Dementia. Risk factors and caregiver burdens. An epidemiological study of the population in Nord-Trøndelag.

The occurrence of dementia is rising with increased life expectancy. As many as 1/10 of the population may be demented at the end of life. The majority of dementia cases suffer from Alzheimer's Disease (AD), while remaining cases are either vascular demen tia(VD), mixed AD and VD, or other dementias. Assumed risk factors for AD are family history of AD, apolipoprotein E gene-allele e3 and e4, previous depression, and head injury. Probable protective factors are non-steroidal anti-inflammatory drugs, estrog en intake, and arthritis. Risk factors for VD are essentially the same as for cerebrovascular disease. Dementia causes a lot of suffering among close relatives. We need knowledge about how many relatives of demented people that suffers from loss of well -being and mental health, and how severely. We want to compare the effect when living with the demented person to the effect after institutionalization. The HUNT study of the adult population in Nord-Trøndelag county took place in 1984-86 and again in 19 95-97, and a new follow-up is now taking place. A large amount of information with possible significance for later development of dementia, related to vascular factors, somatic illness, and life style has been collected. Dementia cases during the last 20 years in the county will be traced through public registry data and information from the health service system. The HUNT material will be grouped in families by means of registry data from Statistics Norway(SN). This permit comparison between spouses/rela tives of demented persons and the remaining population. SN also provides demographic info (like occupation, marital duration, living area). The aims of the study are 1) to assess risk of dementia associated with various types of exposures earlier in lif e, spesific genes and interaction between genes and other risk factors, and 2) to examine loss of well-being and mental health among spouses and relatives of demented persons living at home or in institution