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Reference: Gelber, 2012
Cohort: Honolulu-Asia Aging Study
Risk Factor: Dietary Pattern


Exposure Detail
Dietary habits were measured at baseline using a standardized 24-hour dietary recall administered by a dietitian. Alcohol intake was measured from an interviewer-administered questionnaire. Food and nutrient intakes were adjusted for total caloric intake using the residual method (Willett W, Stampfer MJ. Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 1986; 124:17-27).

A diet quality score was created from consumption frequencies of eight food categories, with a higher score indicating a healthier dietary pattern (range: 8-40). A value from 1 to 5 was assigned for each quintile of energy-adjusted intake for fruit, vegetables, fish, monounsaturated to saturated fat ratio, and cereals (refined and whole grains), with a higher score corresponding to a higher level of intake. For meat and dairy foods, the scoring method was reversed, with a higher score corresponding to lower intake. Alcohol intake was measured by assigning a score of 1 for non-drinkers and intake of >32 ounces/month, a score of 2 for 0-4 ounces/month, a score of 3 for 4-8 ounces/month, a score of 4 for 8-16 ounces/month, and a score of 5 for 16-32 ounces/month. The diet quality score was dichotomized into high (top 40%) and low (bottom 60%) scores.

Screening and Diagnosis Detail
Screening Method:
CASICognitive Abilities Screening Instrument (Teng 1994)
HDSHasegawa's dementia scale
MMSEMini-Mental State Examination (Folstein 1975)
3MSEModified Mini-Mental State Examination (Teng 1987)

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.

"Briefly, cognitive function of all participants was tested
using the 100-point CASI, a combination of the Hasegawa
Dementia Screening Scale, the Folstein Mini-Mental State
Examination, and the Modified Mini-Mental State Examination.
12 The CASI score was used to identify a subgroup
for further evaluation that included a neurological examination, neuropsychological testing, and informant interview about changes in cognitive function and behavior. Computed tomography or magnetic resonance brain imaging was performed and routine blood tests conducted for men suspected of having dementia.

Based on these data, the study neurologist (WR) and two physicians (KHM, LRW) with expertise in dementia gave a consensus diagnosis for dementia according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised [13]. Probable or possible Alzheimer’s disease (AD) was diagnosed according to criteria from the National Institute of Neurological and Communicative Disorders and Stroke—Alzheimer’s Disease and Related Disorders Association[14]."

Covariates & Analysis Detail
Analysis Type:
Logistic regression

AD Covariates:
Aage
Eeducation
APOE4APOE e4 genotype
CVDcardiovascular disease
CYJPNchildhood years spent in Japan
DMdiabetes mellitus
HChigh cholesterol
HXHTNhistory of hypertension
OSOccupational status

TD Covariates:
Aage
Eeducation
APOE4APOE e4 genotype
CVDcardiovascular disease
CYJPNchildhood years spent in Japan
DMdiabetes mellitus
HChigh cholesterol
HXHTNhistory of hypertension
OSOccupational status