The rate of dementia is falling

by on November 22, 2016 at 12:22 am in Data Source, Medicine, Science | Permalink

Is it a kind of Flynn effect for the elderly?:

Dementia is actually on the wane. And when people do get dementia, they get it at older and older ages.

Previous studies found the same trend but involved much smaller and less diverse populations like the mostly white population of Framingham, Mass., and residents of a few areas in England and Wales.

The new study found that the dementia rate in Americans 65 and older fell by 24 percent over 12 years, to 8.8 percent in 2012 from 11.6 percent in 2000. That trend that is “statistically significant and impressive,” said Samuel Preston, a demographer at the University of Pennsylvania who was not associated with the study.

In 2000, people received a diagnosis of dementia at an average age of 80.7; in 2012, the average age was 82.

“The dementia rate is not immutable,” said Dr. Richard Hodes, director of the National Institute on Aging. “It can change.”

And that “is very good news,” said John Haaga, director of the institute’s division of behavioral and social research. It means, he said, that “roughly a million and a half people aged 65 and older who do not have dementia now would have had it if the rate in 2000 had been in place.”

That is from Gina Kolata from the NYT.  The piece has many other points of interest.

1 Sam November 22, 2016 at 12:27 am

Video games and Facebook are better than bridge and crosswords for mental health?

2 Tyler November 22, 2016 at 12:34 am

We’re highly social animals – no data was collected about the social environment of the elderly? Surely living in multi-generational household, for example, would have an effect on the mental health of an elderly person as compared with independent living. What about proximity of their children/grandchildren?

All of the variables that seem to be measured here are individual – their own education level, wealth, weight, history of smoking, etc. But what about the people around them?

3 mulp November 22, 2016 at 4:10 am

Economists advocate policies that destroy families, especially large families.

Only with big government socialist welfare state policies can extended families be preserved or restored.

Jobs would need to to be created to serve the workers at the place and time dictated by family needs.

The policies of the 30s to 70s were reasonable favorable in the industrial age. The railroads moved raw materials to farm communities for manufacture and then shipped them to cities. Along with seasonal foods from the farms. Farms that grew many crops.

The hollow ingredients out of the Midwest that Trump tapped into is more about the rural areas where both farming and industry are gone. Farms are monoculture industries requiring little labor, and can’t support a family. The factories have been moved away from workers to regions where governments bribe the corporations to come. Not just in Mexico or Asia, but Texas, Tennessee, etc. Gov Perry boasted about jobs taken from California, not about new jobs created. Earlier it was about jobs taken from Michigan and Ohio, not new jobs created.

Trade wars have been active inside the US, making one region losers to make the local economy better off, but with total welfare reduced.

And in trade wars, workers move to the jobs, and if families are destroyed, well that’s the price of progress and lower labor costs and higher profits..

4 Steve Sailer November 22, 2016 at 12:47 am

Some other diseases have gotten less pervasive as well, with no clear cause.

5 Anon November 22, 2016 at 2:23 am

Such as ?

6 Steve Sailer November 22, 2016 at 5:55 am

A Medical Mystery of the Best Kind: Major Diseases Are in Decline
Gina Kolata @ginakolata JULY 8, 2016

Something strange is going on in medicine. Major diseases, like colon cancer, dementia and heart disease, are waning in wealthy countries, and improved diagnosis and treatment cannot fully explain it.

Scientists marvel at this good news, a medical mystery of the best sort and one that is often overlooked as advocacy groups emphasize the toll of diseases and the need for more funds. Still, many are puzzled.

7 dearieme November 22, 2016 at 7:19 am

An obvious speculation would be that as CVD rates collapse, presumably because our immune systems have become better at dealing with the causative micro-organisms (whatever they may be), then similarly we have become better protected from whatever micro-organisms cause Alzheimer’s. Heavens, maybe they are the same micro-organisms.

