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Llewellyn D.J.,University of Cambridge | Langa K.M.,University of Michigan | Langa K.M.,usa practice management | Friedland R.P.,Case Western Reserve University | Lang I.A.,Public Health and Epidemiology Group
Current Alzheimer Research | Year: 2010

Results from clinical samples suggest low serum albumin may be associated with cognitive impairment, though evidence from population-based studies is inconclusive. Participants were 1,752 adults (699 men and 1,053 women) aged 65 years and over from the Health Survey for England 2000, a nationally representative population-based study. Cognitive impairment was assessed using the Abbreviated Mental Test Score. The cross-sectional relation of serum albumin quartiles to cognitive impairment was modelled using logistic regression. Two hundred and twelve participants were cognitively impaired (68 men and 144 women). Odds ratios (95% confidence intervals) for cognitive impairment in the first (2.2-3.8 g/dl), second (3.9-4.0 g/dl), and third (4.1-4.3 g/dl) quartiles of serum albumin compared with the fourth (4.4-5.3 g/dl) were 2.5 (1.3-5.1), 1.7 (0.9-3.5), and 1.5 (0.7-2.9), after adjustment for age, sex, education and additional risk factors for cognitive impairment (p for linear trend = 0.002). A highly similar pattern of associations was observed for men and women. Our data provide new evidence to suggest that low serum albumin is independently associated with increased odds of cognitive impairment in the elderly population. ©2010 Bentham Science Publishers Ltd.

Llewellyn D.J.,Public Health and Epidemiology Group | Lang I.A.,Public Health and Epidemiology Group | Matthews F.E.,Institute of Public Health | Plassman B.L.,Duke University | And 7 more authors.
Alzheimer's Research and Therapy | Year: 2010

Introduction. Evidence from clinical samples and geographically limited population studies suggests that vascular health, diabetes and apolipoprotein 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 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 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 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 4 allele and their interaction are strongly associated with dementia. © 2010 Llewellyn et al.; licensee BioMed Central Ltd.

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