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Reference: Ninomiya, 2011
Cohort: Hisayama Study
Risk Factor: Blood Pressure


Average Follow-up Time Detail
In 1988, 668 current, dementia-free participants of the Hisayama study were enrolled in study of late-life hypertension and dementia. These participants were followed prospectively and screened for dementia between 1988 and 2005, for a maximum 17 years of follow-up. Of these 668, 534 had participated in a health screening, including measurement of blood pressure, in 1973-1974, for a maximum of 32 years of follow-up.

This entry describes the association between blood pressure in 1988 and incident dementia between 1988 and 2005.

Exposure Detail
"Sitting BP was measured with a sphygmomanometer 3 times at the right upper arm after [at least] 5 minutes or rest, and the mean of the 3 measurements was used in the analysis. BP levels ... were classified into 4 categories according to the criteria of the seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7).14"

Screening and Diagnosis Detail
Screening Method:
HDSHasegawa's dementia scale
HDS-RHasegawa's dementia scale - revised
MMSEMini-Mental State Examination (Folstein 1975)

AD Diagnosis:
Autopsy
Brain Imaging
NINDS-AIREN National Institute for Neurologic Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (Roman 1993)
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)

Total dementia definition: DSM-III-R

Participants were followed prospectively via a monitoring system involving local physicians and officials, either an annual exam or telephone/mail questionnaire, and neuropsychological testing in 1992, 1998, and 2005. Persons testing below a certain threshold on neuropsychological test scores or persons with suspected neuropsychological symptoms were referred for a comprehensive clinical examination. In addition, the study team reviewed medical records and interviewed the participant's family or attending physician.

"Possible or probable dementia subtypes
were diagnosed with clinical information including neuroimaging. Definite dementia
subtypes were also determined on the basis of clinical and neuropathological information in
deceased dementia subjects who underwent autopsy. The diagnostic procedure for autopsy
cases has been reported previously.11 A neuropathological diagnosis of AD was made
following the National Institute on Aging–Reagan Institute criteria,12 where the frequencies
of senile plaques and neurofibrillary tangles were evaluated using the criteria of the
Consortium to Establish a Registry for Alzheimer’s Disease13 and the Braak stage.14"

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

AD Covariates:
Aage
Eeducation
Ggender
ALCalcohol intake
AHDantihypertensive drug use
BMIbody mass index
DMdiabetes mellitus
Oother
SCHserum cholesterol
SMsmoking status
SHstroke history

TD Covariates:
Aage
Eeducation
Ggender
ALCalcohol intake
AHDantihypertensive drug use
BMIbody mass index
DMdiabetes mellitus
Oother
SCHserum cholesterol
SMsmoking status
SHstroke history