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AlzRisk Paper Detail
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Reference: van Himbergen, 2012
Cohort: Framingham Heart Study
Risk Factor: Inflammatory Biomarkers


Average Follow-up Time Detail
The cohort was followed for a median of 13 years. All confirmed cases of dementia after the 19th biennial examination (through December 31, 2009) were included, providing longitudinal follow-up of up to 24 years.

Exposure Detail
High sensitivity CRP (hsCRP) were measured in plasma on an Olympus AU400 with enzymatic reagents as reported elsewhere (34-36). Interassay coefficients of variation were less than 5% for all assays.

The population distribution of hsCRP was positively skewed, so natural-log-transformed values were used for all analyses. We calculated the weighted mean hsCRP level at baseline, as means were provided for men and women separately. The range of hsCRP level at baseline was 0.2 - 160.7 mg/L.

Ethnicity Detail
No race or ethnicity information provided in report.
According to a description of the cohort, nearly all the members of the original cohort were Caucasian.

Age Detail
The mean age at start of follow-up is the age at the 19th biennial examination (1985-1988). We calculated a weighted average for age, because Table 1 in the paper provides ages for men and women separately.

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

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

Total dementia definition: DSM-IV.

"Members of the dementia cohort have been monitored for the development of stroke and dementia since their inclusion in the cohort. Participants were routinely administered a screening Mini-Mental State Examination at each biennial examination [28]. Persons who scored less than education-based cutoffs or who experienced a decline of 3 or more points on the Mini-Mental State Examination from the most recent previous examination were called back for a neurological and neuropsychological examination. For each case of possible dementia, a detailed case review was undertaken by a panel consisting of at least 1 neurologist (including P.A.W. and S.S.) and a neuropsychologist (R.A.). The panel determined the type of dementia and the date of diagnosis using serial neurological and neuropsychological assessments, a telephone interview with a family member or a caregiver, medical records, and imaging study results. The diagnosis of dementia was made according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [29]. Alzheimer disease was diagnosed when subjects met the criteria of the National Institute of Neurological Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association for definite, probable, or possible AD [30]."

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

AD Covariates:
Aage
Eeducation
Ggender
APOE4APOE e4 genotype
BMIbody mass index
DHAdocosahexaenoic acid concentration
WTCHweight change

TD Covariates:
Aage
Eeducation
Ggender
APOE4APOE e4 genotype
BMIbody mass index
DHAdocosahexaenoic acid concentration
WTCHweight change