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AlzRisk Paper Detail

Reference: Tang, 1996
Cohort: Washington Heights-Inwood Columbia Aging Project
Risk Factor: Hormone Therapy

Average Follow-up Time Detail
Follow-up ranged from 1-5 years.

Exposure Detail
Information on oral estrogen use (including duration and age at time of use) was obtained by interview at study entry. Questionnaire questions about estrogen use had good test-retest reliability (k=0.65). The authors state that the majority of hormone users took conjugated estrogens (Premarin), but do not provide a percentage.

Exposure use was categorized in terms of 1) history of estrogen use (ever v. never), and 2) duration of use (< 1 year, > 1 year). Results reported in this table are for history of estrogen use.

Age Detail
The age of onset for AD was greater in those who had taken estrogen v. those who had not.

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

"For diagnosis of dementia, medical records and imaging studies were used, as well as data from the initial and follow-up study examinations. The diagnosis was established by consensus among an independent group of physicians and neuro-psychologists from this information. This group were not aware of information on oestrogen use at any point during the diagnostic process. The diagnosis of dementia15 required evidence of cognitive decline on the neuropsychological test battery and impairment in social or occupational function. All data were examined to identify the aetiology of dementia with standard criteria16 for the diagnosis of Alzheimer's disease."

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

AD Covariates:
APOE4APOE e4 genotype

Additional adjustment for ethnic group, years of education, and participation group (senior center or housing v. Medicare sample) did not significantly change the results.