Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Llewellyn, David J., Iain A. Lang, Fiona E. Matthews, Brenda L. Plassman, Mary A. M. Rogers, Lewis B. Morgenstern, Gwenith Fisher, Mohammed U. Kabeto, and Kenneth M. Langa. 2010. "Vascular health, diabetes, APOE and dementia: the Aging, Demographics, and Memory Study." Alzheimers Research & Therapy, 2(3): 19.
Introduction: Evidence from clinical samples and geographically limited population studies suggests that vascular health, diabetes and apolipoprotein epsilon 4 (APOE) are associated with dementia.
Methods: A population-based sample of 856 individuals aged 71 years or older from all contiguous regions of the United States received an extensive in-home clinical and neuropsychological assessment in 2001-2003. The relation of hypertension, diabetes, heart disease, stroke, medication usage, and APOE epsilon 4 to dementia was modelled using adjusted multivariable logistic regression.
Results: Treated stroke (odds ratio [OR] 3.8, 95% confidence interval [CI] 2.0, 7.2), untreated stroke (OR 3.5, 95% CI 1.7, 7.3), and APOE epsilon 4 (OR 2.8, 95% CI 1.7, 4.5) all increased the odds of dementia. Treated hypertension was associated with lower odds of dementia (OR 0.5, 95% CI 0.3, 1.0). Diabetes and heart disease were not significantly associated with dementia. A significant interaction was observed between APOE epsilon 4 and stroke (P = 0.001).
Conclusions: Data from the first dementia study that is representative of the United States population suggest that stroke, the APOE epsilon 4 allele and their interaction are strongly associated with dementia.
PMCID: PMC2919699. (Pub Med Central)