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AlzRisk Paper Detail
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Reference: Andel, 2003
Cohort: Study of Dementia in Swedish Twins
Risk Factor: Physical Activity


Average Follow-up Time Detail
This is a case-control study nested within the Swedish Twin Registry, which followed twins several cohorts of twin pairs, the oldest of which consists of likesexed twins born before 1926. This study used all members of the older cohort who completed a questionnaire in 1967 (or in 1970 for those who did not answer in 1967) and underwent dementia assessment in 1998. The cases were compared to the unrelated (external) controls.

Exposure Detail
"Physical exercise was assessed in a questionnaire from 1967 or 1970. Respondents were asked: ‘How much exercise have you had from age 25 to 50?’ Level of exercise was measured on a 4-point scale as 0 (hardly any exercise), 1 (light exercise such as walking or light gardening), 2 (regular exercise involving sports), and 3 (hard physical training)."

This paper and the paper by Gatz et al, 2006, also in this table, both evaluated participants from the HARMONY cohort. This paper reported results on 4 categories of physical activity and adjusted for 8 other factors, while Gatz et al reported on 2 categories of physical activity and adjusted for 2 other factors.

Ethnicity Detail
No data on ethnicity was reported, however all participants reside in Sweden.

Age Detail
The average age at the cognitive screening follow-up was 79.5 (SD=5.0).

Screening and Diagnosis Detail
Screening Method:
BDRSBlessed Dementia Rating Scale
TELETelephone assessment of dementia

AD Diagnosis:
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)

Total dementia diagnosis: DSM-IV

Vascular dementia diagnosis: NINDS-AIREN

Covariates & Analysis Detail
Analysis Type:
Logistic regression

"Only participants with complete data on all study variables were used.

"...Finally, we explored effect modification due to lifestyle by adding exercise as an ordinal variable and the product of exercise and each lifestyle variable (eating fruits and vegetables, alcohol consumption, and BMI) separately into a fully adjusted model.

"The interaction of Exercise x BMI approached significance (p=0.101 for dementia and 0.089 for AD). Post hoc analysis of data stratified by BMI indicated that there was a stronger protective effect for exercise among overweight participants (OR, 0.61; 95% CI, 0.35–1.08 for dementia; OR, 0.52; 95% CI, 0.24–1.14 for AD) than among normal-weight participants (OR, 0.92; 95% CI, 0.73–1.16 for dementia; OR, 0.90; 95% CI, 0.69–1.19 for AD)."

AD Covariates:
Aage
Eeducation
Ggender
ALCalcohol intake
ANGangina
BMIbody mass index
FVGfruit and vegetable consumption
SMsmoking status

TD Covariates:
Aage
Eeducation
Ggender
ALCalcohol intake
ANGangina
BMIbody mass index
FVGfruit and vegetable consumption
SMsmoking status