Journal Article

Risk Factors for Alzheimer’s Disease: A Prospective Analysis from the Canadian Study of Health and Aging

Joan Lindsay, Danielle Laurin, René Verreault, Réjean Hébert, Barbara Helliwell, Gerry B. Hill and Ian McDowell

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 156, issue 5, pages 445-453
Published in print September 2002 | ISSN: 0002-9262
Published online September 2002 | e-ISSN: 1476-6256 | DOI:
Risk Factors for Alzheimer’s Disease: A Prospective Analysis from the Canadian Study of Health and Aging

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A prospective analysis of risk factors for Alzheimer’s disease was a major objective of the Canadian Study of Health and Aging, a nationwide, population-based study. Of 6,434 eligible subjects aged 65 years or older in 1991, 4,615 were alive in 1996 and participated in the follow-up study. All participants were cognitively normal in 1991 when they completed a risk factor questionnaire. Their cognitive status was reassessed 5 years later by using a similar two-phase procedure, including a screening interview, followed by a clinical examination when indicated. The analysis included 194 Alzheimer’s disease cases and 3,894 cognitively normal controls. Increasing age, fewer years of education, and the apolipoprotein E ε4 allele were significantly associated with increased risk of Alzheimer’s disease. Use of nonsteroidal anti-inflammatory drugs, wine consumption, coffee consumption, and regular physical activity were associated with a reduced risk of Alzheimer’s disease. No statistically significant association was found for family history of dementia, sex, history of depression, estrogen replacement therapy, head trauma, antiperspirant or antacid use, smoking, high blood pressure, heart disease, or stroke. The protective associations warrant further study. In particular, regular physical activity could be an important component of a preventive strategy against Alzheimer’s disease and many other conditions.

Keywords: Alzheimer disease; anti-inflammatory agents, non-steroidal; apolipoproteins; cohort studies; education; exercise; risk factors; wine; Abbreviations: APOE, apolipoprotein E; APOE4, apolipoprotein E ε4 allele; CI, confidence interval; CSHA, Canadian Study of Health and Aging; EURODEM, European Community Concerted Action on Epidemiology and Prevention of Dementia; NSAIDs, nonsteroidal anti-inflammatory drugs; OR, odds ratio; 3MS, Modified Mini-Mental State.

Journal Article.  5838 words.  Illustrated.

Subjects: Public Health and Epidemiology

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