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AlzRisk Paper Detail
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Reference: Xu, 2007
Cohort: Kungsholmen Project
Risk Factor: Diabetes Mellitus


Average Follow-up Time Detail
1173 individuals made up the incident sample. In total, 519 individuals died between baseline (1987-1989) and the first (1991-1993; n = 259 deaths), second (1994-1996; n = 161 deaths) or third (1997-1998; n = 99 deaths) follow-up periods. 71 individuals refused to participate or had moved out of the area over the follow-up period.

The mean follow-up time was 5.0 years, and the maximum follow-up time was 10.5 years.

Exposure Detail
This analysis excluded persons with diabetes (defined as having a history of diabetes, using anti-diabetic medication, or having random blood glucose > 11.0 mmol/l). The hazard of AD was compared among those with and without borderline diabetes, as determined by tested random blood glucose levels. Borderline diabetes was defined has having random blood glucose > 7.8 mmol/l but <11 mmol/l.

"Blood samples were taken at baseline, and blood glucose level was measured using a glucose oxidase procedure. Borderline diabetes was considered to be present if the random blood glucose level was > 7.8 mmol/l but <11.0 mmol/l, and considered to be absent otherwise."

Ethnicity Detail
All participants were residents of the Kungsholmen district of Stockholm, Sweden. No other information on ethnicity or race has been reported.

Screening and Diagnosis Detail
Screening Method:
MMSEMini-Mental State Examination (Folstein 1975)

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

Total dementia definition: DSM-III-R

"In brief, two examining physicians independently made a preliminary diagnosis, and in the case of disagreement, a third opinion was sought to reach a concordant diagnosis. The diagnosis of Alzheimer’s disease was similar to the international criteria for probable Alzheimer’s disease (30) and required gradual onset, progressive deterioration, and lack of any other specific causes of dementia. For subjects who died during each follow-up period, two physicians made a diagnosis of dementia or Alzheimer’s disease by thoroughly reviewing medical records and death certificates."

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

"Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% CIs of dementia and Alzheimer’s disease. For nondemented subjects, the follow-up time was calculated from the date of baseline interview to the date of the last follow-up examination or death. For the demented subjects, the follow-up time was estimated as the full time during which the subjects were free of dementia plus half of the follow-up time during which dementia developed (25)."

AD Covariates:
Aage
Eeducation
Ggender
AHDantihypertensive drug use
MMSEbaseline MMSE
BMIbody mass index
CHDcoronary heart disease
DBPdiastolic blood pressure
SVSfollow-up survival status
SHstroke history
SBPsystolic blood pressure

TD Covariates:
Aage
Eeducation
Ggender
AHDantihypertensive drug use
MMSEbaseline MMSE
BMIbody mass index
CHDcoronary heart disease
DBPdiastolic blood pressure
SVSfollow-up survival status
SHstroke history
SBPsystolic blood pressure