Rates and risk factors for dementia and Alzheimer's disease - Results fromEURODEM pooled analyses

Citation
Lj. Launer et al., Rates and risk factors for dementia and Alzheimer's disease - Results fromEURODEM pooled analyses, NEUROLOGY, 52(1), 1999, pp. 78-84
Citations number
41
Categorie Soggetti
Neurology,"Neurosciences & Behavoir
Journal title
NEUROLOGY
ISSN journal
00283878 → ACNP
Volume
52
Issue
1
Year of publication
1999
Pages
78 - 84
Database
ISI
SICI code
0028-3878(19990101)52:1<78:RARFFD>2.0.ZU;2-B
Abstract
Objective: To investigate the risk of AD associated with a family history o f dementia, female gender, low levels of education, smoking, and head traum a. Background: These putative factors have been identified in cross-section al studies. However, those studies are prone to bias due to systematic diff erences between patients and control subjects regarding survival and how ri sk factors are recalled. Methods: The authors performed a pooled analysis o f four European population-based prospective studies of individuals 65 year s and older, with 528 incident dementia patients and 28,768 person-years of follow-up. Patients were detected by screening the total cohort with brief cognitive tests, followed by a diagnostic assessment of those who failed t he screening tests. Dementia was diagnosed with the Diagnostic and Statisti cal Manual of Mental Disorders, 3rd ed. (revised), and AD was diagnosed acc ording to National Institute of Neurological and Communicative Disorders an d Stroke-Alzheimer's Disease and Related Disorders Association criteria. In cident rates and relative risk. (95% CI) express the association of a risk factor far dementia. Results: Incident rates for dementia and AD were simil ar across studies. The incidence of AD increased with age. At 90 years of a ge and older the incidence was 63.5 (95% CI, 49.7 to 81.0) per 1,000 person -years. Female gender, current smoking (more strongly in men), and low leve ls of education (more strongly in women) increased the risk of AD significa ntly. A history of head trauma with unconsciousness and family history of d ementia did not increase risk, significantly. Conclusion: Contrary to previ ous reports, head trauma was not a risk factor for AD, and smoking did not protect against AD. The association of family history with the risk of AD i s weaker than previously estimated on the basis of cross-sectional studies. Female gender may modify the risk. of AD, whether it be via biological or behavioral factors.