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AlzRisk Paper Detail

Reference: Morris, 2001
Cohort: East Boston Established Populations for Epidemiologic Studies of the Elderly
Risk Factor: Blood Pressure

Average Follow-up Time Detail
This study concerned a subset of the East Boston EPESE cohort, comprising participants who were dementia-free at baseline (1982-1983) and who were selected for follow-up to assess AD status in 1985 and 1986. Subset participants were selected using a stratified sampling approach, in which strata were based on age, sex, and change in cognitive performance.

The published study by Morris et al, 2001 contributed data to several entries on this page. This entry reflects the 634 participants who were dementia free at baseline (1982-1983) and who were clinically evaluated for dementia in 1985 or 1986.

Exposure Detail
"All blood pressure measurements were obtained in participants' homes according to the [Hypertension Detection and Follow-up Program] protocol. On each occasion, blood pressure was measured 3 consecutive times with 30 seconds between measurements using mercury sphygmomanometers on seated subjects with the arm resting at heart level. For analyses of each time point, the average of the 3 blood pressure measurements was used. A more detailed description of the blood pressure procedures has been published previously.34 All interviewers passed a written test, a videotaped test of blood pressure readings, and live practice tests with a supervisor using a split stethoscope. The overall mean of blood pressure readings by trainees had to be within ±1.96 mm Hg of the standard mean on the videotaped test.35 Data from the HDFP on blinded duplicate blood pressure readings demonstrated good reproducibility of trainee readings."

"Pulse pressures were computed as the difference between the mean systolic and diastolic pressures."

Ethnicity Detail
No information on the ethnic background of participants has been provided.

Age Detail
All participants were 65 years old or older at baseline (1982-1983).

Screening and Diagnosis Detail
AD Diagnosis:
Modified NINCDS ADRDA "Modified" National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria

"The clinical evaluations included a neurological examination, neuropsychological performance testing, a medical history, and a brief psychiatric evaluation. The definition of probable AD was based on criteria consistent with the National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association.36 We modified the definition to include persons who met the criteria for probable AD and who had a coexisting dementing condition to prevent the possibility of a protective association due to the classification system (for example, if high blood pressure levels were associated with an increased risk of vascular dementia). A more complete description of sampling for incident AD and of the clinical evaluation was published previously.31,37"

Covariates & Analysis Detail
Analysis Type:
Logistic regression

"All models were adjusted for the stratified random sampling using SUDAAN statistical software (Research Triangle Institute, Research Triangle Park, NC)."

AD Covariates:
IDDinterval to disease diagnosis
SSstratified sampling