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AlzRisk Paper Detail
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Reference: Huang, 2002
Cohort: Kungsholmen Project
Risk Factor: Alcohol


Average Follow-up Time Detail
Participants were followed "for up to 6 years." The authors did not report the mean or range of follow-up times.

Exposure Detail
Nondrinker (<1 unit per week)
Light to moderate drinker (1–21 units per week for men, or 1–14 units per week for women)
Excessive drinker (>21 units per week for men, or >14 units per week for women). There were no participants in the analyses who identified as being in the excessive drinker category, so this category is not listed in table.

"Data on alcohol consumption were collected from subjects (or informants in the case of cognitively impaired persons) at baseline using a standard questionnaire, including whether they drank wine, beer, or liquor, and the frequency (never or occasionally, monthly, weekly, or daily) and the quantity of alcohol drinking. The average daily absolute alcohol intake was estimated according to the frequency and quantity of drinking. The ethanol (pure alcohol) content was estimated to be 13.2 g for a bottle or can of beer [12-ounce (340.8 cc) bottle or can], 10.8 g for a standard glass of wine, and 15.1 g for a drink (counting a drink as 44 mL) of liquor [34]. The total ethanol intake for each subject was computed as the sum of contributions from beer, wine, and liquor. According to the recommendation for “sensible drinking limits” made by the Royal College of Physicians, Psychiatrists, and General Practitioners [35–37], the total intake of ethanol was converted into standard units (1 unit = 8 g ethanol) per week for each subject. All subjects were then divided into three categories by units of ethanol intake: nondrinker (<1 unit per week), light to moderate drinker (1–21 units per week for men, or 1–14 units per week for women), and excessive drinker (>21 units per week for men, or >14 units per week for women). In the present study, 18 occasional drinkers (<1 unit per week) were included in the nondrinker category."

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

Age Detail
Average age not provided, only the number of participants in specific age categories:
75-79: 84 (21%)
80-84: 101 (25%)
85-89: 129 (32%)
90+: 88 (22%)

Screening and Diagnosis Detail
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: Dementia via DSM-III-R.

"The Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition–Revised criteria [30] were used to define incident dementia."
"Our criteria for Alzheimer’s disease were similar to those of the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association [33] for probable Alzheimer’s disease."

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

"Excessive drinkers were excluded from multivariate analyses because there were too few subjects in this category (see Table 1). Cox regression was used to estimate the relative risk of incident dementia and Alzheimer’s disease associated with light to moderate alcohol consumption compared with nondrinking. Crude and adjusted analyses controlling for age, gender, education, smoking, institutionalization, and MMSE score were performed first. Age and baseline MMSE score were entered in the model as continuous variables. Other variables were dichotomized: female vs. male, educational level >=8 vs. <8 years, smokers vs. nonsmokers, and institutionalization vs. community dwelling. More variables were also considered as covariates in analyses to further control for the potential confounding effects, including high blood pressure, stroke, heart diseases, and depressive symptoms. High blood pressure (with a cutoff point of systolic pressure >160 or diastolic pressure >90 mmHg), stroke, heart diseases, and depressive symptoms were used as dichotomous variables."

AD Covariates:
Aage
Eeducation
Ggender
MMSEbaseline MMSE
INSTinstitutionalization
SMsmoking status

TD Covariates:
Aage
Eeducation
Ggender
MMSEbaseline MMSE
INSTinstitutionalization
SMsmoking status