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Very old women at highest risk of dementia and Alzheimer's disease: incidence data from the Kungsholmen Project, Stockholm
Fratiglioni L, Viitanen M, von Strauss E, Tontodonati V, Herlitz A, Winblad B.. Neurology, 1997-01-01
Topic: Risk, prevention and care in population studies
Objective To determine the incidence of different types of dementia in the very old, and to explore the relation with age and gender. Design A dementia-free cohort was followed for an average of three years in Stockholm, Sweden. At the end of the follow-up, the subjects were interviewed by nurses, clinically examined by physicians, and cognitively assessed by psychologists. Deceased cohort members were studied using death certificates, hospital clinical records, and discharge diagnoses. Dementia diagnoses were made according to the DSM-III-R criteria independently by two physicians. Participants The cohort consisted of 1,473 subjects (75+ years old), of which 987 were clinically examined at follow-up, 314 died before the examination, and 172 refused to participate. Results During the follow-up, 148 subjects developed dementia. In the age-group 75 to 79, the incidence rates for dementia were 19.6 for women and 12.4 for men per 1,000 person-years, whereas for 90+ year-old subjects the corresponding figures were 86.7 and 15.0 per 1,000 person-years. A similar pattern of distribution by age and gender was seen for Alzheimer's disease. In each age stratum, the incidence rates of dementia and Alzheimer's disease were higher for women than for men. The age-adjusted odds ratio for women was 1.9 for dementia and 3.1 for Alzheimer's disease. Conclusions (1) The incidence of dementia increases with age, even in the oldest age groups; (2) women have a higher risk of developing dementia than men, especially at very old ages; (3) this pattern is mainly due to the age and gender distribution of Alzheimer's disease, rather than vascular dementia.
Key findings
- Results During the follow-up, 148 subjects developed dementia.
- Conclusions (1) The incidence of dementia increases with age, even in the oldest age groups; (2) women have a higher risk of developing dementia than men, especially at very old ages; (3) this pattern is mainly due to the age and gender distribution of Alzheimer's disease, rather than vascular dementia.
Why it matters
In a Stockholm cohort of 1,473 dementia-free people aged 75 and over, followed for about three years (including through records for those who died), 148 developed dementia. Rates rose with age, most steeply in women: from 19.6 to 86.7 per 1,000 person-years between ages 75–79 and 90+, against 12.4 and 15.0 in men, and the age-adjusted odds ratio for women was 1.9 for dementia and 3.1 for Alzheimer's disease. The authors attribute the gap mainly to Alzheimer's disease rather than vascular dementia. This describes who develops dementia, not why, and it does not test any treatment or prevention.
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Study details
- Participants1,473
- Evidence strengthModerate
How this study scored 59/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1997 — older than 20 years, still counted |
| Sample size | 3 / 4 | 1,473 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 557 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 18.0 citations a year over 31 year(s) since 1997 |
| Impact for its field and year | 5 / 6 | Cited 20.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 47 other studies in this library |
| Still being cited | 2 / 4 | Cited 30 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Bengt G. Winblad: h-index 171 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Stockholm Gerontology Research Center Foundation: institution h-index 125 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 9008508) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 59 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Fratiglioni, L., Viitanen, M., von Strauss, E., Tontodonati, V., Herlitz, A., & Winblad, B. (1997). Very old women at highest risk of dementia and Alzheimer's disease: incidence data from the Kungsholmen Project, Stockholm. Neurology. https://doi.org/10.1212/wnl.48.1.132
Vancouver
Fratiglioni L, Viitanen M, von Strauss E, Tontodonati V, Herlitz A, Winblad B. Very old women at highest risk of dementia and Alzheimer's disease: incidence data from the Kungsholmen Project, Stockholm. Neurology. 1997. doi:10.1212/wnl.48.1.132. PMID: 9008508.
BibTeX
@article{fratiglioni1997-9008508,
author = {Fratiglioni, L. and Viitanen, M. and von Strauss, E. and Tontodonati, V. and Herlitz, A. and Winblad, B.},
title = {{Very old women at highest risk of dementia and Alzheimer's disease: incidence data from the Kungsholmen Project, Stockholm}},
journal = {Neurology},
year = {1997},
doi = {10.1212/wnl.48.1.132},
pmid = {9008508},
url = {https://doi.org/10.1212/wnl.48.1.132}
}
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