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AlzRisk Paper Detail

Reference: Arvanitakis, 2008
Cohort: Religious Orders Study
Risk Factor: Statin use

Average Follow-up Time Detail
Members of the cohort were followed for up to 12 years. The article does not report the average follow-up time for the cohort.

Exposure Detail
Investigators ascertained exposure information by direct visual inspection of prescription and over-the-counter medication containers at baseline and at each follow-up visit; the Medi-Span Drug Database was used to record and code the medications. The investigators reported results separately for any statin use at baseline compared to no statin use at baseline; in addition, the investigators examined the relation of statin use with more or less lipophilic properties at baseline compared to no statin use at baseline to incident AD. This entry pertain to any statin use at baseline in the study.

The investigators compared incident AD risk in two groups: the group of participants who used statins at baseline ("Used") and the reference group who did not use statins at baseline ("Did not use"). Approximately 13% of participants were using statins at baseline.

Ethnicity Detail
The cohort was predominantly Caucasian (89%).

Screening and Diagnosis Detail
Screening Method:
CERADConsortium to Establish a Registry for Alzheimer's Disease (Morris 1989)
MMSEMini-Mental State Examination (Folstein 1975)
Neuropsych Testing

AD Diagnosis:
CERAD Consortium to Establish a Registry for Alzheimer’s Disease (Morris 1989)
Neuropsychological examination

"Clinical evaluations followed procedures recommended by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), as previously described in detail. Each subject underwent a baseline uniform structured evaluation. Annual follow-up evaluations were identical to baseline in all essential details, and were performed blinded to previously collected data. Cognition was evaluated at baseline and each follow-up evaluation using neuropsychological tests that were selected to assess a broad range of abilities, as reported previously. Neuropsychological data were reviewed by a neuropsychologist. The Mini-Mental State Examination (MMSE) was used for descriptive purposes. Nineteen tests were used to form summary measures of global cognition
and five separate cognitive domains (seven tests for episodic memory, four for semantic memory, four for working memory, two for perceptual speed, and two for visuospatial ability), as previously described. The global cognition measure was based on all 19 tests. Summary measures, derived by converting the raw scores of individual tests to z scores and averaging the z scores, allow for decreased floor and ceiling artifacts."

"Dementia and AD were identified by clinicians experienced in diseases of aging, after review of all available clinical data from that year. At time of death, a neurologist, blinded to pathologic data, reviewed all clinical information to render a classification of dementia status proximate to death."

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

AD Covariates: