The ZARADEMP Project on the incidence, prevalence and risk factors of dementia (and depression) in the elderly community: I. The context and the objectives

Abstract

Background and Objectives: The public health dimension of the problem of dementia and depression in the elderly population is well documented, but epidemiological data are generally considered to be insufficient and, at times, contradictory. This paper identifies relevant research areas for the ZARADEMP Project, which follows the Zaragoza Study (or ZARADEMP 0) and is part of both EURODEM and EURODEP Studies. Methods: Review of the literature. Hypotheses emerging in previous studies of this research group. Results: The following relevant objectives to study in relation to dementia (and depression) have been identified: a) potential variations over time in the prevalence rate; b) provision of reliable estimations of incidence rates, specific for age and gender; c) data about the course and natural history of so called "mild cognitive deficit"; d) association between hypothesized risk factors and cases of dementia (and depression) and its most frequent subtypes; and e) testing of hypotheses related to the overlap between dementia and depression and, specifically, to what extent depression has an increased risk for DAT. Other objectives of the study are also reviewed, in particular the cross-cultural comparison of findings in Zaragoza and in other European cities incorporated in both EURODEM and EURODEP Studies. The importance of maintaining good, contemporary methodological standards is emphasized. Conclusions: A number of relevant research areas in the epidemiology of both dementia and depression in the elderly have been identified. Case-control studies based on incident cases of dementia of the Alzheimer's type (DAT) to adequately assess risk factors seem particularly timely.