The epidemiologic study of dementia: a life-long quest?
Section snippets
Brain structure and function
Studies conducted at different ages suggest brain aging begins relatively early. From the studies of Braak et al. [2], we have learned that the classical markers of Alzheimer's disease pathology can start to appear in autopsied brains of 40-year-olds. White matter hyperintensities appear on magnetic resonance images (MRI) of the brains of middle-age adults without a history of cerebrovascular disease [24]. Cross-sectional MRI studies show that selected sub-regions of the hippocampus also begin
Risk factors
The levels of risk factors, such as a blood pressure or cholesterol level, also change with age, as a result of alterations in brain and peripheral structures, in gene expression, and in the nature of endogeneous and exogenous environmental exposures.
Long-term perspectives on the study of dementia: mid-life risk factors and the risk for late-life disorders of cognition
These age-related changes in brain structure and function, and concurrent changes in risk factors for cognitive impairment may be dependent or independent and various scientific approaches are needed to determine how such changes are related. One important approach is prospective population-based studies that measure cognitive function in late age—and risk factors in early and middle age, when presumably risk factors are less affected by the disease. The value of prospective studies of dementia
Lessons about diseases of cognition from the long-term follow-up studies
The body of research reviewed here suggests mid-life levels of cardiovascular risk factors, and in particular elevated levels of blood pressure, increase the risk for DOC that emerge 20 years or more after the risk factor is measured. There is some support for the hypothesis that increased genetic susceptibility, marked by having the apolipoprotein E ɛ4 allele, may interact with these risk factors to increase the risk for DOC. Chronic inflammation may also contribute to an increased risk for
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2019, Annals of EpidemiologyCitation Excerpt :However, relatively few studies have examined the impact of adolescent cognition on cognitive function at midlife as opposed to older ages. The observation that dementia has a long preclinical period has led to calls for the study of risk factors and cognitive outcomes many years before the clinical diagnosis of disease [14,15]. Furthermore, prior studies have not examined whether the amount of cognitive change during adolescence, independently of the level of cognition measured at one time point, impacts cognitive function in midlife.
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