The Incidence of Dementia in England and Wales: Findings from the Five Identical Sites of the MRC CFA Study

TL;DR

This study finds no significant variation in dementia incidence across five sites in England and Wales, with rates increasing sharply after age 75.

Contribution

The study provides the first multisite dementia incidence analysis in England and Wales using identical methods across five locations.

Findings

Dementia incidence rates rise sharply with age, reaching 84.9 per 1,000 person years at age 85 and above.

No significant variation in dementia incidence was found across the five study sites.

Approximately 180,000 new dementia cases occur annually in England and Wales.

Abstract

Although incidence of dementia is known to vary between nations, variation within country has not been explored because most incidence studies are single site or have insufficient numbers to compare sites. Few countries have conducted multisite incidence studies in order to facilitate national comparisons. This study aims to provide robust measures of the variation of the incidence of dementia across sites within England and Wales and produce overall estimates by age and sex.

The Medical Research Council Cognitive Function and Ageing Study used identical methodology in five diverse sites across the United Kingdom, each with different risk patterns and mortality rates. Incidence has been estimated using likelihood-based methods between the first two waves of interviews. Incidence rates rise with age, particularly above the age of 75 y, from 7.4 (95% confidence interval, 3.6–16.1) per 1,000 person years at age 65–69 y to 84.9 (95% confidence interval, 63.0–107.8) per 1,000 person years at age 85 y and above. The rate of increase for both sexes is marked, and continues into the oldest age groups. Hence, it is estimated that approximately 180,000 new cases of dementia occur in England and Wales each year. There is no convincing evidence of variation across sites, and incidence rates do not reflect the variations in the prevalence of possible risk factors in these sites.

There is no evidence, within England and Wales, of variation in dementia incidence across sites. Dementia incidence rates do not tail off at the oldest ages.

No evidence for variation in dementia incidence between areas with different vascular disease risk or between men and women, nor for reduced indidence amongst oldest age groups.

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