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Reference: Devore, 2010
Cohort: Rotterdam Study
Risk Factor: Nutritional Antioxidants


Exposure Detail
Exposure was evaluated using a two-stage protocol at 2 baseline visits; baseline visits occurred between 1990 and 1993. The first stage involved a checklist that asked about all food, drinks, and supplements used at least two times a month for the past year. The second stage involved a 170-item semiquantitative food frequency questionnaire (SFFQ) that asked about foods consumed at least two times per month for the past year.

Both this study and the study by Engelhart et al (2002) examined dietary vitamin C and AD risk in the Rotterdam Study cohort. This study followed participants for about 3.6 additional years and also explored vitamin C in relation to overall dementia risk.

Ethnicity Detail
According to other descriptions of the cohort, participants were sampled from a suburb of Rotterdam, The Netherlands. No information on the ethnic background of participants has been provided.

Screening and Diagnosis Detail
Screening Method:
CAMDEXCambridge Examination for Mental Disorders of the Elderly
GMSGeriatric Mental State Schedule (Copeland 1976)
Informant interview
MMSEMini-Mental State Examination (Folstein 1975)

AD Diagnosis:
DSM IIIR Diagnostic and Statistical Manual III-Revised
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)

Total Dementia Definition: Dementia via DSM IIIR.

"The diagnosis of dementia was made according to a 3-step protocol at baseline and follow-up examinations (21). First, a combined Mini-Mental State Examination (22) and Geriatric Mental State Schedule (23) organic level was used to screen all subjects. Second, those with Mini-Mental State Examination scores lower than 26 or Geriatric Mental State Schedule scores higher than 0 underwent the Cambridge Examination of Mental Disorders in the Elderly (20). Third, if necessary, participants were evaluated by a neurologist and neuropsychologist; when available, neuroimaging data were used. In addition, the total cohort was continuously monitored for memory problems and dementia via computerized linkage of the study database to digitalized medical records from general practitioners and the regional institute for outpatient mental health care. For this study, dementia was diagnosed by a panel consisting of a neurologist, neuropsychologist, and research physician using all existing information. Diagnoses were made in accord with internationally accepted criteria for dementia (Diagnostic and Statistical Manual of Mental Disorders [Third Edition Revised]) (24), AD (National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association) (25)..."

Both this study and the study by Engelhart et al (2002) examined dietary vitamin C and AD risk in the Rotterdam Study cohort. This study followed participants for about 3.6 additional years and also explored vitamin C in relation to overall dementia risk.

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

Total energy intake was included as a covariate in the analysis.

AD Covariates:
Aage
Eeducation
Ggender
ALCalcohol intake
AOSantioxidative Supplements
APOE4APOE e4 genotype
BMIbody mass index
Kcalcaloric intake
SMsmoking status

TD Covariates:
Aage
Eeducation
Ggender
ALCalcohol intake
AOSantioxidative Supplements
APOE4APOE e4 genotype
BMIbody mass index
Kcalcaloric intake
SMsmoking status

Interactions were also evaluated for:

(1) vitamin C with E
(2) each antioxidant with education, smoking status, APOE4, and followup time