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AlzRisk Paper Detail

Reference: Curb, 1999
Cohort: Honolulu-Asia Aging Study
Risk Factor: Diabetes Mellitus

Average Follow-up Time Detail
This report from the HAAS cohort ascertained diabetes at study enrolment in 1965 and dementia at the fourth examination between 1991 and 1993. See the row for Peila et al. in this table for a related study from this cohort.

Exposure Detail
Diabetes diagnosis was ascertained at the time of study enrolment through self-reports of history of diabetes and use of insulin or diabetes medications. As participants were aged 45-68 at enrolment, classification as diabetic in this study specifically reflects having had a diagnosis of diabetes in midlife (compare with Peila et al.).

"During the baseline examination, the subjects were interviewed regarding their medical history, including whether they had been told by a physician that they had diabetes and whether they were taking PO diabetic medications or insulin."

Ethnicity Detail
This was a cohort of Japanese-American men living in Hawaii. See the cohort description for more details.

Age Detail
All participants were between 45 and 68 years of age when diabetes assessments were made at the time of study enrolment in 1965-1968. Of the 3742 participants included in this analysis, 29% were aged 45-49, 41% were aged 50-54, 19% were aged 55-59, and 11% were aged 60-68 when diabetes assessments were made.

Screening and Diagnosis Detail
Screening Method:
CASICognitive Abilities Screening Instrument (Teng 1994)

AD Diagnosis:
CERAD Consortium to Establish a Registry for Alzheimer’s Disease (Morris 1989)
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)
Neurologic examination

Total Dementia Definition: DSM-III-R

“A three-phase stratified random sampling procedure was used to identify and evaluate potential cases of dementia.14 The Phase I CASI score was used to stratify the cohort into low, intermediate, and high scorers. All low scorers and men aged ≤85 years, and a sample of intermediate- and high-scoring groups, were invited to Phase II, at which time a second CASI, a neurologic examination, and tests of the participant’s hearing and vision were completed...Individuals with persistently low CASI scores and a sample of remaining participants were invited for Phase III assessment, which included a standardized interview and neurologic examination and the neuropsychological test battery from the Consortium to Establish a Registry for Alzheimer’s Disease.24,25Participants judged by the study neurologist to meet Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., revised (DSM–III-R) criteria for dementia 26 underwent brain CT scans and blood tests (complete blood count, chemistry profile, vitamin B12 level, folate level, rapid plasma reagin, and thyroid function). Final diagnosis and clinical dementia rating 27 index were assigned by a panel consisting of the study neurologist and at least two other physicians with expertise in geriatric medicine and dementia. Probable and possible AD were diagnosed according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association. 28

Covariates & Analysis Detail
Analysis Type:
Logistic regression

AD Covariates:

TD Covariates: