Head trauma and risk of dementia and Alzheimer's disease: The Rotterdam Study.

Objective: To investigate the relation between head trauma and incidence of dementia in a prospective population-based study.

Background: Whether head trauma increases the risk of dementia and AD remains controversial. It has been suggested that the risk might be particularly increased for carriers of the APOE-epsilon4 allele.

Diabetes mellitus and the risk of dementia: The Rotterdam Study.

Objective: To determine the influence of type 2 diabetes mellitus on the risk of dementia and AD.

Background: Both dementia and diabetes are frequent disorders in elderly people.

Methods: Prospective population-based cohort study among 6,370 elderly subjects.

Study on COgnition and Prognosis in the Elderly (SCOPE).

The Study on COgnition and Prognosis in the Elderly (SCOPE) is a multicentre, prospective, randomized, double-blind, parallel-group study designed to compare the effects of candesartan cilexetil and placebo in elderly patients with mild hypertension. The primary objective of the study is to assess the effect of candesartan cilexetil on major cardiovascular events. The secondary objectives of the study are to assess the effect of candesartan cilexetil on cognitive function and on total mortality, cardiovascular mortality, myocardial infarction, stroke, renal function, hospitalization, quality of life and health economics.

A follow-up study of blood pressure and cerebral white matter lesions.

White matter lesions are often observed on cerebral magnetic resonance imaging scans of elderly people and may play a role in the pathogenesis of dementia. Cross-sectional studies have shown an association between elevated blood pressure and white matter lesions. We prospectively studied the relation between blood pressure and white matter lesions in 1,077 subjects aged 60 to 90 years who were randomly sampled from two prospective population-based studies.

Is age-related maculopathy associated with Alzheimer's Disease? The Rotterdam Study.

The authors examined the relation between age-related maculopathy and Alzheimer's disease in the Rotterdam Study, a prospective population-based study in the Netherlands. From 1990 to mid-1993, subjects aged 75 years or older (n = 1,438) were screened for the presence of age-related maculopathy and Alzheimer's disease, and follow-up examinations were conducted from mid-1 993 to the end of 1994. Subjects with advanced age-related maculopathy at baseline showed an increased risk of incident Alzheimer's disease (relative risk = 2.

The effect of APOE on dementia is not through atherosclerosis: the Rotterdam Study.

The APOE genotype is involved in atherosclerosis, and atherosclerosis increases the risk of dementia, in particular among carriers of the APOE-epsilon4 allele. We studied, in a population-based setting (244 dementia cases; 1,002 nondemented controls), whether APOE is associated with dementia through atherosclerosis. As neither adjusting nor stratification for atherosclerosis altered the association of APOE with dementia, our study suggests that atherosclerosis is not an intermediate factor.

N-acetyltransferase-2 polymorphism in Parkinson's disease: the Rotterdam study.

The N-acetyltransferase-2 gene (NAT-2) has been associated with Parkinson's disease. The genotype associated with slow acetylation has been reported to be increased in patients with Parkinson's disease. Three mutant alleles M1, M2, and M3 of NAT-2 were investigated in 80 patients with idiopathic Parkinson's disease and 161 age matched randomly selected controls from a prospective population based cohort study.

Burden of mortality and morbidity from dementia.

The purpose of this study was to estimate severity-specific mortality and to quantify the global health burden of dementia by assessing the time spent disabled with dementia and the life years lost due to dementia. We used mortality data from the Rotterdam study, a population-based prospective study in the 55+-year age range to calculate overall and severity-specific excess mortality for the demented. Lost life years were calculated by decomposing the (mixed) Dutch life table of 1990-1992 in two populations, the demented and the healthy, using prevalence and excess (all cause) mortality.

The Ile93Met mutation in the ubiquitin carboxy-terminal-hydrolase-L1 gene is not observed in European cases with familial Parkinson's disease.

Recently an Ile93Met mutation in the ubiquitin-carboxy-terminal-hydrolase-L1 gene (UCH-L1) has been described in a German family with Parkinson's disease (PD). The authors showed that this mutation is responsible for an impaired proteolytic activity of the UCH-L1 protein and may lead to an abnormal aggregation of proteins in the brain. In order to determine the importance of this or any other mutation in the coding region of the UCH-L1 gene in PD, we performed mutation analysis on Caucasian families with at least two affected sibs.

Total homocysteine and cognitive decline in a community-based sample of elderly subjects: the Rotterdam Study.

Homocysteine has been associated with an increased risk of cardiovascular disease. Cardiovascular diseases have been related to cognitive decline. The authors investigated the association of homocysteine with concurrent cognitive impairment and subsequent cognitive decline in a random sample of 702 community-dwelling respondents aged 55 years or over to the prospective Rotterdam Study in 1990-1994.

Scalability, reliability, and validity of the benzodiazepine dependence self-report questionnaire in outpatient benzodiazepine users.

As there is no multidimensional instrument available that reflects the severity of benzodiazepine (BZD) dependence comprehensively, the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ) was developed and investigated. The Bendep-SRQ, Symptom Checklist-90 (SCL-90), Schedules for Clinical Assessments in Neuropsychiatry (SCAN), and Addiction Severity Index-Revised (ASI-R) were administered to 115 general practice (GP) patients, 124 psychiatric outpatients, and 33 self-help patients who were using BZDs. Factor and Rasch analyses were applied to construct scales.

Coagulation and fibrinolysis markers and risk of dementia. The Dutch Vascular Factors in Dementia Study.

We performed a cross-sectional case-control study among 277 subjects with dementia and 298 control subjects drawn from participants of the Rotterdam Study, a population-based cohort study among subjects aged 55 years or over, and from participants of the Rotterdam Stroke Databank, a hospital-based stroke registry, with the objective to evaluate the association of indicators of coagulability, fibrinogen, prothrombin fragments 1+2, thrombin-antithrombin complex (TAT), and indicators of fibrinolysis, plasmin-inhibitor complex, D-dimer and tissue-type plasminogen activator (t-PA) with dementia. Increased levels of TAT, D-dimer and t-PA activity were associated with an increased risk of dementia. Additional stratified analyses indicated that an increased TAT level was the primary factor related to dementia.

Response to activated protein C in subjects with and without dementia. The Dutch Vascular Factors in Dementia Study.

We performed a cross-sectional case-control study among 295 subjects with dementia and 406 control subjects drawn from participants of the Rotterdam Study, a population-based cohort study among subjects aged 55 years or over, and from participants of the Rotterdam Stroke Databank, a hospital-based stroke registry, to evaluate the association of the factor V Leiden mutation and activated protein C (APC) response with dementia and its subtypes. The risk of dementia was 2.11-fold increased among carriers of factor V Leiden mutation relative to subjects lacking factor V Leiden mutation (95% confidence interval, CI, 0.

Risk factors for vascular disease and dementia.

There is increasing evidence that risk factors for vascular disease and stroke are associated with cognitive impairment and Alzheimer's disease. This paper reviews current knowledge on the relationship between risk factors for stroke and Alzheimer's disease. The focus will be on 'classical' risk factors, including age and gender, socioeconomic status, diabetes, cholesterol, prior cardiovascular disease, atrial fibrillation, cigarette smoking and alcohol use; as well as on factors that more recently have been recognized as putative risk factors, including APOE genotype, serum homocysteine concentration, relative abnormalities in the hemostatic and thrombotic systems, and inflammation.

The new epidemic: frequency of dementia in the Rotterdam Study.

Dementia is one of the most frequent and devastating disorders in the elderly. Due to the increased longevity and the increasing number of elderly people in our society, it is emerging more and more as a major health problem. We quantified the frequency and lifetime risk of dementia, and of subtypes of dementia, in the Rotterdam Study, a population-based prospective cohort study among 7, 983 subjects over the age of 55 years.

1H chemical shift imaging of the human brain at age 60-90 years reveals metabolic differences between women and men.

