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:	Tang, 1996

Cohort:	Washington Heights-Inwood Columbia Aging Project

Risk Factor:	Hormone Therapy

Average Follow-up Time Detail
Follow-up ranged from 1-5 years.

Exposure Detail
Information on oral estrogen use (including duration and age at time of use) was obtained by interview at study entry. Questionnaire questions about estrogen use had good test-retest reliability (k=0.65). The authors state that the majority of hormone users took conjugated estrogens (Premarin), but do not provide a percentage.

Exposure is categorized by 1) History of estrogen use (ever v. never), and 2) Duration of use ( < year, > 1 year). Results reported in this table are for duration of estrogen use.

31 (20%) of the estrogen users did not recall their duration of use. Their results are reported separately.

Screening and Diagnosis Detail
AD Diagnosis:

Brain Imaging
DSM IIIR	Diagnostic and Statistical Manual III-Revised
Medical History
NINCDS ADRDA	National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)
Neuropsychological examination

"For diagnosis of dementia, medical records and imaging studies were used, as well as data from the initial and follow-up study examinations. The diagnosis was established by consensus among an independent group of physicians and neuro-psychologists from this information. This group were not aware of information on oestrogen use at any point during the diagnostic process. The diagnosis of dementia¹⁵ required evidence of cognitive decline on the neuropsychological test battery and impairment in social or occupational function. All data were examined to identify the aetiology of dementia with standard criteria¹⁶ for the diagnosis of Alzheimer's disease."

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

AD Covariates:

A	age
E	education
APOE4	APOE e4 genotype
RE	race/ethnicity

Additional adjustment for ethnic group, years of education, and participation group (senior center or housing v. Medicare sample) did not significantly change the results.