THE RELATION BETWEEN ANTIANAPHYLAXIS AND ANTIBODY BALANCE : I. THE ROLE OF EXCESS OF CIRCULATING ANTIBODY IN HYPERSENSITIVENESS

1. Sensitized guinea pigs injected with normal rabbit or guinea pig serum previous to intravenous inoculation of antigen may be protected against a few lethal doses of antigen. The protection is greater with foreign than with homologous serum and appears to be related roughly to the amount of serum introduced. 2. Sensitized guinea pigs injected with antibody-containing serum preliminary to intravenous injection of antigen, show no greater refractoriness to anaphylaxis than do those injected with normal serum. 3. Moreover, in many instances, the injection of an excess of antibody into the circulation of sensitized guinea pigs, leads to an increased susceptibility of these animals to anaphylaxis. 4. These results indicate that an excess of circulating antibody is not responsible for a state of antianaphylaxis, but on the contrary, may contribute toward the anaphylactic reaction itself.

THE PROBABLE NATURE OF THE INFECTIOUS AGENT OF TRACHOMA

1. The infectious agent of trachoma can be freed from extraneous bacteria by passage through rabbit testicle. 2. The infectious agent multiplies little, if at all, during such passage, but in many instances retains its infectivity undiminished. 3. No specific changes occur in the rabbit testicle incidentally to the passage. 4. On rare occasion the trachoma agent may be freed from bacteria by intracerebral passage. The brain tissues show no specific reaction. 5. Filtration experiments with Seitz, Kramer, Berkefeld, and Elford filters confirm the general observation that the infectious agent is filterable with difficulty. 6. Tissue culture experiments, with tissues containing the infectious agent (conjunctiva, rabbit testicle, brain, etc.), conducted under a wide variety of conditions, proved uniformly unsuccessful in the cultivation of the agent. 7. The agent is inactivated by bile, AgNO₃, phenol, cocaine, tartar emetic, and gentian violet. Its heat inactivation temperature is between 45° and 50°C., at a time interval of 15 minutes. 8. Attempts to preserve the infectious agent in glycerine were unsuccessful. 9. The accumulated evidence suggests that the infectious agent of trachoma is a virus.

The role of nutrition in Alzheimer's disease: epidemiological evidence

The prevalence of Alzheimer's disease (AD) increases exponentially with age but there is limited knowledge of the modifiable risk factors for AD. However, there is growing evidence for possible dietary risk factors in the development of AD and cognitive decline with age, such as antioxidant nutrients, fish, dietary fats, and B-vitamins. Numerous animal and laboratory studies have shown that antioxidant nutrients can protect the brain from oxidative and inflammatory damage, but there are limited data available from epidemiological studies. There is more substantial epidemiological evidence from a number of recent studies that demonstrate a protective role of omega-3 fatty acids, such as docosahexaenoic acid, in AD and cognitive decline. This review will focus on epidemiological evidence investigating the relationship between nutrition and AD, focusing particularly on the roles of dietary fats and antioxidants.

Enhanced 'Reading the Mind in the Eyes' in borderline personality disorder compared to healthy controls

BACKGROUND

Borderline personality disorder (BPD) is partly characterized by chronic instability in interpersonal relationships, which exacerbates other symptom dimensions of the disorder and can interfere with treatment engagement. Facial emotion recognition paradigms have been used to investigate the bases of interpersonal impairments in BPD, yielding mixed results. We sought to clarify and extend past findings by using the Reading the Mind in the Eyes Test (RMET), a measure of the capacity to discriminate the mental state of others from expressions in the eye region of the face.

METHOD

Thirty individuals diagnosed with BPD were compared to 25 healthy controls (HCs) on RMET performance. Participants were also assessed for depression severity, emotional state at the time of assessment, history of childhood abuse, and other Axis I and personality disorders (PDs).

RESULTS

The BPD group performed significantly better than the HC group on the RMET, particularly for the Total Score and Neutral emotional valences. Effect sizes were in the large range for the Total Score and for Neutral RMET performance. The results could not be accounted for by demographics, co-occurring Axis I or II conditions, medication status, abuse history, or emotional state. However, depression severity partially mediated the relationship between RMET and BPD status.

