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Population attributable risk for dementia in the Seattle region
Author(s) -
Montine Thomas
Publication year - 2008
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.22.1_supplement.119.1
Subject(s) - dementia , dementia with lewy bodies , population , medicine , lewy body , autopsy , cohort , alzheimer's disease , gerontology , disease , psychology , environmental health
Previously published community‐ or population‐based studies of brain aging and dementia with autopsy are limited to one gender, ethnic group, clergy, or focused assessments. Our goal is to determine the contributors to dementia in a typical U.S. population of older individuals. We considered autopsy data from the Adult Changes in Thought (ACT) study, an on‐going longitudinal population‐based study of brain aging and dementia. Analyses were based on data collected between 1994 and 2006, which included approximately 3,400 men and women who were 65 years or older and cognitively intact at the time they were sampled in King County, WA. All consecutive autopsies (n = 221, 20% of deaths) from the cohort were evaluated. A weighted multivariate analysis was employed to account for potential participation bias, and thereby facilitate interpretation of the results beyond autopsied subjects. After adjusting for age, gender, education, and APOE , independent correlates of dementia (relative risk, 95% CI; overall p‐value) included Alzheimer's disease (5.89, 1.62–17.60; p < 0.05), microvascular brain injury (4.80. 1.91–10.26; p < 0.001), and neocortical Lewy bodies (5.08, 1.37–18.96; p < 0.05). Estimated population attributable risk for the three processes for dementia was 45% for Braak stage, 33% for microvascular brain injury, and 10% for neocortical Lewy bodies. Our results underscore the therapeutic imperative for Alzheimer's and Lewy body diseases, and provide evidence for immediate use of strategies that target cerebral microinfarcts to prevent or delay onset of dementia in our progressively aging population.