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AlzRisk Paper Detail

Reference: Xu, 2004
Cohort: Kungsholmen Project
Risk Factor: Diabetes Mellitus

Exposure Detail
"Data on medical drug use were collected for the 2 weeks preceding the baseline survey. Both prescription and non-prescription drug use were inquired about, and if possible, the drug containers and prescriptions were inspected to verify this information. Drug use was coded and classified according to the Anatomic Therapeutic Chemical (ATC) classification system(29). Blood samples were taken at baseline, and blood glucose level was measured using a glucose oxidase procedure(26). Data on blood glucose were available for 95.9% (n = 1,248) of the subjects. Diabetes mellitus at baseline was considered to be present if the subject was registered with diabetes (ICD-8 code 250), or the subject was taking antidiabetic drugs (hypoglycemic medications or insulin injection, ATC code A10), or the blood glucose level was higher than 11 mmol/L (30)."

Ethnicity Detail
All participants lived in a district of Stockholm, Sweden. According to a description of the cohort, no other information on ethnicity or race has been reported.

Screening and Diagnosis Detail
AD Diagnosis:
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)

Other AD diagnosis approaches: Deceased participants were evaluated via medical record.

Total Dementia Definition: Dementia via DSM IIIR.

"The incident cases were all subjects who developed dementia over the two follow-up periods. The Diagnostic and Statistical Manual of Mental Disorders, revised third edition (DSM-III-R) criteria (33) were used to define dementia with a three-step diagnostic procedure, i.e., two examining physicians independently made a preliminary diagnosis and a third opinion was asked for in case of disagreement. (34) The cases fulfilling the DSM-III-R criteria were denominated “clinically definite dementia,” in contrast with a category of “questionable dementia,” which was used when there was evident memory impairment but dysfunction of a second cognitive ability was questionable. In this analysis, we treated both groups as dementia. The diagnosis of AD required gradual onset, progressive deterioration, and lack of any other specific causes of dementia. The diagnosis of VaD required abrupt onset, stepwise deterioration, history of stroke, or focal deficits. Hachinski’s ischemic scale (35) was used to support the differential diagnosis between AD and VaD. The diagnosis of dementia subtype was made clinically, without using the neuroimaging or pathologic data. Our diagnostic criteria for AD and VaD were equivalent to probable AD according to the National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association criteria(36) and to possible VaD according to National Institute of Neurological Disorders and Stroke–Association Internationale pour la Recherche en l’Enseignement en Neurosciences criteria.(37) For the deceased subjects, the diagnosis of dementia and subtypes was made by two physicians through reviewing the medical records and death certificates. Details of the clinical examination and diagnostic procedure have already been reported elsewhere.(28)"

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

AD Covariates:

TD Covariates: