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Vol. 22, No. 1, 2003
Issue release date: January–February 2003
Section title: Original Paper
Neuroepidemiology 2003;22:13–22
(DOI:10.1159/000067109)

Risk Factors for Dementia in the Cardiovascular Health Cognition Study

Kuller L.H. · Lopez O.L. · Newman A. · Beauchamp N.J. · Burke G. · Dulberg C. · Fitzpatrick A. · Fried L. · Haan M.N.
aDepartment of Epidemiology, University of Pittsburgh Graduate School of Public Health, and bDepartment of Neurology and cDivision of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pa.; dNeuroradiology Division, Johns Hopkins Radiology, and eThe Johns Hopkins Medical Institutions, Baltimore, Md.; fDepartment of Public Health Sciences, WFU School of Medicine, Winston-Salem, N.C.; Departments of gBiostatistics and hEpidemiology, University of Washington, Seattle, Wash., and iDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Mich., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 1/13/2003

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 5

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED

Abstract

Background: The Cardiovascular Health Cognition Study has evaluated the determinants of dementia among 3,608 participants that had a magnetic resonance imaging (MRI) of the brain in 1991 and were followed to 1998–1999. Methods: There were 480 incident dementia cases, 330 (69%) were classified as Alzheimer’s disease (AD). Results: In univariate analysis, low scores on the Modified Mini-Mental State Examination (3MSE) and on the Digit Symbol Substitution Test as well as declines in scores over time prior to the development of dementia were significant predictors of dementia. A high ventricular grade on the MRI (atrophy) as well as high white matter grade, a number of brain infarcts on the MRI were all determinants of dementia. Apolipoprotein E ε4 (ApoE-4) was also a powerful predictor of dementia. In a multivariate Cox proportional hazards model controlling for race, gender and grade, the hazard ratios for age (1.1), 3MSE score (0.9), ventricular size (1.4), white matter grade (1.8), presence of large infarcts >3 mm (1.3) and ApoE-4 (2.1) were significant predictors of dementia. The combination of an ApoE-4 genotype, 3MSE score <90, ≧5 ventricular grade, ≧3 white matter grade at the time of the MRI were associated with a 17-fold increased risk (95% CI: 8.6–34.9) of dementia as compared to individuals with none of the above attributes. Conclusions: Measures of cognition, ApoE-4 and MRI of the brain are strong predictors of both dementia and of AD.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 1/13/2003

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 5

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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