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AlzRisk Paper Detail
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Reference: Bettermann, 2012
Cohort: Gingko Evaluation of Memory Study
Risk Factor: Statin use


Average Follow-up Time Detail
The mean follow-up duration for members of the cohort, including participants with MCI at baseline, was six years. The article does not provide the mean follow-up time for participants included in this analysis.

Exposure Detail
The investigators ascertained statin use by examining participants' medication bottles at baseline and at regularly scheduled follow-up visits. The investigators reported results separately for ever/never statin use, lipophilic statin use, non-lipohilic statin use, former/current use, and newly initiated use. This entry pertains to results on the former/current statin use.

The investigators compared incident AD risk in two separate sets of comparison groups: the group of participants who used statins at baseline or anytime during follow-up but were not current users at the time of AD assessment ("Formerly used") and the reference group of participants who never used statins or other LLM at baseline or during follow-up ("Never used"); the article does not specify the time window for former use. In addition, the incident AD risk was compared between the group of participants who were current users at the time of AD assessment ("Currently uses") and the reference group of participants who never used statins or other LLM at baseline or during follow-up ("Never used"). Approximately 25% of members of the cohort, excluding participants with MCI, were statin users at baseline. The articles does not provide the exposure distribution of the individuals included in this analysis.

Ethnicity Detail
The cohort was predominantly white.

Screening and Diagnosis Detail
Screening Method:
"Modified" 3MSE"Modified" Modified Mini-Mental State Examination (Tschantz 2002)
CDRClinical Dementia Rating (Berg 1988) (CDR)
ADAS_cogCognitive sub-scale of AD assessment scale
Informant interview
Neuropsych Testing
TICSTelephone Interview of Cognitive Status

AD Diagnosis:
Brain Imaging
DSM IV Diagnostic and Statistical Manual IV
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)
Neuropsychological examination

Total dementia definition: Dementia via DSM-IV

The details of the clinical evaluation are given below:

"At each follow-up visit, participants were re-evaluated with an abbreviated cognitive test battery including the Modified Mini-Mental State Exam (3MSE), the Clinical Dementia Rating Scale, and the cognitive subscale of the AD Assessment Scale (ADAS-Cog). If scores on 2 of the 3 assessments were below preset cutpoints, or when dementia was suspected by the proxy, family, or a treating physician, the complete baseline neuropsychological test battery was repeated, followed by an additional neurologic and medical examination and brain magnetic resonance imaging. Final diagnosis classification was made by an expert consensus panel"

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

AD Covariates:
Aage
Eeducation
Ggender
APOE4APOE e4 genotype
CHDcoronary heart disease
FCfield center
OLLMother lipid lowering drug use
RErace/ethnicity
SHstroke history
TRTGRPtreatment group (not the exposure of interest)

TD Covariates:
Aage
Eeducation
Ggender
APOE4APOE e4 genotype
CHDcoronary heart disease
FCfield center
OLLMother lipid lowering drug use
RErace/ethnicity
SHstroke history
TRTGRPtreatment group (not the exposure of interest)