Risk Factors; Prevention and Control; Health Promotion; Health Behavior

MeSH Terms

Cost of Illness
Dementia/economics/*epidemiology/prevention & control
Developed Countries
Diabetes Mellitus/epidemiology
Health Behavior
Humans
Hypertension/epidemiology
Obesity/epidemiology
Prevalence
Republic of Korea/epidemiology
Risk Factors

Reference

1. World Health Organization and Alzheimer's Disease International. Dementia: a public health priority. Geneva: World Health Organization;2012.

2. Ministry of Health and Welfare. 2012 study on the prevalence of dementia. Seoul: Ministry of Health and Welfare;2012.

3. Statistics Korea. Population projections for Korea: 2010-2060. Daejeon: Statistics Korea;2012. accessed on 5 January 2014. Available at http://kosis.kr/ups/ups_02List01.jsp?kor_id=&pubcode=PJ&type=F.

4. Alzheimer's Disease International. World Alzheimer report 2010: the global economic impact of dementia. London: Alzheimer's Disease International;2010. accessed on 11 October 2013. Available at http://www.alz.co.uk/research/files/WorldAlzheimerReport2010.pdf.

5. Ministry of Health and Welfare. Status of older people with dementia in Korea. Seoul: Ministry of Health and Welfare;2011.

6. Alzheimer's Disease International. World Alzheimer report 2009. London: Alzheimer's Disease International;2009. accessed on 23 October 2013. Available at http://www.alz.co.uk/research/files/WorldAlzheimerReport.pdf.

7. Manton KC, Gu XL, Ukraintseva SV. Declining prevalence of dementia in the U.S. elderly population. Adv Gerontol. 2005; 16:30–37.

8. Lobo A, Saz P, Marcos G, Dia JL, De-la-Camara C, Ventura T, Montañes JA, Lobo-Escolar A, Aznar S. ZARADEMP Workgroup. Prevalence of dementia in a southern European population in two different time periods: the ZARADEMP Project. Acta Psychiatr Scand. 2007; 116:299–307.

9. Langa KM, Larson EB, Karlawish JH, Cutler DM, Kabeto MU, Kim SY, Rosen AB. Trends in the prevalence and mortality of cognitive impairment in the United States: is there evidence of a compression of cognitive morbidity. Alzheimers Dement. 2008; 4:134–144.

10. Rocca WA, Petersen RC, Knopman DS, Hebert LE, Evans DA, Hall KS, Gao S, Unverzagt FW, Langa KM, Larson EB, et al. Trends in the incidence and prevalence of Alzheimer's disease, dementia, and cognitive impairment in the United States. Alzheimers Dement. 2011; 7:80–93.

11. Matthews FE, Arthur A, Barnes LE, Bond J, Jagger C, Robinson L, Brayne C. Medical Research Council Cognitive Function and Ageing Collaboration. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet. 2013; 382:1405–1412.

12. Christensen K, Thinggaard M, Oksuzyan A, Steenstrup T, Andersen-Ranberg K, Jeune B, McGue M, Vaupel JW. Physical and cognitive functioning of people older than 90 years: a comparison of two Danish cohorts born 10 years apart. Lancet. 2013; 382:1507–1513.

13. Schrijvers EM, Verhaaren BF, Koudstaal PJ, Hofman A, Ikram MA, Breteler MM. Is dementia incidence declining? trends in dementia incidence since 1990 in the Rotterdam Study. Neurology. 2012; 78:1456–1463.

14. Qiu C, von Strauss E, Bäckman L, Winblad B, Fratiglioni L. Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden. Neurology. 2013; 80:1888–1894.

15. Brookmeyer R, Gray S, Kawas C. Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. Am J Public Health. 1998; 88:1337–1342.

16. Brookmeyer R, Johnson E, Ziegler-Graham K, Arrighi HM. Forecasting the global burden of Alzheimer's disease. Alzheimers Dement. 2007; 3:186–191.

17. Jang SN, Kim DH. Trends in the health status of older Koreans. J Am Geriatr Soc. 2010; 58:592–598.

18. Chung KH, Cho AJ, Oh YH, Byun JK, Byun YC, Moon HS. 1998 survey on the Living Status and Welfare Needs of Older People. Seoul: Korea Institute of Health and Social Affairs;1998.

19. Chung KH, Oh YH, Lee YK, Sohn CK, Lee SY, Lee JH, Kwon JD, Kim SB, Lee SJ, Lee YS, et al. 2011 survey on the Living Status of Older People. Seoul: Korea Institute of Health and Social Affairs;2012. accessed on 12 December 2013. Available at https://www.kihasa.re.kr/html/jsp/publication/policy/list.jsp.

20. Yeo YJ, Kim MG, Kwon MI, Choi OK, Choi JY. Old-age poverty in Korea and how should the government reduce it. Seoul: Korea Institute for Health and Social Affairs;2012. accessed on 11 January 2014. Available at https://www.kihasa.re.kr/html/jsp/publication/research/list.jsp?key=title&ryear_value=2014&query=%BA%F3%B0%EF.

21. Kim HC, Oh SM. Noncommunicable diseases: current status of major modifiable risk factors in Korea. J Prev Med Public Health. 2013; 46:165–172.

22. Dodge HH, Buracchio TJ, Fisher GG, Kiyohara Y, Meguro K, Tanizaki Y, Kaye JA. Trends in the prevalence of dementia in Japan. Int J Alzheimers Dis. 2012; 2012:956354.

23. Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurol. 2011; 10:819–828.

24. Lee Y, Back JH, Kim J, Kim SH, Na DL, Cheong HK, Hong CH, Kim YG. Systematic review of health behavioral risks and cognitive health in older adults. Int Psychogeriatr. 2010; 22:174–187.

25. Lee Y, Na DL, Cheong HK, Hong CH, Back JH, Kim J, Kim SH, Kim YG. Lifestyle recommendations for dementia prevention: PASCAL. J Korean Geriatr Soc. 2009; 13:61–68.

26. Lövdén M, Xu W, Wang HX. Lifestyle change and the prevention of cognitive decline and dementia: what is the evidence? Curr Opin Psychiatry. 2013; 26:239–243.

27. Andrieu S, Aboderin I, Baeyens JP, Beard J, Benetos A, Berrut G, Brainin M, Cha HB, Chen LK, Du P, et al. IAGG workshop: health promotion program on prevention of late onset dementia. J Nutr Health Aging. 2011; 15:562–575.