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Beard, C.M.1
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0030977937
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Kalmijn S, Launer LJ, Ott A, Witteman JCM, Hofman A, Breteler MMB. Dietary fat intake and the risk of incident dementia in the Rotterdam study. Ann Neurol 1997; 42:776-782. This is a prospective study on risk of dementia, with over 5000 participants who were nondemented at baseline. Food intake was assessed at baseline by a food-frequency questionnaire and dementia was assessed 2 years later. Risk of VaD was associated with higher intake of total and saturated fat. Risk of Alzheimer's disease was associated with lower fish consumption (relative risk of 0.3). The importance of this study is that so little is known about nutritional risk factors for Alzheimer's disease and the findings potentially have great public health impact. However, the findings need replication before being taken too seriously.
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Ann Neurol
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Kalmijn, S.1
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Itzhaki RF, Lin W, Shang D, Wilcock GK, Faragher B, Jamieson GA. Herpes simplex virus type 1 in brain and risk of Alzheimer's disease. Lancet 1997; 349:241-244. This study examined DNA from the brains for 46 AD patients and 44 elderly control individuals. The apoE a4 allele was found to increase risk for AD marginally, whereas the presence of DNA from the herpes simplex virus type 1 was not a risk factor. However, the risk was much higher in individuals with both the a4 allele and DNA from the herpes simplex virus type 1. The authors hypothesized that reactivation of the virus is more damaging in carriers of the a4 allele. This study illustrates a trend for epidemiological studies to examine synergistic effects of the apoE a4 allele and environmental risk factors.
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Hofman A, Ott A, Breteler MMB, Bots ML, Slooter AJC, van Harskamp F, et al. Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer's disease in the Rotterdam study. Lancet 349:151-154. Atherosclerosis was investigated in participants in a large population-based study; 284 participants were demented and 1698 were not. Atherosclerosis was assessed in the carotid arteries (measured by ultrasonography) and in the large vessels of the legs (measured by the ratio of the ankle-to-brachial systolic blood pressure). All indicators of atherosclerosis were associated with both VaD and AD. The association was particularly strong in individuals who carried the apoE a4 allele. The importance of this study is that it challenges the distinction between AD and VaD. To some extent, AD may also be a vascular dementia.
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Dent OF, Sulway MR, Broe GA, Creasey H, Kos SC, Jorm AF, et al. Alcohol consumption and cognitive performance in a random sample of Australian soldiers who served in the second world war. Br Med J 1997; 314:1655-1657. Daily alcohol intake was assessed in over 200 ex-servicemen (mean age 64 years). Eighty-five per cent of the men were drinkers, with 19% of these drinking at the 'hazardous' level and 21% at the 'harmful' level. An extensive battery of neuropsychological tests and a computed tomography scan were given 9 years later, but no associations were found with alcohol consumption. Furthermore, mortality over the 9-year follow-up did not relate to alcohol consumption. This study questions the conventional wisdom that alcohol abuse is an important risk factor for dementia.
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