1H magnetic resonance spectroscopy was used to compare brain metabolism in 540 elderly persons, stratified by sex and age (60-90 years old). An 8 x 8 x 2 cm3 supraventricular brain volume, a transverse plane parallel to the canthomeatal line, was examined by automated 1H chemical shift imaging [point-resolved spectroscopy (PRESS), TE of 35 msec]. Regional choline (Cho), creatine (Cr), and N-acetyl aspartate (NAA) peak areas in the 518 successful examinations (96%) were studied by division through the total area of the particular metabolite in each spectral map.

Excess stroke among hypertensive men and women attributable to undertreatment of hypertension.

Background And Purpose: Most population-based studies indicate that a considerable proportion of hypertensive subjects are undertreated and that undertreatment is more prevalent among hypertensive men than among hypertensive women. The aim of our study was to investigate the consequences of undertreatment of hypertension for women and men in terms of stroke occurrence.

Methods: Approximately 45 000 men and women aged >/=20 years were examined in 2 population-based studies in the Netherlands.

Familial aggregation of Parkinson's disease: a population-based case-control study in Europe. EUROPARKINSON Study Group.

Objective: To investigate the familial aggregation of PD in a large collaborative population-based case-control study.

Background: Most previous case-control studies of the familial aggregation of PD have been hospital- or clinic-based.

Methods: We included 219 prevalent cases ascertained in three European populations (centers), using a two-phase design consisting of screening and examination by a neurologist.

Apolipoprotein E genotype and progression of Alzheimer's disease: the Rotterdam Study.

The APOE*4 allele of the apolipoprotein E gene increases the risk of Alzheimer's disease (AD), but whether it also affects the course of the disease is controversial. However, all studies on this issue until now have been based on patients at various stages of disease. In the present population-based study, 97 patients were included at a similar stage, i.

An evaluation of DSM-III-R and ICD-10 benzodiazepine dependence criteria using Rasch modelling.

Aims: To evaluate the homogeneity of the elements of the Substance Dependence Syndrome (SDS) as applied to benzodiazepines (BZDs) by Rasch modelling.

Measurements: The Rasch scaling model was applied to data obtained by administering the SCAN (Schedules for Clinical Assessments in Neuropsychiatry) substance dependence sections. Subsequently, Rasch-homogeneous sets of DSM-III-R and ICD-10 BZD dependence criteria were assessed for subject and item discriminability.

NSAIDs and incident Alzheimer's disease. The Rotterdam Study.

Recent studies suggest that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the risk for Alzheimer's disease (AD). We investigated the relation of NSAID use over a 10-year period and the risk for incident AD using a nested case-control design in the population-based Rotterdam Study. The study was performed in 306 subjects; 74 Alzheimer patients diagnosed according to NINCDS-ADRDRA criteria and 232 age and sex-matched controls.

Education and the incidence of dementia in a large population-based study: the Rotterdam Study.

We assessed the risk of dementia by educational level in a prospective population-based study. In the Rotterdam Study, 6,827 nondemented participants with known education level were followed for an average of 2.1 years.

Cerebral vasomotor reactivity and cerebral white matter lesions in the elderly.

Objective: The pathogenesis of white matter lesions is still uncertain, but an ischemic-hypoxic cause has been suggested. Cerebral vasomotor reactivity reflects the compensatory dilatory mechanism of the intracerebral arterioles to a vasodilatory stimulus and provides a more sensitive hemodynamic index than the level of resting flow.

Methods: The authors determined the association between vasomotor reactivity and white matter lesions in 73 consecutive individuals from the Rotterdam Scan Study who also participated in the Rotterdam Study, a large population-based prospective follow-up study of individuals > or =55 years old.

Socioeconomic differences in stroke among Dutch elderly women: the Rotterdam Study.

Background And Purpose: We sought to assess the association between socioeconomic status and the risk of stroke among elderly women. Methods--The association between socioeconomic status and stroke emerged in cross-sectional and longitudinal data on 4274 female participants of the Rotterdam Study, a prospective, population-based, follow-up study in the Netherlands among older subjects.

Results: A history of stroke was more common among women in lower socioeconomic strata.