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AlzRisk Paper Detail

Reference: Lindsay, 2002
Cohort: Canadian Study of Health and Aging
Risk Factor: Physical Activity

Average Follow-up Time Detail
Initial cohort assessment occurred in 1991-1992 (CSHA-1) and follow-up occurred in 1996-1997 (CSHA-2).

"The effect of physical activity on cognitive impairment and dementia was analyzed using a case-control approach within the CSHA-1 cohort, with incident cases and controls selected at the end of CSHA-2."

Though the authors refer to their analysis as a case-control analysis, this study was conducted in an established cohort, whose members were selected to be dementia-free at the start of follow-up. The authors refer to "controls" as cohort members who did not develop cognitive impairment or dementia over the course of follow-up.

Exposure Detail
"Detailed information about risk factors was gathered from a self-administered questionnaire completed at CSHA-1 by those participants found to be cognitively normal on the basis of either the screening test or clinical examination. The risk factor questionnaire covered sociodemographic characteristics, occupational and environmental exposures, lifestyle (smoking, alcohol consumption, intake of selected food items, and regular exercise), and family and medical history (prior head injury with and without loss of consciousness, chronic diseases, and medication use). Participants were asked whether they engaged in regular exercise (yes/no), but 'regular' was not explicitly defined."

Ethnicity Detail
The report does not provide data on ethnicity. The cohort is a representative sample of Canadian men and women aged 65 and older living in urban and rural Canada from all 10 provinces.

Screening and Diagnosis Detail
Screening Method:
"Modified" 3MSE"Modified" Modified Mini-Mental State Examination (Tschantz 2002)

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

Total dementia definition: Total dementia defined as AD, vascular dementia, and other specific and unclassifiable dementia. Dementia diagnosed via DSM IV, vascular dementia via NINDS-AIREN.

Covariates & Analysis Detail
Analysis Type:
Logistic regression

In Middleton et al. (2007), the authors investigated whether exercise confounds the relationship between folate and cerebrovascular events, all-cause dementia, and Alzheimer’s disease in 466 participants from the CSHA-1 cohort. Moderate/high exercise was associated with a decreased risk of AD and total dementia as compared to those reporting low exercise (AD: OR=0.43, 95% CI=0.19–0.98; dementia: OR=0.35,95% CI=0.17–0.72). These results were adjusted for age, sex, education, vascular risk, and vitamin B or folate supplementation.

AD Covariates: