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From the Second Department of Internal Medicine (Drs. Yoshitake, Kiyohara, Kato, Ohmura, Iwamoto, Nakayama, Ohmori, Nomiyama, Kawano, Ueda, and Fujishima), the First Department of Pathology (Dr. Sueishi), and the Second Department of Pathology (Dr. Tsuneyoshi), Faculty of Medicine, Kyushu University, Japan.
Article abstract—We followed 828 nondemented residents of Hisayama Town, Kyushu, Japan, aged 65 years or older (88.3% of the elderly population) for 7 years starting in 1985 in order to determine the type-specific incidence of dementia and its risk factors in the general Japanese population. Only two subjects were lost to the follow-up, during which period 103 subjects developed dementia. Morphologic examination of the brains of 89 subjects (86.4%) was made by autopsy or CT. We made the initial diagnosis of dementia based on the DSM-111-R criteria, with the diagnoses of vascular dementia (VD) being based on the NINDS-AIREN criteria and Alzheimer's disease (AD) on the NINCDS-ADRDA criteria. The incidence of VD and AD increased with age for both sexes. The age-adjusted total incidence (per 1,000 person-years) of dementia was 19.3 for men and 20.9 for women. The corresponding rates for VD were 12.2 for men and 9.0 for women, and for AD, 5.1 for men and 10.9 for women. Among the VD subjects whose brain morphology we examined, the most frequent type of stroke was multiple lacunar infarcts (42%), but half these subjects lacked a stroke episode in their histories. Multivariate analysis showed that age, prior stroke episodes, systolic blood pressure, and alcohol consumption were significant independent risk factors for the occurrence of VD. In contrast, age and a low score on Hasegawa's dementia scale were significant risk factors for AD, and physical activity was a significant preventive factor for AD. Our findings suggest that asymptomatic stroke is an important factor in the development of VD, with age, prior stroke episodes, systolic blood pressure, and alcohol consumption being independent risk factors for its occurrence. Age and a low scare on Hasegawa's dementia scale are significant risk factors for AD, with moderate physical activity having a statistically significant preventive effect.
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K. Andersen, L. J. Launer, M. E. Dewey, L. Letenneur, A. Ott, J. R. M. Copeland, J.-F. Dartigues, P. Kragh-Sorensen, M. Baldereschi, C. Brayne, et al. Gender differences in the incidence of AD and vascular dementia: The EURODEM Studies Neurology, December 1, 1999; 53(9): 1992 - 1992. [Abstract] [Full Text] [PDF]
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F. Massoud, G. Devi, Y. Stern, A. Lawton, J. E. Goldman, Y. Liu, S. S. Chin, and R. Mayeux A Clinicopathological Comparison of Community-Based and Clinic-Based Cohorts of Patients With Dementia Arch Neurol, November 1, 1999; 56(11): 1368 - 1373. [Abstract] [Full Text] [PDF]
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Z. Guo, L. Fratiglioni, L. Zhu, J. Fastbom, B. Winblad, and M. Viitanen Occurrence and Progression of Dementia in a Community Population Aged 75 Years and Older: Relationship of Antihypertensive Medication Use Arch Neurol, August 1, 1999; 56(8): 991 - 996. [Abstract] [Full Text] [PDF]
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J. T. Moroney, M.-X. Tang, L. Berglund, S. Small, C. Merchant, K. Bell, Y. Stern, and R. Mayeux Low-Density Lipoprotein Cholesterol and the Risk of Dementia With Stroke JAMA, July 21, 1999; 282(3): 254 - 260. [Abstract] [Full Text] [PDF]