CONCLUSIONS

Mental state discrimination based on the eye region of the face is enhanced in BPD. An enhanced sensitivity to the mental states of others may be a basis for the social impairments in BPD.

Body mass index and cognitive decline in a biracial community population

OBJECTIVE

To examine whether a higher body mass index (BMI) in older adults is associated with greater cognitive decline.

METHODS

A longitudinal study was conducted from 1993 to 2003 with an average follow-up of 6.4 years of a biracial community population on the south side of Chicago. Participants were 3,885 community-dwelling adults aged 65 and older who participated in at least two assessments. A composite measure of global cognitive function was used which was derived from the average of standardized scores from four cognitive tests.

RESULTS

There was a significant curvilinear association between BMI and cognitive function scores at baseline for both black (= -0.0014, p = 0.001) and non-black subjects (= -0.0011, p = 0.002). In a mixed model adjusted for age, sex, race, and education, higher BMI was associated with less cognitive decline in both black (= 0.0013, p = 0.009) and non-black subjects (= 0.0021, p = 0.006). Adjusting for comorbid illnesses did not change these findings substantially. However, the associations were much smaller and no longer significant among participants with no cognitive decline at baseline as measured by a Mini-Mental State Examination score of greater than 24.

CONCLUSIONS

The findings suggest that greater body mass index in old age is not predictive of cognitive decline in a cognitively unimpaired community population.

IANA task force on nutrition and cognitive decline with aging

Cognitive impairment can be influenced by a number of factors. The potential effect of nutrition has become a topic of increasing scientific and public interest. In particular, there are arguments that nutrients (food and/or supplements) such as vitamins, trace minerals, lipids, can affect the risk of cognitive decline and dementia, especially in frail elderly people at risk of deficiencies. Our objective in this paper is to review data relating diet to risk of cognitive decline and dementia, especially Alzheimer's disease (AD). We chose to focus our statements on homocysteine-related vitamins (B-vitamins), antioxidant nutrients (vitamins E and C, carotenoids, flavonoids, enzymatic cofactors) and dietary lipids. Results of epidemiological studies may sometimes appeared conflicting; however, certain associations are frequently found. High intake of saturated and trans-unsaturated (hydrogenated) fats were positively associated with increased risk of AD, whereas intake of polyunsaturated and monounsaturated fats were protective against cognitive decline in the elderly in prospective studies. Fish consumption has been associated with lower risk of AD in longitudinal cohort studies. Moreover, epidemiologic data suggest a protective role of the B-vitamins, especially vitamins B9 and B12, on cognitive decline and dementia. Finally, the results on antioxidant nutrients may suggest the importance of having a balanced combination of several antioxidant nutrients to exert a significant effect on the prevention of cognitive decline and dementia, while taking into account the potential adverse effects of these nutrients. There is no lack of attractive hypotheses to support research on the relationships between nutrition and cognitive decline. It is important to stress the need to develop further prospective studies of sufficiently long duration, including subjects whose diet is monitored at a sufficiently early stage or at least before disease or cognitive decline exist. Meta analyses should be developed, and on the basis of their results the most appropriate interventional studies can be planned. These studies must control for the greatest number of known confounding factors and take into account the impact of the standard social determinants of food habits, such as the regional cultures, social status, and educational level.

A non-covalent peptide-based strategy for siRNA delivery

The major obstacle to clinical development of siRNAs (short interfering RNAs), like for most of the nucleic-acid-based strategies, is their poor cellular uptake and bioavailability. Although several viral and non-viral strategies have been proposed to improve siRNA delivery, their applications in vivo remain a major challenge. We have developed a new strategy, based on a short amphipathic peptide, MPG, that is able to form stable nanoparticles with siRNA. MPG-based particles enter the cell independently of the endosomal pathway and can efficiently deliver siRNA in a fully biologically active form into a variety of cell lines and in vivo. This short review will discuss the mechanism and the potency of the MPG strategy for siRNA delivery both in vitro and in vivo.

