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Risk Factor Studies. 1991 (Case-Control) 1996 (Cohort Study). Risk Factors for Alzheimer’s Disease (CSHA-1 Case-Control Study). OR 95% CI One or more relatives with AD 2.6 1.5 - 4.5 0-6 yrs education 4.0 2.5 - 6.4 Occupational exposure to glues 2.2 1.3 - 3.7
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Risk Factor Studies 1991 (Case-Control) 1996 (Cohort Study)
Risk Factors for Alzheimer’s Disease(CSHA-1 Case-Control Study) OR 95% CI • One or more relatives with AD 2.6 1.5 - 4.5 • 0-6 yrs education 4.0 2.5 - 6.4 • Occupational exposure to glues 2.2 1.3 - 3.7 • Head injury1.7 0.97 - 2.8 • Arthritis 0.5 0.4 - 0.8 • Use of NSAID drugs 0.6 0.4 - 0.8 • Age of onset for smokers 80 yrs; nonsmokers 84 yrs. Source: Neurology 1994;44:2073-80
Risk Factors for Alzheimer’s Disease:CSHA-2 Cohort StudyI: Physical activity Odds ratios and 95% CI Controlling for age, sex & education. Source: Arch Neurol 2001;58:498-504
Risk Factors for Alzheimer’s Disease:CSHA-2 Cohort StudyII: Education Odds ratios and 95% CI Controlling for age and sex. Source: CMAJ 2001;165:1495-1498
Risk Factors for Alzheimer’s Disease:CSHA-2 Cohort StudyIII: Vaccinations Odds ratios and 95% CI Controlling for age, sex and education. Source: CMAJ 2001;165:1495-1498
Risk Factors for Alzheimer’s Disease:CSHA-2 Cohort StudyIV: Age Odds ratios and 95% CI Controlling for sex and education. Source: CMAJ 2001;165:1495-1498
Vascular Risk Factors • Risk factors for vascular dementia include • living in a rural area or in an institution • age; low education • diabetes • depression; history of alcohol abuse • ApoE-4 • hypertension or heart problems; taking aspirin • exposure to pesticides or fertilizers • Regular exercise is protective(Hébert et al., 1995, 2000; Lindsay et al., 1997) • Most vascular risk factors are being treated (Rockwood et al., 1997)
Other Risk Factors • Age, 3MS score and an informant’s report of memory problems are significant predictors of the development of dementia 5 years later (Hogan & Ebly, 2000) • Age-standardised rates of dementia are highest among unmarried people, and for those who were previously married (Kristjansson et al., 2000) • Hypertension is associated with a lower prevalence of Alzheimer’s disease (OR 0.38) (Rockwood et al., 1996) • Smoking is not a risk factor for AD, but it may interact with alcohol consumption (Tyas et al., 2000)