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L. T. Kwan, B. R. Reed, J. L. Eberling, N. Schuff, J. Tanabe, D. Norman, M. W. Weiner, and W. J. Jagust Effects of Subcortical Cerebral Infarction on Cortical Glucose Metabolism and Cognitive Function Arch Neurol, July 1, 1999; 56(7): 809 - 814. [Abstract] [Full Text] [PDF]
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G. W. Ross, H. Petrovitch, L. R. White, K. H. Masaki, C. Y. Li, J. D. Curb, K. Yano, B. L. Rodriguez, D. J. Foley, P. L. Blanchette, et al. Characterization of risk factors for vascular dementia: The Honolulu-Asia Aging Study Neurology, July 1, 1999; 53(2): 337 - 337. [Abstract] [Full Text] [PDF]
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M. Tsolaki, C. Fountoulakis, I. Pavlopoulos, E. Chatzi, and A. Kazis Prevalence and incidence of Alzheimers disease and other dementing disorders in Pylea, Greece American Journal of Alzheimer's Disease and Other Dementias, May 1, 1999; 14(3): 138 - 148. [Abstract] [PDF]
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L Letenneur, V Gilleron, D Commenges, C Helmer, J M Orgogozo, and J F Dartigues Are sex and educational level independent predictors of dementia and Alzheimer's disease? Incidence data from the PAQUID project J. Neurol. Neurosurg. Psychiatry, February 1, 1999; 66(2): 177 - 183. [Abstract] [Full Text]
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L. J. Launer, K. Andersen, M. E. Dewey, L. Letenneur, A. Ott, L. A. Amaducci, C. Brayne, J. R. M. Copeland, J.-F. Dartigues, P. Kragh-Sorensen, et al. Rates and risk factors for dementia and Alzheimer's disease: Results from EURODEM pooled analyses Neurology, January 1, 1999; 52(1): 78 - 78. [Abstract] [Full Text] [PDF]
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K. Andersen, H. Nielsen, A. Lolk, J. Andersen, I. Becker, and P. Kragh-Sorensen Incidence of very mild to severe dementia and Alzheimer's disease in Denmark: The Odense Study Neurology, January 1, 1999; 52(1): 85 - 85. [Abstract] [Full Text] [PDF]
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R STEWART Cardiovascular factors in Alzheimer's disease J. Neurol. Neurosurg. Psychiatry, August 1, 1998; 65(2): 143 - 147. [Full Text]
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T. Pohjasvaara, T. Erkinjuntti, R. Ylikoski, M. Hietanen, R. Vataja, and M. Kaste Clinical Determinants of Poststroke Dementia Stroke, January 1, 1998; 29(1): 75 - 81. [Abstract] [Full Text] [PDF]
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I. Akiguchi, H. Tomimoto, T. Suenaga, H. Wakita, and H. Budka Alterations in Glia and Axons in the Brains of Binswanger's Disease Patients Stroke, July 1, 1997; 28(7): 1423 - 1429. [Abstract] [Full Text]
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A. Herlitz, B. J. Small, L. Fratiglioni, O. Almkvist, M. Viitanen, and L. Backman Detection of Mild Dementia in Community Surveys: Is It Possible to Increase the Accuracy of Our Diagnostic Instruments? Arch Neurol, March 1, 1997; 54(3): 319 - 324. [Abstract] [PDF]
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J. Lindsay, R. Hebert, and K. Rockwood The Canadian Study of Health and Aging : Risk Factors for Vascular Dementia Stroke, March 1, 1997; 28(3): 526 - 530. [Abstract] [Full Text]
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P. B. Gorelick Status of Risk Factors for Dementia Associated With Stroke Stroke, February 1, 1997; 28(2): 459 - 463. [Abstract] [Full Text]
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L. White, H. Petrovitch, G. W. Ross, K. H. Masaki, R. D. Abbott, E. L. Teng, B. L. Rodriguez, P. L. Blanchette, R. J. Havlik, G. Wergowske, et al. Prevalence of Dementia in Older Japanese-American Men in Hawaii: The Honolulu-Asia Aging Study JAMA, September 25, 1996; 276(12): 955 - 960. [Abstract] [PDF]
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