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AlzRisk Paper Detail

Reference: Verghese, 2003
Cohort: Bronx Aging Study
Risk Factor: Cognitive Activity

Average Follow-up Time Detail
The sample of 469 participants was followed for a total of 2702 person-years.

Exposure Detail
Study participants were asked at baseline about the frequency with which they participated in six cognitive leisure activities: (i) reading books or newspapers, (ii) writing for pleasure, (iii) doing crosswords, (iv) playing board games or cards, (v) participating in organized group discussions, and (vi) playing musical instruments. For each activity, the investigators scored participation as follows: "daily" (7 points), "several days per week" (4 points), "once a week" (1 point), "monthly", "occasionally", or "never", (all 0 points). On this scoring scale, 1 point corresponds to participation in one activity once a week. A composite cognitive activity scale score ranging from 0 to 42 was obtained by summing participation scores across the six cognitive activities. In this study, the mean composite cognitive activity score was 9.8 (SD = 5.7).

"At base line, subjects were interviewed regarding participation in 6 cognitive activities (reading books or newspapers, writing for pleasure, doing crossword puzzles, playing board games or cards, participating in organized group discussions, and playing musical instruments)... Subjects reported the frequency of participation as “daily,” “several days per week,” “once weekly,” “monthly,” “occasionally,” or “never.” We recoded these responses to generate a scale with one point corresponding to participation in one activity for one day per week. The units of the scales are thus activity-days per week...For each activity, subjects received seven points for daily participation; four points for participating several days per week; one point for participating once weekly; and zero points for participating monthly, occasionally, or never. We summed the activity-days for each activity to generate a cognitive-activity score, ranging from 0 to 42..."

Ethnicity Detail
In this analytic sample, 92% of the participants are Caucasian.

Screening and Diagnosis Detail
Screening Method:
BlessedBlessed Information-Memory-Concentration Test

AD Diagnosis:
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)

Total dementia diagnosis: DSM-III-R

"At study visits, subjects in whom dementia was suspected on the basis of the observations of members of the study staff, results of neuropsychological tests, or a worsening of the scores on the Blessed test21 by four points or a total of more than seven errors underwent a workup including computed tomographic scanning and blood tests.19,20 A diagnosis of dementia was assigned at case conferences attended by study neurologists, a neuropsychologist, and a geriatric nurse clinician, according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) or, after 1986, the revised third edition (DSM-III-R).27-29

"Updated criteria for the diagnosis of dementia and particular types of dementia were introduced after the study had begun. To ensure uniformity of diagnosis, all cases were discussed again at new diagnostic conferences held in 2001 and involving a neurologist and a neuropsychologist who had not participated in diagnostic conferences between 1980 and 1998.29 Dementia was diagnosed according to the DSM-III-R criteria.28...Disagreements between raters were resolved by consensus after the case was presented to a second neurologist, with blinding maintained. Cases of dementia were classified according to the criteria for probable or possible Alzheimer’s disease published by the National Institutes of Neurological Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association30 and the criteria for probable, possible, or mixed vascular dementia published by the Alzheimer’s Disease Research Centers of California. 31 "

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

AD Covariates:
Blessedbaseline Blessed score
CDUBchronic disease up to baseline

TD Covariates:
Blessedbaseline Blessed score
CDUBchronic disease up to baseline