Cognitive ability is associated with suspected reporting errors on food frequency questionnaires

OBJECTIVE

To examine potential for bias in reported total energy intake on a Food Frequency Questionnaire (FFQ) among older adults.

DESIGN

Longitudinal cohort study.

SUBJECTS/SETTING

2,706 Community-dwelling Black and White older adults, aged 70-79 years, enrolled in the Health, Aging, and Body Composition study. Multivariate logistic regression analyses were conducted with potential errors on reported total energy intake on the Food Frequency Questionnaire (FFQ) as the outcome variable and with cognitive ability, measured by the Modified Mini Mental State Exam (3MS) as the primary independent variable. The regression model controlled for site, race, gender, age, body size, and physical activity. Separate models were fit using 3MS as a continuous variable and for multiple 3MS cutpoints. All models revealed similar findings.

RESULTS

Cognitive ability was inversely associated with potential errors in reporting total energy intake, whereby a five-point increase in 3MS scores was associated with a 14% decreased likelihood of reporting errors (Odds Ratio=0.86, 95% Confidence Interval: 0.77, 0.95). Additionally, compared to White women, White men were 2 times more likely, and Black women and Black men were 3 times more likely, to have errors in reporting total energy intake.

CONCLUSION

This study provides evidence that for older adults, lower cognition scores are associated with increased potential errors in reporting total energy intake.

APPLICATIONS

Dietary reporting from older adults may be inaccurate due to cognitive deficits. A brief assessment of cognitive function may assist clinicians in dietary evaluations and recommendation and may benefit studies using FFQ data where the measure of cognitive function could be utilized to stratify data analyses and conduct sensitivity analyses.

Associations of vegetable and fruit consumption with age-related cognitive change

OBJECTIVE

To examine the association between rates of cognitive change and dietary consumption of fruits and vegetables among older persons.

METHODS

The authors conducted a prospective cohort study of 3,718 participants, aged 65 years and older of the Chicago Health and Aging Project. Participants completed a food frequency questionnaire and were administered at least two of three cognitive assessments at baseline, 3-year, and 6-year follow-ups. Cognitive function was measured using the average z-score of four tests: the East Boston Tests of immediate memory and delayed recall, the Mini-Mental State Examination, and the Symbol Digit Modalities Test.

RESULTS

The mean cognitive score at baseline for the analyzed cohort was 0.18 (range: -3.5 to 1.6), and the overall mean change in score per year was a decline of 0.04 standardized units. In mixed effects models adjusted for age, sex, race, and education, compared with the rate of cognitive decline among persons in the lowest quintile of vegetable intake (median of 0.9 servings/day), the rate for persons in the fourth quintile (median, 2.8 servings/day) was slower by 0.019 standardized units per year (p = 0.01), a 40% decrease, and by 0.018 standardized units per year (p = 0.02) for the fifth quintile (median, 4.1 servings/day), or a 38% decrease in rates. The association remained significant (p for linear trend = 0.02) with further control of cardiovascular-related conditions and risk factors. Fruit consumption was not associated with cognitive change.

CONCLUSION

High vegetable but not fruit consumption may be associated with slower rate of cognitive decline with older age.

Dietary fat intake and 6-year cognitive change in an older biracial community population

OBJECTIVE

To examine whether consumption of different types of fat is associated with age-related change in cognition.

METHODS

The authors related fat consumption to 6-year change in cognitive function among 2,560 participants of the Chicago Health and Aging Project, ages 65 and older, with no history of heart attack, stroke, or diabetes at baseline. Fat intake was measured by food frequency questionnaire. Cognitive function was measured at baseline and 3-year and 6-year follow-ups, using the average z score of four cognitive tests: the East Boston Tests of Immediate and Delayed Recall, the Mini-Mental State Examination, and the Symbol Digit Modalities Test.

