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AlzRisk Paper Detail

Reference: Lindsay, 2002
Cohort: Canadian Study of Health and Aging
Risk Factor: Non-Steroidal Anti-Inflammatory Drugs

Average Follow-up Time Detail
Initial cohort assessment occurred in 1991-1992 (CSHA-1) and follow-up occurred in 1996-1997 (CSHA-2).

Exposure Detail
Investigators ascertained exposure information via self-administered questionnaire at baseline. The questionnaire identified salicylates and nonsalicylate use and any use of NSAIDs.

The investigators compared AD risk in two groups: the group of participants who used ASA at baseline ("Current use") and the reference group of participants who did not use ASA at baseline ("Not using").

Ethnicity Detail
The cohort study is on a representative, nationwide sample of the Canadian population. The distribution of ethnicity was not reported.

Screening and Diagnosis Detail
Screening Method:
3MSEModified Mini-Mental State Examination (Teng 1987)

AD Diagnosis:
DSM IIIR Diagnostic and Statistical Manual III-Revised
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)

Total dementia definition: Dementia via DSM-III-R.

"All participants were screened for dementia by using the Modified Mini-Mental State (3MS) Examination.14,15 Those who screened positive (a 3MS Examination score of below 78/100) and a random sample of those who screened negative (a score of 78 or above) were invited to participate in an extensive clinical evaluation, which followed a three stage protocol. A nurse first readministered the 3MS Examination and collected information on the participant’s medical and family history. Next, a physician conducted a standardized physical and neurologic examination. Finally, for those participants deemed testable (a 3MS Examination score of50 or above), a psychometrist administered a series of neuropsychological tests16, which were interpreted later by a neuropsychologist. Independent preliminary diagnoses were made by the physician and neuropsychologist, which was followed by a case conference in which a consensus diagnosis was reached according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, criteria for dementia17; the National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) criteria for Alzheimer’s disease18; and other specific criteria for cognitive impairment19 and vascular dementia 20. Diagnoses comprised the following categories: no cognitive impairment; cognitive impairment, no dementia; probable and possible Alzheimer’s disease; vascular dementia; other specific dementia; and unclassifiable dementia."

Covariates & Analysis Detail
Analysis Type:
Logistic regression

"Univariate and multivariate logistic regression models were used to calculate crude and adjusted odds ratios for the various risk factors. Under the rare disease assumption, the odds ratio can be considered a valid estimate of the relative risk. Age, sex, and education (age and education both as continuous variables with 1-year increments) were introduced into all multivariate models as potential confounders."

AD Covariates: