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Societies should begin planning how to improve quality of life for citizens who develop dementia and mental impairment as they age, as increasing life expectancies mean more and more people will reach the end of life with cognitive problems, UK researchers warn in a report.

It's unlikely that medical science will find a way to completely prevent dementia and cognitive impairment among the very old, Dr. Carol Brayne of Cambridge University and colleagues note in the October issue of PLoS Medicine. "Researchers may be doing those who are aging now and themselves a disservice in the future if they assume, and project to the public, that dementia and cognitive impairment can be prevented altogether during increasingly long lives," Brayne and her team write.

The researchers sought to determine how common dementia was at the end of life among a large group of people, and whether factors that are known to reduce the risk of dementia and cognitive impairment with aging, such as more education and higher social status, might have any effect at the population level.

Brayne and her colleagues analyzed data from a 10-year study of 13,004 men and women aged 65 and older living in Wales and England. Overall, they found, 30 percent of people were demented at the time they died. The likelihood of being demented at the end of life climbed with age; 6 percent of people who died at 65 to 69 years of age had dementia, compared to 58 percent of those who were 95 or older when they died.

Having more education and belonging to a higher social class reduced the risk of dying with dementia, but the effects were small once the researchers controlled for other contributing factors. More educated, wealthier people live longer, Brayne and her team note, so the effects of aging likely weakened the effects of schooling and class.

While "substantial claims" are being made for strategies to prevent dementia, Brayne and her colleagues write, there is as yet little solid information to back them up. "Our findings suggest that preventive efforts are unlikely to be able to counteract the profound effects of age and proximity to death altogether," they add.

Based on the findings, the researchers conclude, societies should make it a priority to learn how to best improve the quality of life for people who do become demented or lose cognitive function as they age, given that their numbers will only swell in the coming years.

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