Prospective Cohort Study

2016 Alzheimer's disease facts and figures

Dementia prevention, intervention, and care

This report provides information to increase understanding of the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality rates, health expenditures and costs of care, and effect on caregivers and society in general. It also explores the roles and unique challenges of long‐distance caregivers, as well as interventions that target those challenges. An estimated 5.2 million Americans have AD. Approximately 200,000 people younger than 65 years with AD comprise the younger onset AD population; 5 million comprise the older onset AD population. Throughout the coming decades, the baby boom generation is projected to add about 10 million to the total number of people in the United States with AD. Today, someone in America develops AD every 68 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, or nearly a million new cases per year, and the total estimated prevalence is expected to be 13.8 million. AD is the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age 65 years or older. Between 2000 and 2010, the proportion of deaths resulting from heart disease, stroke, and prostate cancer decreased 16%, 23%, and 8%, respectively, whereas the proportion resulting from AD increased 68%. The number of deaths from AD as determined by official death certificates (83,494 in 2010) likely underrepresents the number of AD‐related deaths in the United States. A projected 450,000 older Americans with AD will die in 2013, and a large proportion will die as a result of complications of AD. In 2012, more than 15 million family members and other unpaid caregivers provided an estimated 17.5 billion hours of care to people with AD and other dementias, a contribution valued at more than $216 billion. Medicare payments for services to beneficiaries age 65 years and older with AD and other dementias are three times as great as payments for beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2013 for health care, long‐term care, and hospice services for people age 65 years and older with dementia are expected to be $203 billion (not including the contributions of unpaid caregivers). An estimated 2.3 million caregivers of people with AD and other dementias live at least 1 hour away from the care recipient. These “long‐distance caregivers” face unique challenges, including difficulty in assessing the care recipient's true health condition and needs, high rates of family disagreement regarding caregiving decisions, and high out‐of‐pocket expenses for costs related to caregiving. Out‐of‐pocket costs for long‐distance caregivers are almost twice as high as for local caregivers.

2013 Alzheimer's disease facts and figures

ACC
: American College of Cardiology
ACE
: angiotensin-converting enzyme
ACS
: acute coronary syndrome
AF
: atrial fibrillation
AGNES
: Arrhythmia Genetics in the Netherlands
AHA
: American Heart Association
AMIOVIRT
: AMIOdarone Versus Implantable cardioverter-defibrillator:

/pdf/2015-esc-guidelines-for-the-management-of-patients-with-3hzn8vw0c4.pdf

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC)

Chronic traumatic encephalopathy in the National Football League.

https://www.sportsmed.theclinics.com/article/S0278-5919(02)00095-9/pdf

Recurrent athletic head injury: risks and when to retire

Objective Brain injuries have been the most common direct cause of death among American football players since the annual recording of football-related deaths began in 1931. This study examines the 55-year experience with brain injury-related fatalities in American football from 1945 to 1999, including not only the incidence but also the cause of death in discrete 5-year spans to focus on the variables that have either increased or decreased fatalities. In addition, we describe the types of injuries that have occurred, the activities in which the players were engaged at the time of injury, the level of play involved, and whether the injuries occurred during games or in practice sessions. Methods Data were collected nationwide regarding football fatalities in all organized football programs in public schools and in college, professional, and youth programs by conducting personal interviews and eliciting responses to questionnaires. The information collected included demographic data about the injured player, equipment data, injury type and body part involved, and pertinent information regarding the exact circumstances of the accident. Results We found that a total of 497 brain injury-related fatalities occurred among American football players during the period from 1945 through 1999. The causes of death were brain injuries in 69% of the cases, cervical spine injuries in 16%, and other injuries in 15%. Subdural hematoma was the type of injury associated with the majority (429, 86%) of brain injury-related fatalities. A majority (61%) of the brain injury-related fatalities occurred during participation in football games, and 75% of these were high school players. It should be noted that the number of high school football players is far greater (more than 1 million) than the number of either college (approximately 75,000) or professional (approximately 2000) players. The most frequent on-field activity involved when players sustained their fatal injuries was either tackling or being tackled (35%). Conclusion Brain injury-related fatalities accounted for 69% of all football fatalities from 1945 through 1999. The greatest number and percentage of brain injury-related fatalities occurred during the 5-year span from 1965 through 1969, and the smallest number and percentage occurred during the 2 decades from 1975 through 1994. Most brain injury-related fatalities involved a subdural hematoma sustained by high school football players while either tackling or being tackled in a game. In the 2 decades from 1975 through 1994, there was a dramatic reduction in these fatalities, and the preventive measures that have received most of the credit are 1) the 1976 rule change that prohibits initial contact with the head and face when blocking and tackling and 2) the National Operating Committee on Standards for Athletic Equipment helmet standard, which went into effect in colleges in 1978 and in high schools in 1980.

Brain injury-related fatalities in American football, 1945-1999.

BackgroundCatastrophic cervical spine injuries in football are rare but tragic events.PurposeTo update the incidence of catastrophic cervical injuries in scholastic football players and identify ne...

Catastrophic Cervical Spine Injuries in High School and College Football Players

This document provides an overview of select medical issues that are important to team physicians who are responsible for athletes with concussion. It is not intended as a standard of care, and should not be interpreted as such. This document is only a guide, and as such, is of a general nature, consistent with the reasonable, objective practice of the healthcare professional. Individual treatment will turn on the specific facts and circumstances presented to the physician. Adequate insurance should be in place to help protect the physician, the athlete, and the sponsoring organization. This statement was developed by a collaboration of six major professional associations concerned about clinical sports medicine issues; they have committed to forming an ongoing project-based alliance to bring together sports medicine organizations to best serve active people and athletes. The organizations are: American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and the American Osteopathic Academy of Sports Medicine.

Robert C. Cantu

Papers

Chronic traumatic encephalopathy in the National Football League.

Recurrent athletic head injury: risks and when to retire

Brain injury-related fatalities in American football, 1945-1999.

Catastrophic Cervical Spine Injuries in High School and College Football Players

Concussion (mild traumatic brain injury) and the team physician: A consensus statement