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Epidemiology of Dementia

Definition of Dementia

Dementia occurs when both memory and cognitive function of a person deteriorates in a progressive nature. The condition results from various diseases, such as Alzheimer’s. In 2017, it was estimated that approximately 261,914 deaths were related to dementia as a key underlying cause of death in the United States (Kramarow & Tejada-Vera, 2019). The health problem is significant to nursing practice in that it can provide a basis to educate nurses about the condition and advice on a possible diagnosis, available support, and care for better clinical outcomes.

Agent 

The main agent of dementia is Alzheimer’s. Alzheimer’s disease has proved to be the leading cause of dementia. The disease is ranked as one of the leading causes of death in the United States (Kramarow & Tejada-Vera, 2019).

Description of Dementia 

Dementia is a collective term used to describe conditions and diseases marked by both deteriorations in memory and a decline in thinking. Dementia is a result of several diseases, including Alzheimer’s, vascular dementia, Lewy body dementia, frontotemporal degeneration, and mixed dementias. The majority of dementia cases are found in older adults, and most of them have other chronic conditions. Thus, when dementia co-occurs along, other chronic conditions can lead to death. As a progressive condition it has become a major health challenge across the United States. The condition is primarily found in older adults with other underlying conditions (Kramarow & Tejada-Vera, 2019).

Mortality and Morbidity

Kramarow and Tejada-Vera (2019) reported that a total of 261, 914 deaths were linked to dementia as a major underlying cause of mortality across the United States. Dementia-related deaths by specific causes changed over time.  Forty-six percent of the above deaths were as a result of Alzheimer’s disease.

Distribution of Dementia  

Table 1 below presents a distribution summary of dementia as a health problem by age, sex, and nativity.

Selected Characteristics  Distribution  Number 
1. Age Under 65 3,577
65-74 16,893
75-84 66,314
85-89 65,908
90-94 67,202
95-99 34,460
100 and over 7,558
2. Sex Female 176,785
Male 85,129
3. Nativity Non-Hispanic White 220,841
Non-Hispanic Black 20,655
Non-Hispanic American Indian or Alaska Native 768
Non-Hispanic or Pacific Islander 5,327
Hispanic 13,820
4. Marital Status Not specified
5. Ethnic Group Not specified

The distribution of dementia was as well presented based on environmental characteristics. The distribution based on geographical areas indicated that dementia deaths in metropolitan and non-metropolitan areas were 215,857 and 46,057, respectively (Kramarow & Tejada-Vera, 2019). It was also revealed that socioeconomic status differences could explain variations in dementia deaths in various geographical areas. Besides, a seasonal variation of dementia deaths was reported, with 2013 to 2016 having steady rates, while between 2016 and 2017, the rates increased (Kramarow & Tejada-Vera, 2019). The distribution of dementia deaths also varied in terms of location. In 2017, 60.4% of dementia deaths occurred in a nursing home or hospice facility. Medical facilities accounted for 8.7% of dementia deaths, while 22.9% happened in the deceased’s home (Kramarow & Tejada-Vera, 2019).

Hypothesis 

The distribution is consistent with the hypothesis by Buckley, Waller, Masters, and Dobson (2019). The authors hypothesized that women are at risk of progressing to dementia at a faster rate than men. The hypothesis argued that there are differences in dementia rates of mortality in terms of sex/gender.

Gaps in Knowledge

There is a possible gap in knowledge since it is challenging to identify reasons behind changes in reporting of dementia causes of mortality when there are concurrent alterations in the scientific understanding of the main causes. It is also unknown if changes in practices used to diagnose Alzheimer’s disease and other dementias affect the overall reporting of deaths related to dementia (Kramarow & Tejada-Vera, 2019).

Further Research    

Future researchers need to examine dementia death rate by other factors, such as education and occupation. Thus, further epidemiologic research is needed to determine the influence of occupation and education on the rate of dementia deaths. Researchers would be able to determine if limited educational level and occupational attainment are risk factors for dementia.

Critical Appraisal 

The report was based on information obtained across a total of 50 states and the District of Columbia (Kramarow & Tejada-Vera, 2019). The use of such broad sources of data gave the report some strength. In return, this allowed the authors to build-up more accurate and reliable findings concerning dementia causes of death overtime. The study is relevant in that it presents meaningful data concerning dementia as a major underlying cause of death using selected characteristics, including sex, age, race, and Hispanic origin. The data reveals dementia as a primary health concern in the aging population. Similarly, de Souto Barreto, Cesari, Denormandie, Armaingaud, Vellas, and Rolland (2017) revealed that the percentage of the aging population with dementia is growing.

References

Buckley, R. F., Waller, M., Masters, C. L., & Dobson, A. (2019). To what extent does age at death account for sex differences in rates of mortality from Alzheimer disease?. American Journal of Epidemiology188(7), 1213-1223. https://doi.org/10.1093/aje/kwz048

de Souto Barreto, P., Cesari, M., Denormandie, P., Armaingaud, D., Vellas, B., & Rolland, Y. (2017). Exercise or social intervention for nursing home residents with dementia: a pilot randomized, controlled trial. Journal of the American Geriatrics Society65(9), E123-E129. doi:10.1111/jgs.14947

Kramarow, E. A., & Tejada-Vera, B. (2019). Dementia mortality in the United States, 2000-2017. National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, 68(2), 1–29. Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_02-508.pdf