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Prevalence of Dementia and Dementing Diseases in Japan
The Tajiri Project
Kenichi Meguro, MD, PhD;
Hiroshi Ishii, MD;
Satoshi Yamaguchi, MD, PhD;
Junichi Ishizaki, PhD;
Masumi Shimada, PhD;
Mari Sato, MSc;
Ryusaku Hashimoto, MSc;
Yoichi Shimada, MSc;
Mitsue Meguro, BA;
Atsushi Yamadori, MD, PhD;
Yasuyoshi Sekita, PhD
Arch Neurol. 2002;59:1109-1114.
Background Vascular dementia (VaD) has been considered to be more prevalent than
Alzheimer disease in Japan. However, this might be the result of overdiagnosis
stemming from some problematic diagnosis of VaD or of the frequent use of
magnetic resonance imaging to detect cerebrovascular disease in older adults.
Objectives We investigated the prevalence of dementia and the ratios of dementing
diseases. The effects of different criteria for VaD (DSM-IV, Alzheimer's Disease Diagnostic and Treatment Centers [ADDTC], and
National Institute of Neurological Disorders and Stroke and the Association
Internationale pour la Recherche et l'Enseignement en Neurosciences [NINDS-AIREN])
were considered. Hippocampal atrophy and vascular contribution to dementia
were evaluated using magnetic resonance imaging findings.
Methods We targeted all residents 65 years and older (n = 3207) in Tajiri, Japan,
and examined 1654 (participant group 1). Of these, 564 (participant group
2) were randomly selected, and 497 underwent magnetic resonance imaging and
diagnosis of dementing diseases.
Results We found the overall prevalence of dementia to be 8.5% (141/1654) in
participant group 1. Of these, 21 (14.9%) had a history of stroke. Of the
113 participants who had a history of stroke independent of dementia, 18.6%
(21/113) were demented. For participant group 2 (n = 497), 32 were demented.
The ratio among the dementia for probable VaD based on the NINDS-AIREN criteria
was 18.8% (6/32), whereas that for ischemic vascular dementia was 31.3% (10/32)
according to the ADDTC criteria.
Conclusion We confirmed the overall prevalence of dementia in adults 65 years and
older to be 8.5%. We found that VaD was not a common disorder according to
the NINDS-AIREN criteria. Rather, the condition of possible Alzheimer disease
with cerebrovascular disease was more common.
From the Division of Neuropsychology, Department of Disability Medicine,
Tohoku University Graduate School of Medicine (Drs Meguro, Ishii, Yamaguchi,
Ishizaki, Shimada, and Yamadori; Miss Sato; and Messrs Hashimoto and Shimada,
Sendai), The Tajiri SKIP Center (Dr Ishii), Tajiri; and the Division of Health
Care System Science, Department of Planning for Welfare Programs and Public
Policy, Tohoku University Graduate School of Economics (Mrs Meguro and Dr
Sekita), Sendai, Japan.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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J Geriatr Psychiatry Neurol 2004;17:183-189.
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