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Table 2 Longitudinal aging cohort with autopsy

From: Vascular risk factors and Alzheimer's disease: are these risk factors for plaques and tangles or for concomitant vascular pathology that increases the likelihood of dementia? An evidence-based review

Grade

Study

Original sample

Autopsy sample

AD pathology

Cerebral infarcts

A1

Peila et al. 2002 [15]; Honolulu Asia Aging Study 1991

Community-based Japanese-American males (n = 3,734)

216/521 deaths (42.5%)

Negative: type 2 diabetes was not associated with cortical neuritic plaques (RR 0.8, 95% CI 0.5 to 1.4) or tangles (RR 1.0, 95% CI 0.6 to 2.4)

Positive: type 2 diabetes was associated with higher risk of large infarcts (RR 1.8, 95% CI 1.1 to 3.0)

A2

Arvanitakis et al. 2006 [18]; Religious Orders Study

Older Catholic nuns, priests, or brothers (n = 1,060)

233 autopsies (94%)

Negative: diabetes was not related to global AD pathology score, or to specific measures of neuritic plaques, diffuse plaques or tangles, or to amyloid burden or tangle density

Positive: diabetes (present in 15% subjects) was associated with an increased odds of infarction (OR 2.47, 95% CI 1.16 to 5.24)

A2

Wang et al. 2009 [19]; Adult Changes in Thought

Health Maintenance Organization (n = 2,581)

250/1,167 deaths (21.4%)

Negative: hypertension in midlife was not associated with plaques and tangles

Positive: among persons aged <80 years, each 10 mmHg increase in systolic blood pressure was associated with 1.15 (95% CI 1.0 to 1.33) increased risk of ≥ 2 microinfarcts

A1

Ahtilouoto et al. 2010 [16]; Vantaa 85%+ Study

Community-based, elderly longitudinal study (n = 553)

n = 291 (48% of total cohort; age = 92+ years)

Negative: history of diabetes mellitus was less likely to have Aβ (OR 0.48, 95% CI 0.23 to 0.98) and tangles (OR 0.72, 95% CI 0.39 to 1.33)

Positive: history of diabetes mellitus was more likely to have cerebral infarcts (OR 1.88, 95% CI 1.06 to 3.34)

A2

Dolan et al. 2010 [20]; Baltimore Longitudinal Study on Aging

Longitudinal cohort study with autopsy; number of incident dementia cohort = 1,236 (Kawas et al. 2000 [48])

n = 200 (16% of incident cohort; 87.6 ± 7.1 years)

Negative: no relationship between the degree of atherosclerosis in intracranial, aorta, or heart and the degree of AD-type brain pathology

Positive: intracranial atherosclerosis significantly increased the odds of infarcts (OR = 1.8, 95% CI 1.2 to 2.7) and for dementia, independent of cerebral infarction

  1. Aβ, amyloid-beta; AD, Alzheimer's disease; CI, confidence interval; OR, odds ratio; RR, relative risk.