8 Steve Sailer November 22, 2016 at 11:18 pm

Maybe using antibiotics for ear aches and the like wipes out less obvious germs too?

9 JeffR23 November 23, 2016 at 7:06 pm

It occurs to me that dentistry/flouridization might be worth looking into as a possible root cause for lots of general improvements. (Along with lower smoking rates and environmental lead). The modern mouth is much less of a reservoir for disease than it was a few decades ago…

10 Michael Tinkler November 22, 2016 at 1:15 am

My mother is suffering from mildish cognitive loss (it’s all dementia) – but still plays bridge multiple times a month in different configurations of ladies – all of whom would kick her to the curb if she couldn’t still bid and play. Bridge and jigsaw puzzles are fine – but she can’t read novels any more because she can’t remember the plot if she puts a book down. I hope dementia is declining – I’ll play bridge if I lose fiction, but I don’t really like jigsaw puzzles.

11 JayT November 22, 2016 at 2:07 am

I wonder how much of this is due to the end of leaded gasoline. We know that lead has connections to cognitive issues, and people are being exposed to lead less than in the past.

12 Mark Thorson November 22, 2016 at 2:43 am

No, lead is not the cause of dementia. If it were, how does that explain the geographic variation in dementia?

What explains that variation? There’s a strong association between type 2 diabetes and Alzheimer’s Disease. Alzheimer’s disease is about 70% of dementia, and another 15% of dementia is vascular dementia which is arguably not separable from Alzheimer’s Disease. Obesity is a major risk factor for type 2 diabetes. Compare that map with this one.

13 Steve Sailer November 22, 2016 at 5:57 am

Do we even have a a good idea of where lead was worse?

For example, I went to school from K-12 in Sherman Oaks, CA, home to the busiest freeway interchange of the 1960s-1970s (101-405). Should I be worried about lead poisoning?

14 Ray Lopez November 22, 2016 at 7:42 am

Clearly. Is that even debatable? You no doubt have elevated Pb in your bloodstream I’m pretty sure, if you test for it.

15 JWatts November 22, 2016 at 11:58 am

The half life of lead in blood is 25 days. So, no Steve doesn’t have elevated levels of lead in his bloodstream from the 1970’s.

16 Mark Bahner November 22, 2016 at 12:25 pm

“For example, I went to school from K-12 in Sherman Oaks, CA, home to the busiest freeway interchange of the 1960s-1970s (101-405). Should I be worried about lead poisoning?”

You almost certainly *had* lead poisoning in the 60s-70s. We all did. I’m too lazy to look up the exact numbers, but from what I remember, more than 70% of the U.S. population in the 60s to early 70s had blood lead levels above 10 micrograms per deciliter, which used to be lead poisoning. Now the CDC “level of concern” is 5 micrograms per deciliter. I’m fairly sure more than 95% of the continental U.S. population in the 1960s and early 1970s had blood lead levels above 5 micrograms per deciliter.

“You no doubt have elevated Pb in your bloodstream I’m pretty sure, if you test for it.”

I doubt it. The average blood lead level in the U.S. now (again, I’m too lazy to look up the exact number) less than 1.5 micrograms per deciliter. The blood lead levels came down after cars with catalytic converters (that required unleaded gasoline) were introduced in 1975. Where lead remains much longer is in the bones. From

“Lead stays in the body for different periods of time, depending on where it is. Half of the lead in the blood will be excreted in 25 days (this is called the “half-life”). In soft tissues, it takes 40 days for half of the lead to be excreted. In bones and teeth it takes much longer, up to 10 years or longer.”

However, even with a half-life of 10 years in the bones, if the majority of cars on the road were using unleaded gasoline by 1986, you would still have 3 half-lives up to now…so 1/8th of what your bone concentration was in 1986.

17 Troll me November 22, 2016 at 2:58 pm

And anyways, the total daily volume excreted from bones is going to be pretty irrelevant compared to, say, daily maximum exposure.

18 Mark Thorson November 22, 2016 at 2:21 am

This seems contrary to estimates.

It’s difficult to believe there is a mechanism by which dementia can wane. Demographics would favor a decline if the population was getting younger, but it is not.

19 Blaise November 22, 2016 at 3:24 am

It’s the rate of dementia of people aged 65 or more. It’s independent of the population getting older/younger. Absolute number of cases of dementia could still be rising.

20 anon November 22, 2016 at 5:39 am

This is certainly not true. It doesn’t depend on the ENTIRE population getting older/younger, but the population OVER 65 getting older/younger.

21 Ray Lopez November 22, 2016 at 7:44 am

Blaise is right, anon. Reed the article, it’s a plea for more funding and it simply implies ‘more dementia coming’ which is absolute numbers not rate.

22 Axa November 22, 2016 at 2:27 am

But, blue collar jobs are cool. Real men work in factories around welding fumes and chlorinated solvents.

23 psmith November 22, 2016 at 9:11 am

An interesting point. I wonder about the long-term effects of office work, too:

24 Axa November 22, 2016 at 10:09 am

VOCs, they’re eveywhere. In your car, in carpets and all things plastic in buildings. As long as there’s good ventilation, the impact on people’s health is minimized.

25 Mark Thorson November 22, 2016 at 3:22 am

FYI, forgetting the name of the Vice-President during the Carter Administration is not an indicator of dementia. Forgetting the name of the state capital of Vermont is not dementia.

Forgetting what you ate for breakfast this morning might be a sign of dementia. Not knowing what day of the week it is might be a sign of dementia.

Not knowing who the Secretary of State is is not a sign of dementia. Is it Kerry? I don’t know and I don’t care.

26 Ray Lopez November 22, 2016 at 8:12 am

From Wikipedia, it’s of course Walter Mondale, which is pretty obvious if you think about it. And the capital of Vermont is Montpelier. Off topic, as for vice presidents, surely this Texas right-wing leaning, austerity loving, against Supreme Court packing FDR VP is underrated?

27 The Original Other Jim November 22, 2016 at 9:24 am

Missing Mark Thorson’s point by this much is a very good indicator of dementia.

28 Greg November 23, 2016 at 11:33 am

My guess is that Ray understands Mark’s point but is nevertheless unable to resist showing off his ability to look up irrelevant facts and make “jokes” about them. Not sure what you would call that.

29 rayward November 22, 2016 at 5:45 am

Then how does one explain the election of Trump if not dementia. I suppose it could be amnesia, a malady that resurfaces every few years. As for dementia, I have heard and read many reports that the early stages are marked by an obsession with watching Fox News, a condition that afflicts even those who were liberals before the onset of dementia.

30 dearieme November 22, 2016 at 7:23 am

“how does one explain the election of Trump”: by observing that his opponent was appalling. Hell, she couldn’t beat daft old Sanders without the DNC cheating on her behalf.

31 Ray Lopez November 22, 2016 at 8:19 am

But Trump’s opponents were not appalling, not even Rand Paul. And Trump won. Clearly it’s not so much that Clinton lost that’s appalling but that Trump won on a racist ticket. As Krugman said, why was Trump even close? In any sane country it would have been the biggest blowout in history, even if a dog was running against Trump. It’s the beginning of the end of the USA, not unlike the Gracchi brothers in the late Roman republic set a bad precedent for mob rule and violence (thought their land reform efforts arguably were laudable).

32 Greg November 23, 2016 at 11:39 am

While I voted for Clinton, she was not a great candidate. Starting off with unfavorable ratings second only to the guy with the orange hair is already pretty strong stuff. Making a bunch of speeches at Goldman when you don’t need the money and plan on running for president is just stupid. So is saying that you’re going to eliminate all the coal jobs, even if it’s basically true. She also had a million policy proposals, which from a communications perspective is almost the same as having none. Her campaign took the Midwest for granted and turns out to have had a poor ground game, surprisingly. She never articulated a clear vision, she mostly waited for Trump to implode. I find Trump appalling, but let’s all remember Occam’s Razor. The notion that Clinton ran a horrible campaign is much more straightforward than the entire nation being insane or racist, right after electing Obama. I do think the jury’s still out on sexism.

