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Average Follow-up Time Detail
Baseline interviews were conducted in 1999 and 2000. The initial round of follow-up was completed from 2001-2002 and the second round of follow-up was completed from 2003-2004.
Method of exposure ascertainment: technician measurement
"Height, weight and waist circumference were measured in lightly dressed subjects. Waist circumference was measured between the lower rib margin and the iliac crest following a normal expiration."
Large waist circumference is defined as > 88cm in women and > 102cm in men.
All participants were of French nationality.
Entry criteria required a minimum age of 65 years.
Screening and Diagnosis Detail
Benton Visual Retention Test (Benton 1974)
Isaacs' Set Test (Isaacs & Kennie 1973)
Mini-Mental State Examination (Folstein 1975)
Diagnostic and Statistical Manual IV
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-IV clinical criteria
"A three-step procedure was used to diagnose cases of dementia. First, screening was based on a thorough neuropsychological examination by trained psychologists. This examination included a battery of cognitive tests covering memory, attention, language, and visuo-spatial abilities. Data on activities of daily living, severity of cognitive disorders, and, where possible, magnetic resonance images or computed tomography scans were collected. Second, the participants who were suspected of having dementia on the basis of their neuropsychological performance (in particular the Mini Mental Status Examination, the Benton Visual Retention Test, and the Isaac's Set Test administered uniformly in all three study centers at each follow-up) were examined by a neurologist in the three study centers. Finally, all suspected dementia cases were analyzed by a common independent committee of neurologists according to the criteria of the DSM-IV. This committee of neurologists reviewed by teleconference all potential cases of dementia of the three study centers to obtain a consensus on its diagnosis and etiology based on all existing information. With regard to the different subtypes of dementia, we considered the two most frequent causes of dementia as determined by committee (Alzheimer's disease according to National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria and vascular dementia based on history of vascular disease, Hachinski score, and magnetic resonance imaging whenever possible)."
Covariates & Analysis Detail
Cox proportional hazards regression
The analysis was adjusted for age by using age as the time scale.
"Associations between metabolic syndrome, or each of its components, with incident dementia over 4 years were estimated using separate proportional hazards models with delayed entry and age as time scale
. ...All metabolic syndrome components were then included in a single model to evaluate their own independent effect on the risk of dementia. Models tested associations with all-cause dementia and its different subtypes (Alzheimer's disease/vascular dementia)."