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AlzRisk Paper Detail

Reference: Hooshmand, 2010
Cohort: North Karelia Project/FINMONICA/Cardiovascular Risk Factors, Aging, and Dementia
Risk Factor: Homocysteine

Average Follow-up Time Detail
"The 271 subjects included in the present study were selected based on availability of serum samples from 1998 for tHcy, holoTC, and folate measurements. The mean (SD) follow-up duration of the CAIDE subsample from 1998 reexamination (baseline for this study) was 7.4 (0.3) years. There was no clinically significant difference between the CAIDE subsample and the entire dementia-free CAIDE cohort. "

Exposure Detail
"Venous blood samples were taken at the 1998 reexamination and serum specimens were stored at or below −20°C until analysis at the National Institute for Health and Welfare. Serum tHcy was determined by chemiluminescent microparticle immunoassay (Abbott Laboratories, Abbott Park, IL). The interassay coefficients of variation of homocysteine were 5.9% and 5.4% at the levels of 6.6 μM/L and 11 μM/L."

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

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

"Dementia was diagnosed according to DSM-IV criteria,[20] and AD was diagnosed according to the US National Institute of Neurologic and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association criteria.[21]"

Covariates & Analysis Detail
Analysis Type:
Logistic regression

"Analyses were adjusted for baseline age, sex, years of full-time education, and follow-up time (model 1), and then additionally for other potential confounding or mediating factors, including APOE ϵ4 status, baseline BMI, SBP, DBP, MMSE score, history of stroke, and smoking (model 2). All variables were entered as continuous into the models except sex, APOE ϵ4, history of stroke, and smoking, which were dichotomized."

AD Covariates:
APOE4APOE e4 genotype
MMSEbaseline MMSE
BMIbody mass index
DBPdiastolic blood pressure
SMsmoking status
SHstroke history
SBPsystolic blood pressure

Results adjusted only for age, education and gender were nearly identical with adjusted RR = 1.18 (95%CI, 1.02-1.36). Compared with a crude result (OR, 1.16; 95% CI, 1.04-1.31), adjustment for serum holotranscobalamin (holoTC; the biologically active fraction of vitamin B12) attenuated the tHcy-AD association somewhat (OR, 1.10; 95% CI, 0.96-1.25). Adjustment for serum folate did not change the association (OR, 1.17; 95% CI, 1.04-1.31).