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Biomedical subjects

C Brayne

Publications and source records attributed to C Brayne.

15 recordsLinked to original sources
PubMed1992

A longitudinal study in progress: a five-year follow-up of women aged 70-79 years living in a rural community.

The study in progress is a 5-year follow-up of an epidemiological investigation of the indices of dementia in women aged 70-79. From the original sample of 365 women approximately 78 had died at 5 years. Of those remaining all are being reapproached for the purpose of reassessment using the same tools as the original study and informants of both surviving and decreased participants are likewise being contacted. Observations will be made with respect to cognitive change over time.

Aged↗
PubMed1992

The Cambridge Project for Later Life: design and preliminary results.

The Cambridge Project for Later Life is the follow-up at 2.4 years of the Hughes Hall Project for Later Life, a prevalence study of dementia in Cambridge city in which 40% of the population aged 75 and over were screened for dementia. In the follow-up, 1,173 people were screened a second time, and using Mini-Mental Scale Examination scores were selected for a more intensive interview with CAMDEX. This was followed by detailed neuropsychological testing and magnetic resonance imaging in a smaller proportion of individuals.

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PubMed1992

Methodological issues in screening for dementia.

Screening for dementia in populations presents particular difficulties for researchers. In the absence of gold standards for diagnosis, the methods used must be determined by the purposes of the study. In two-stage epidemiological study the screening wave and the diagnostic instrument should be considered together in relation to a third proxy gold standard such as progression of the disorder to moderate and greater severity and neuropathological diagnosis. This provides a measure of the predictive performance of the original screening method and its diagnostic phase. To reduce the variance of estimates of prevalence and incidence it is suggested that the screening interview be a subset of the diagnostic interview.

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PubMed1992

Epidemiologic approach to the study of dementing diseases: a nested case-control study in European incidence studies of dementia.

In 1994 several European studies will have available risk factor information on incident cases of dementia collected in prospective community-based studies. These centers will collaborate in a nested-case control study based on the pooled cases and a sample of the non-diseased respondents. This paper describes the general design and the risk factors to be studied in a European nested case-control study of Alzheimer's disease and vascular dementia.

Aged↗
PubMed1991

Frequency and distribution of Alzheimer's disease in Europe: a collaborative study of 1980-1990 prevalence findings. The EURODEM-Prevalence Research Group.

We reanalyzed and compared current prevalence estimates of Alzheimer's disease in Europe. Studies characterized as follows qualified for comparison: dementia defined by the Diagnostic and Statistical Manual for Mental Disorders, 3rd edition, or equivalent criteria; Alzheimer's disease diagnosed by the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association or equivalent criteria; case-finding through direct individual examination; appropriate sample size; and inclusion of institutionalized persons. Of the 23 European surveys of dementia considered, six fulfilled the inclusion criteria. When age and sex were considered, there were no major geographic differences in the prevalence of Alzheimer's disease across Europe. Overall European prevalence (per 100 population) for the age groups 30 to 59, 60 to 69, 70 to 79, and 80 to 89 years was, respectively, 0.02, 0.3, 3.2, and 10.8. Prevalence increased exponentially with advancing age and, in some populations, was consistently higher in women. Prevalence remained stable over 15 years in one study.

Adult↗
PubMed1991

The prevalence of vascular dementia in Europe: facts and fragments from 1980-1990 studies. EURODEM-Prevalence Research Group.

We selected, reanalyzed, and compared data from current prevalence studies of vascular dementia in Europe. Inclusion criteria were: dementia defined by the Diagnostic and Statistical Manual for Mental Disorders, edition 3, or equivalent criteria; case finding through direct individual examination; appropriate sample size; and inclusion of institutionalized persons. Mixed dementia was combined with vascular dementia. Of the 23 surveys of dementia considered, five fulfilled the inclusion criteria. Age-specific prevalence varied more widely for men than for women; differences were greater in older ages. The prevalence increased steeply with advancing age in all countries, and was generally higher in men; it declined over 15 years in the age class of 80 to 89 years in one Swedish population. Within populations, Alzheimer's disease was generally more common than vascular dementia. Unfortunately, prevalence studies of vascular dementia are limited in Europe and worldwide, and their comparison is impeded by the lack of common diagnostic criteria.

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PubMed1991

The prevalence of dementia in Europe: a collaborative study of 1980-1990 findings. Eurodem Prevalence Research Group.

To obtain age- and gender-specific estimates of the prevalence of dementia in Europe and to study differences in prevalence across countries, we pooled and re-analysed original data of prevalence studies of dementia carried out in some European countries between 1980 and 1990. The study followed these steps: census of existing datasets, collection of data in a standardized format, selection of datasets suitable for comparison, comparison of age and gender patterns. From the 23 datasets of European surveys considered, 12 were selected for comparison. Only population-based studies in which dementia was defined by DSM-III or equivalent criteria and in which all subjects were examined personally were included. Studies in which institutionalized subjects were not investigated were excluded. Age- and gender-specific prevalences were compared within and across studies and overall prevalences were computed. Although prevalence estimates differed across studies, the general age- and gender-distribution was similar for all studies. The overall European prevalences for the five-year age groups from 60 to 94 years, were 1.0, 1.4, 4.1, 5.7, 13.0, 21.6 and 32.2%, respectively. In subjects under 75 years the prevalence of dementia was slightly higher in men than in women; in those aged 75 years or over the prevalence was higher in women. The prevalence figures nearly doubled with every five years of increase in age.

