Midlife Risk Factors for Subtypes of Dementia: A Nested Case-Control Study in Taiwan

• Published in: The American journal of geriatric psychiatry 2007-09, Vol.15 (9), p.762-771
• Main Authors: Chiang, Chun-Ju, Ph.D, Yip, Ping-Keung, M.D, Wu, Shiao-Chi, Sc.D, Lu, Chin-Song, M.D, Liou, Chia-Wei, M.D, Liu, Hsiu-Chih, M.D, Liu, Ching-Kuan, M.D., Ph.D, Chu, Ching-Hua, M.D, Hwang, Chi-Shin, M.D, Sung, Sheng-Feng, M.D, Hsu, Yaw-Don, M.D, Chen, Cheng-Chung, M.D, Liu, Shen-Ing, M.D., Ph.D, Yan, Sui-Hing, M.D, Fong, Chin-Shih, M.D, Chang, Shu-Feng, M.D, You, San-Lin, Ph.D, Chen, Chien-Jen, Sc.D
• Format: Article
• Language: English
• Subjects: Aged; Alcohol Drinking - adverse effects; Alcohol Drinking - epidemiology; Alzheimer disease; Alzheimer Disease - epidemiology; Alzheimer Disease - etiology; Blood Glucose - metabolism; Body Mass Index; Case-Control Studies; Cholesterol - blood; Cohort Studies; Data Collection - statistics & numerical data; Dementia - epidemiology; Dementia - etiology; Dementia, Vascular - epidemiology; Dementia, Vascular - etiology; Diabetes Mellitus - epidemiology; epidemiology; Female; Geriatric Assessment - statistics & numerical data; Humans; Hypercholesterolemia - complications; Hypercholesterolemia - epidemiology; Hypertension - complications; Hypertension - epidemiology; Internal Medicine; Male; Mass Screening - statistics & numerical data; Middle Aged; Risk Factors; Smoking - adverse effects; Smoking - epidemiology; Statistics as Topic; Stroke - complications; Stroke - epidemiology; Taiwan; Triglycerides - blood; vascular dementia
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1097/JGP.0b013e318050c98f

Objective To identify the midlife risk factors for subtypes of dementia newly developed later in life. Methods A nested case-control study was conducted on 157 demented cases and 628 comparison cases selected from 40,636 men and women who were enrolled from 1982 to 1992. Four comparison cases were frequency-matched on age, time at enrollment (within 6 months), gender, and residential township. Midlife risk factors included vascular risk factors (body mass index [BMI], total cholesterol, total triglycerides, blood glucose, cerebrovascular accident [CVA] history, diabetes mellitus history, and hypertension history), cigarette smoking, and alcohol consumption. Dementia assessments were ascertained through the computerized data linkage from National Health Insurance Database from 2000 to 2002 and clinically confirmed by neurologists or psychiatrists. Conditional logistic regression analysis was used to estimate the matched odds ratio (OR) and its 95% confidence intervals (CI) for each risk factor. Results A J-shaped relationship was observed between BMI (kg/m2 ) and dementia. The multivariate-adjusted ORs (95% CI) of developing dementia were 1.84 (1.02–3.33), 1.87 (1.08–3.23) and 2.44 (1.39–4.28), respectively, for BMIs of