33 Boonton November 22, 2016 at 6:18 am

Possibly it’s a cohort thing. Someone 65 or older in 2000 would have been born in 1937 or earlier, in 2012 that would be 1947. So perhaps growing up after WWII did something to lower the risk of the disease (moving from canned goods to frozen perhaps, low levels of radiation in the air due to atomic tests?)

34 dearieme November 22, 2016 at 7:24 am

Health: it’s nearly all germs or genes. Decline of CVD – germs; the rise and fall look just like those of an infectious epidemic.

35 P Burgos November 22, 2016 at 9:05 am

What do you mean by CVD? When I do a Google search, all I seem to come up with is cardiovascular disease, but I am not aware of the connection between microbes and cardiovascular disease.

36 Mark Bahner November 22, 2016 at 12:31 pm

“When I do a Google search, all I seem to come up with is cardiovascular disease, but I am not aware of the connection between microbes and cardiovascular disease.”

One area of current discussion/debate is the relationship between periodontal disease and CVD:

37 Boonton November 22, 2016 at 10:06 am

OK let’s use as a working assumption that people often grew up close to where they were born. Look at death certificates of those who were 65 & older in 2001 and later died of dementia and death certificates of those from 2012 and after. Assuming you can get place of birth from the death certificates you might, Freakanomics Style, be able to see a wave of dementia reduction tied to place over time. That can then perhaps be correlated to some underlying societal change (vaccination, introduction of some new product, etc.).

38 Mark Bahner November 22, 2016 at 12:42 pm

“Possibly it’s a cohort thing. Someone 65 or older in 2000 would have been born in 1937 or earlier, in 2012 that would be 1947. So perhaps growing up after WWII did something to lower the risk of the disease…”

Fluoride first introduced to U.S. drinking water in…1945! 🙂

(Mostly kidding…but it’s one possibility.)

39 Ray Lopez November 22, 2016 at 7:40 am

My Greek uncle has dementia. There are four types of dementia, Alzheimer’s being 60-80% of the most probable kind. He have away or had stolen half his considerable wealth before I rescued the funds from his enemies (and kept them myself, to paraphrase a memorable phrase). I think possibly what’s going on is people are getting healthier over time. Back in the days lead poisoning was common (just to pick an example, not that Pb causes dementia), as was smoking, boxing, etc. Nowadays over-eating is common and arguably the extra nutrition from junk food and high fructose corn syrup is preventing dementia and colon cancer (but increasing diabetes, heart attacks, etc) .

Bonus Trivia: Carlsen lost, just like TC ‘predicted’. There are more games to play so Carlsen can still win it. And to date I am FOUR FOR FOUR: I called (by email to TC): BrExit, Columbia’s NO, Trump’s win and Karjakin winning the chess championship.

40 chuck martel November 22, 2016 at 8:05 am

There might indeed be a decline in dementia but it couldn’t be proven by the behavior of the US Senate.

41 Ted Craig November 22, 2016 at 8:42 am

Aren’t people over the age of 65 younger on average than they were 12 years earlier?

42 Boonton November 22, 2016 at 11:18 am

Yes but you’re talking about a cohort. So many people were 65 or older in 2000. In 2012 so many were also over 65. Anyone in that group in 2000 is also in that group in 2012 unless they died. Some people in that group in 2000 were young (like just turned 65) and some were already older (i.e. 80). Likewise in 2012 some of the old people were young members in 2000 and some weren’t even members.

What the study seems to be picking up is that the average age of diagnosis older and the overall rate of diagnosis is lower, so that’s a positive on both fronts and a bit of a surprise.

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