Adult↗
PubMed1991

The EURODEM collaborative re-analysis of case-control studies of Alzheimer's disease: implications for public health.

In the EURODEM pooling and re-analysis of case-control studies of Alzheimer's disease it has been possible to examine putative risk factors with increased power to detect associations. The fundamental problems of case and control selection persist, such as use of prevalent cases, selection through contact with specific services, difficulties of control choice. Risk factors such as family history and head trauma are shown again, although the biases introduced in collection of exposure data could still account for these findings. Other associations which are shown, such as smoking may be accounted for by factors related to survival and use of prevalent cases. The direct public health implications of these findings are limited. Intervention based on many of the associations found in this re-analysis would have relatively low impact on overall rates of Alzheimer's disease because of the small proportion of the population exposed. The total public health impact of any such intervention would be also limited according to the contribution which Alzheimer's disease makes to overall rates of dementia. Improvement of cardiovascular indices may improve the cerebrovascular status of the population, possibly reducing the incidence of vascular dementia. Other broad strategies to maintain health and function would seem prudent, but specific recommendations to reduce the incidence of Alzheimer's disease, or to slow progression of the disorder cannot be recommended on the basis of these re-analyses. It is clear that more research is needed to understand the risks of different pathologies related to Alzheimer's disease as well as dementia and cognitive change generally in the population.(ABSTRACT TRUNCATED AT 250 WORDS)

Alzheimer Disease↗
PubMed1990

The association of education and socioeconomic status with the Mini Mental State Examination and the clinical diagnosis of dementia in elderly people.

The distribution of scores in the Mini Mental State Examination (MMSE) of women aged 70-79 years from a rural area of Cambridgeshire is reported. Increasing age, lower socioeconomic group and less education were all found to be associated with lower scores on MMSE. Of these, only increasing age was significantly related to an increase in the diagnosis of dementia.

Aged↗
PubMed1990

Serum creatine kinase BB isoenzyme levels in an epidemiological study of dementia and cognitive impairment.

It has been suggested that serum creatine kinase levels might be useful in the investigation of dementia. In this study serum creatine kinase BB (CKBB) isoenzyme levels were investigated in a community population of elderly women aged 70 to 80 years. Normative data for this group were compared with the findings in younger age groups. No relationship was found between levels of CKBB and level of dementia, or with the specific clinical diagnosis of senile dementia of the Alzheimer type, although a weakly positive relationship was found between CKBB and 3 cognitive scales.

Age Factors↗
PubMed1990

Estimation of verbal intelligence in an elderly community: a prediction analysis using a shortened NART.

Estimation of premorbid IQ is useful for estimating true cognitive decline in dementia. The National Adult Reading Test-NART (Nelson, 1982)-has been shown to estimate premorbid IQ in hospital patients. NART is potentially of use in epidemiological studies. However, asking community elderly people to read a list of irregular and difficult words can cause distress. This paper explores the possibility of administering only a part of the NART. On the basis of scores on the first half of the test from an elderly rural community sample (N = 316), a regression equation has been developed to predict performance on the second half of the test. It was built using the scores of half the population free from clinical diagnoses and tested on the other half. It was also applied to a demented group and a depressed group from the same population. Total NART scores predicted in this way were highly significantly correlated with the actual NART score for all groups. Recommendations about the use of this shortened test are made.

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PubMed1990

Estimation of verbal intelligence in an elderly community: an epidemiological study using NART.

The National Adult Reading Test (NART) has become widely used by psychologists in clinical practice as part of the assessment of cognitive decline in organic mental disorders. Some normative data have been presented on community samples from a wide range of ages, but little is known of the instrument's performance in true community samples of the elderly. This study presents data on NART from an epidemiological study of dementia and cognitive impairment in elderly women. The contribution of educational level and social class to performance on the scale was examined. NART was found to be strongly related to current level of cognitive function as measured by the Mini Mental State Examination and CAMCOG-the neuropsychological battery of the Cambridge Examination for Mental Disorders in the Elderly. For most subjects in the community the NART was found acceptable as a measure of premorbid intelligence.

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PubMed1989

An epidemiological study of dementia in a rural population of elderly women.

A study of 365 women aged 70-79 in a rural community was carried out using the Cambridge Examination of Mental Disorders in the Elderly (CAMDEX). Prevalence rates of dementia are reported by severity for the 70-74 and 75-79 age groups. Differential diagnosis was made according to CAMDEX guidelines. Senile dementia of Alzheimer type accounted for half the dementia cases. The prevalence rates overall did not differ from those reported in other recent studies, but the rates for levels greater than mild/moderate were lower, despite the inclusion of subjects in institutions.

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PubMed1988

Normal ageing, impaired cognitive function, and senile dementia of the Alzheimer's type: a continuum?

There is little evidence to support the view that senile dementia of the Alzheimer's type (SDAT) is distinct from the normal ageing process. The changes in brain function found in normal ageing, benign senescent forgetfulness, and SDAT can be seen as a continuum, which may reflect a single underlying process. The failure to account for this possibility in research design may explain why few risk factors for SDAT have been identified.

Age Factors↗