Alzforum: AlzRisk Paper Detail

AlzRisk Paper Detail

Risk Factors

Alcohol

Inflammatory Biomarkers

Non-Steroidal Anti-Inflammatory Drugs

Nutritional Antioxidants

Obesity

Physical Activity

Statin use

Reference:	Ninomiya, 2011

Cohort:	Hisayama Study

Risk Factor:	Blood Pressure

Average Follow-up Time Detail
In 1988, 668 current, dementia-free participants of the Hisayama study were enrolled in study of late-life hypertension and dementia. These participants were followed prospectively and screened for dementia between 1988 and 2005, for a maximum 17 years of follow-up. Of these 668, 534 had participated in a health screening, including measurement of blood pressure, in 1973-1974.

This entry describes the association between blood pressure in 1973-1974 and incident dementia between 1988 and 2005.

Exposure Detail
"Sitting BP was measured with a sphygmomanometer 3 times at the right upper arm after [at least] 5 minutes or rest, and the mean of the 3 measurements was used in the analysis. BP levels ... were classified into 4 categories according to the criteria of the seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7).¹⁴"

Screening and Diagnosis Detail
Screening Method:

HDS	Hasegawa's dementia scale
HDS-R	Hasegawa's dementia scale - revised
MMSE	Mini-Mental State Examination (Folstein 1975)

AD Diagnosis:

Autopsy
Brain Imaging
NINDS-AIREN	National Institute for Neurologic Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (Roman 1993)
NINCDS ADRDA	National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)

Total dementia definition: DSM-III-R

Participants were followed prospectively via a monitoring system involving local physicians and officials, either an annual exam or telephone/mail questionnaire, and neuropsychological testing in 1992, 1998, and 2005. Persons testing below a certain threshold on neuropsychological test scores or persons with suspected neuropsychological symptoms were referred for a comprehensive clinical examination. In addition, the study team reviewed medical records and interviewed the participant's family or attending physician.

"Possible or probable dementia subtypes
were diagnosed with clinical information including neuroimaging. Definite dementia
subtypes were also determined on the basis of clinical and neuropathological information in
deceased dementia subjects who underwent autopsy. The diagnostic procedure for autopsy
cases has been reported previously.¹¹ A neuropathological diagnosis of AD was made
following the National Institute on Aging–Reagan Institute criteria,¹² where the frequencies
of senile plaques and neurofibrillary tangles were evaluated using the criteria of the
Consortium to Establish a Registry for Alzheimer’s Disease13 and the Braak stage.¹⁴"

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

p-value for trend for reported analyses:

Alzheimer disease: 0.45
Total dementia: <0.001

AD Covariates:

A	age
E	education
G	gender
ALC	alcohol intake
AHD	antihypertensive drug use
BMI	body mass index
O	other
SCH	serum cholesterol
SM	smoking status
SH	stroke history

TD Covariates:

A	age
E	education
G	gender
ALC	alcohol intake
AHD	antihypertensive drug use
BMI	body mass index
O	other
SCH	serum cholesterol
SM	smoking status
SH	stroke history