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AlzRisk Paper Detail

Reference: Lindsay, 2002
Cohort: Canadian Study of Health and Aging
Risk Factor: Alcohol

Average Follow-up Time Detail
Initial cohort assessment occurred in 1991-1992 (CSHA-1) and follow-up occurred in 1996-1997 (CSHA-2).

Exposure Detail
Information about risk factors, including alcohol, was obtained via self-administered questionnaire at baseline. Regular consumption of beer, wine, and spirits was defined as at least once a week. Investigators collected data on participants’ consumption of many types of alcoholic beverages; this entry pertains to wine.

Ethnicity Detail
The investigators do not provide data on ethnicity.
The CSHA is based on a representative, nationwide sample of Canadians.

Age Detail
Entry criteria required all participants to be 65+ in 1989-1990.
Age derived from: [#cases(194)*mean case age(81.0) + #controls(3,894)*mean control age(72.9)] / total n (4088) = 73.3
Note: In the blood pressure categorical table, this same ref has 68.0 as the mean age at start of follow-up. Not clear how that was derived.

Screening and Diagnosis Detail
Screening Method:
3MSEModified Mini-Mental State Examination (Teng 1987)

AD Diagnosis:
NINDS-AIREN National Institute for Neurologic Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (Roman 1993)

Total dementia definition: Dementia via DSM-III-R.

"All participants were screened for dementia by using the Modified Mini-Mental State (3MS) Examination.14,15 Those who screened positive (a 3MS Examination score of below 78/100) and a random sample of those who screened negative (a score of 78 or above) were invited to participate in an extensive clinical evaluation, which followed a three stage protocol. A nurse first readministered the 3MS Examination and collected information on the participant’s medical and family history. Next, a physician conducted a standardized physical and neurologic examination. Finally, for those participants deemed testable (a 3MS Examination score of50 or above), a psychometrist administered a series of neuropsychological tests16, which were interpreted later by a neuropsychologist. Independent preliminary diagnoses were made by the physician and neuropsychologist, which was followed by a case conference in which a consensus diagnosis was reached according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, criteria for dementia17; the National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) criteria for Alzheimer’s disease18; and other specific criteria for cognitive impairment19 and vascular dementia 20. Diagnoses comprised the following categories: no cognitive impairment; cognitive impairment, no dementia; probable and possible Alzheimer’s disease; vascular dementia; other specific dementia; and unclassifiable dementia."

Covariates & Analysis Detail
Analysis Type:
Logistic regression

"This analysis included only those participants living in the community as of CSHA-1. A case-control analysis was conducted, with incident cases and controls selected at CSHA-2. To be included, participants' initial screening results had to be negative or, at CSHA-1, participants had to be clinically diagnosed without 1) cognitive impairment, no dementia, or 2) dementia. Cases were diagnosed with probable or possible AD at CSHA-2. Comparisons were made with controls who, at CSHA-2, remained without cognitive impairment, no dementia or dementia according to the clinical evaluation or screening test at follow-up"

All participants who met these criteria were included in the analyses.

AD Covariates: