Risk Factors for Dementia of Alzheimer Type and Aging-Associated Cognitive Decline in a Spanish Population Based Sample, and in Brains with Pathology Confirmed Alzheimer's Disease
Affiliations: [a] Banco de Tejidos para Investigaciones Neurológicas, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain | [b] CIBER-NED, Madrid, Spain | [c] Unidad de Bioestadística Clínica, Hospital Ramón y Cajal, Madrid, Spain | [d] CIBER-ESP, Madrid, Spain | [e] Neurofarma, SA, Madrid, Spain | [f] Servicio de Neurología, Hospital Ramón y Cajal, Madrid, Spain
Correspondence:
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Corresponding author: Justo García de Yébenes, M.D., Servicio de Neurología, Hospital Ramón y Cajal, Carretera de Colmenar, km 9, 1, Madrid 28034, Spain. Tel.: +34 91 3368821; E-mail: jgyebenes@yahoo.com.
Abstract: We investigated the environmental and genetic factors for Alzheimer's disease (AD) in Spain and performed a door to door study of a cohort of more than 500 subjects, over 70 years old, from Leganés, a suburban area near Madrid. The cohort was followed for 6 years by neurologists and other health workers and was divided in three groups: normal controls, subjects with aging-associated cognitive decline (AACD) and probable AD or dementia of Alzheimer's type (DAT). Biological variables and polymorphisms of different genes, important in neurodegeneration or reported to be associated with AD, were investigated as putative risk modifiers. These polymorphisms have also been analyzed in 94 brains, 39 from patients with pathologically confirmed AD and 55 controls. The statistical investigation included the evaluation of different individual risks and a multinomial logistic regression analysis to detect predictive factors. The risk of AACD and AD increased with age, feminine gender and history of stroke and decreased with education. The allele ApoE4 increased the risk of AD but not of AACD. When the impact of ApoE4 was added to the model, the effect of education and stroke disappeared as risk modifiers.
