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Duke University Medical Center

Department of Psychiatry and Behavioral Science






Epidemiology of Dementia

The Aging, Demographics, and Memory Study (ADAMS) is sponsored by the National Institute on Aging (NIA), a federal program dedicated to improving the health of older Americans.  Scientists from the University of Michigan and nationwide are collaborating with researchers from Duke University who are carrying out the research. Dr. Brenda Plassman, a nationally recognized scientist in the field of memory research, is the Study Director at Duke University.  The project has enrolled approximately 850 adults aged 70 and older. Information about medical illnesses and everyday activities is being collected to find conditions that impact our memory as we age.  The study also investigates how memory changes affect older American’s need for assistance from families and agencies.  Links and Resources

University of Michigan 
Institute for Social Research

University of Michigan
Health and Retirement Study

National Institute of Aging/National Institutes of Health

The Aging, Demographics, and Memory Study (ADAMS)

Overview and Purpose
The Aging, Demographics, and Memory Study (ADAMS) is a part of the Health and Retirement Study (HRS) funded by the National Institute on Aging with the specific aim of conducting a population-based study of dementia.  HRS formed a partnership with a research team at Duke University Medical Center led by Brenda Plassman, Ph.D. to conduct in-person clinical assessments for dementia on selected HRS respondents.  The purpose was to gather additional information on respondents’ cognitive status and assign a diagnosis of dementia, cognitive impairment but not demented (CIND), or normal cognition.  Prior community-based studies of dementia have focused on a particular geographical area or have been based on nationally distributed samples that are not representative of the population.  This study is the first of its kind to conduct in-home assessments of dementia in a national sample that is representative of the 
U. S. elderly population.

Study Goals
The primary goal of the ADAMS was to collect data that will allow researchers to estimate the prevalence, predictors, and outcomes of dementia in the U. S. elderly population.  The study will facilitate our understanding of the natural history of pre-clinical dementia as well as the role of dementia in changing the health and social functioning of older Americans.  ADAMS will provide an opportunity for conducting in-depth investigations related to the impact of dementia on formal health care utilization, informal caregiving, and the total societal costs of this care.  A second aim of the study is to examine the validity of the HRS cognitive functioning measures as a screening tool for cognitive impairment or dementia.

Study Design
A group of 1,770 HRS respondents, age 70 or older, was selected from the 2000 and 2002 waves based on the score on the self- or proxy-cognitive assessment measure.  Among this group, we completed assessments with 856 respondents.  In order to ensure a sufficient number of respondents across the full range of cognitive ability, the sample was stratified based on cognitive status.  Five cognitive strata (ranging from “low functioning” to “high normal”) were defined based on respondents’ performance in the cognitive measures in the most recent HRS interview (either 2000 or 2002, depending on the timing of recruitment into ADAMS).  Scores on the full set of HRS cognitive items (ranging from 0 to 35 points) were used to classify self respondents, and scores on the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE; Jorm, 1994) were used to classify proxy respondents.  The cognitively normal group was further stratified by age (age 70-79 versus 80 or older) and sex in order to ensure adequate numbers in each of these subgroups.  More detailed information on the ADAMS sampling strategy, including the cut-points and sample size for each cognitive stratum is available here in the documentation regarding the ADAMS sample selection (coming soon).  More information about the HRS self and proxy respondent cognitive measures is described in the HRS cognition documentation report by Ofstedal, Fisher, & Herzog, 2005 at the 
Health and Retirement Study's website.

The Aging, Demographics, and Memory Study was funded by The National Institute on Aging as a part of the Health and Retirement Study.

Project Investigators and Staff

ADAMS Principal Investigators:
Robert Willis, Ph.D., University of Michigan
Brenda Plassman, Ph.D., Duke University Medical Center

ADAMS Co-Investigators:
A. Regula Herzog, Ph.D.
University of Michigan (deceased)

Willard Rodgers, Ph.D., M.P.H.
University of Michigan

Kenneth Langa, M.D., Ph.D.
University of Michigan

Robert Wallace, M.D.
University of Iowa

Michael Hurd, Ph.D.
 RAND Corporation

David Weir, Ph.D.
University of Michigan

Steve Heeringa, Ph.D.
University of Michigan

Mary Beth Ofstedal, Ph.D. 
University of Michigan

David Steffens, M.D.
Duke University Medical Center

James Burke, M.D., Ph.D.
Duke University Medical Center

Gwenith Fisher, Ph.D.
 University of Michigan

Nancy Fultz, Ph.D.
University of Michigan

Guy Potter, Ph.D.
Duke University Medical Center

The ADAMS required the collaboration of a large number of investigators and research staff.  In addition to all of the ADAMS subjects and informants, we thank the following people, without whom the ADAMS could not have been completed: Kent Anglin; Jennifer Arrieta; Carolyn Bellion; Carol Bowen; Candace Boyette; John Breitner, M.D.; Andrew Broughton; Jackie Cardenas; Deborah Chestnutt; Kelly Cutshall; Munira Dhanani; Debbie Drosdick; Norman Edwards; Larry Ellefson; Douglas Ewbank, Ph.D., Denis Evans, M.D.; Ella Faircloth; Norman Foster, M.D.; Shannon Foster; Carri Fuller; Bruno Giordani, Ph.D.; Deanna Hamilton; Hugh Hendrie, MB, ChB; Heather Hewett; Eva Hildreth; Myca Jeter; Leslie Johnson; Janet Keller; Colleen Kelly; Josh Kittinger; Nicole Kirgis; Eric Larson, M.D., MPH; Laurie Leeson; Cathy Liebowitz; Jack McArdle, Ph.D.; Pauline Moore; Roberta Moore; Tiffany Newman; Kristin Olver; Diane Roberts; Vicki Robertson; Karen Rodin; Cuancha Serrant; Madeline Schoberl; Richard Schulz, Ph.D.; Joyce Sisung, Katie Szilagyi; Pat Titus; Frederick Unverzagt, Ph.D.; Taeh Ward; Kathleen Welsh-Bohmer, Ph.D.; and Courtnee Willetts.

For general information, pleas Contact Dept: 919-682-6722

For help with website: Roberta Moore (hyperlink) email: rmoore@psych.duhs.duke.edu 

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