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Neurology. 2011 Jul 19;77(3):227-34. doi: 10.1212/WNL.0b013e318225c6bc. Epub 2011 Jul 13.

Nontraditional risk factors combine to predict Alzheimer disease and dementia.

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  • 1Department of Medicine, Dalhousie University, Halifax, Canada.

Abstract

OBJECTIVE:

To investigate whether dementia risk can be estimated using only health deficits not known to predict dementia.

METHODS:

A frailty index consisting of 19 deficits not known to predict dementia (the nontraditional risk factors index [FI-NTRF]) was constructed for 7,239 cognitively healthy, community-dwelling older adults in the Canadian Study of Health and Aging. From baseline, their 5-year and 10-year risks for Alzheimer disease (AD), dementia of all types, and survival were estimated.

RESULTS:

The FI-NTRF was closely correlated with age (r2 > 0.96, p < 0.001). The incidence of AD and dementia increased exponentially with the FI-NTRF (r2 > 0.75, p < 0.001 over 10 years). Adjusted for age, sex, education, and baseline cognition, the odds ratio of dementia increased by 3.2% (p = 0.021) for each deficit (that was not known to predict dementia) accumulated, outperforming the individual cognitive risk factors. The FI-NTRF discriminated people with AD and all-cause dementia from those who were cognitively healthy with an area under the receiver operating characteristic curve of 0.66 ± 0.03.

CONCLUSIONS:

Comprehensive re-evaluation of a well-characterized cohort showed that age-associated decline in health status, in addition to traditional risk factors, is a risk factor for AD and dementia. General health may be an important confounder to consider in dementia risk factor evaluation. If a diverse range of deficits is associated with dementia, then improving general health might reduce dementia risk.

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PMID:
21753161
[PubMed - indexed for MEDLINE]
PMCID:
PMC3136058
Free PMC Article

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