RESULTS

In separate mixed models adjusted for demographic and cardiovascular risk factors and intakes of antioxidant nutrients and other dietary fats, higher intakes of saturated fat (p for trend = 0.04) and trans-unsaturated fat (p for trend = 0.07) were linearly associated with greater decline in cognitive score over 6 years. These associations became stronger in analyses that eliminated persons whose fat intake changed in recent years or whose baseline cognitive scores were in the lowest 15%. Inverse associations with cognitive decline were observed in these latter restricted analyses for high intake of monounsaturated fat and a high ratio of polyunsaturated to saturated fat intake. Intakes of total fat, vegetable and animal fats, and cholesterol were not associated with cognitive change.

CONCLUSION

A diet high in saturated or trans-unsaturated fat or low in nonhydrogenated unsaturated fats may be associated with cognitive decline among older persons.

Noncompliance after kidney transplantation: a systematic review

We performed a systematic review of the literature on medical noncompliance after kidney transplantation in the cyclosporine era. We wished to define commonalities that may help the clinician identify patients for early intervention. We found that patients who were at a higher risk of noncompliance after kidney transplants were younger, female, unmarried, and non-Caucasians. Patients who were recipients of living donor transplants and had been transplanted for a longer time with a history of a previous transplant were also at risk of noncompliance. We also found that patients displaying emotional problems, such as anxiety, hostility, depression, distress, lack of coping, and avoidant behaviors, were also at risk for noncompliance after kidney transplantation.

Dietary niacin and the risk of incident Alzheimer's disease and of cognitive decline

BACKGROUND

Dementia can be caused by severe niacin insufficiency, but it is unknown whether variation in intake of niacin in the usual diet is linked to neurodegenerative decline. We examined whether dietary intake of niacin was associated with incident Alzheimer's disease (AD) and cognitive decline in a large, prospective study.

METHODS

This study was conducted in 1993-2002 in a geographically defined Chicago community of 6158 residents aged 65 years and older. Nutrient intake was determined by food frequency questionnaire. Four cognitive tests were administered to all study participants at 3 year intervals in a 6 year follow up. A total of 3718 participants had dietary data and at least two cognitive assessments for analyses of cognitive change over a median 5.5 years. Clinical evaluations were performed on a stratified random sample of 815 participants initially unaffected by AD, and 131 participants were diagnosed with 4 year incident AD by standardised criteria.

RESULTS

Energy adjusted niacin intake had a protective effect on development of AD and cognitive decline. In a logistic regression model, relative risks (95% confidence intervals) for incident AD from lowest to highest quintiles of total niacin intake were: 1.0 (referent) 0.3 (0.1 to 0.6), 0.3 (0.1 to 0.7), 0.6 (0.3 to 1.3), and 0.3 (0.1 to 0.7) adjusted for age, sex, race, education, and ApoE e4 status. Niacin intake from foods was also inversely associated with AD (p for linear trend = 0.002 in the adjusted model). In an adjusted random effects model, higher food intake of niacin was associated with a slower annual rate of cognitive decline, by 0.019 standardised units (SU) per natural log increase in intake (mg) (p = 0.05). Stronger associations were observed in analyses that excluded participants with a history of cardiovascular disease (beta = 0.028 SU/year; p = 0.008), those with low baseline cognitive scores (beta = 0.023 SU/year; p = 0.02), or those with fewer than 12 years' education (beta = 0.035 SU/year; p = 0.002)

CONCLUSION

Dietary niacin may protect against AD and age related cognitive decline.

Combination of a new generation of PNAs with a peptide-based carrier enables efficient targeting of cell cycle progression

The design of potent systems for the delivery of charged and noncharged molecules that target genes of interest remains a challenge. We describe a novel technology that combines a new generation of peptide nucleic acids (PNAs), or HypNA-pPNAs, with a new noncovalent peptide-based delivery system, Pep-2, which promotes efficient delivery of PNAs into several cell lines. We have validated the potential of this technology by showing that Pep2-mediated delivery of an antisense HypNA-pPNA chimera directed specifically against cyclin B1 induces rapid and robust downregulation of its protein levels and efficiently blocks cell cycle progression of several cell lines, as well as proliferation of cells derived from a breast cancer. Pep-2-based delivery system was shown to be 100-fold more efficient in delivering HypNA-pPNAs than classical cationic lipid-based methods. Whereas Pep-2 is essential for improving the bioavailability of PNAs and HypNA-pPNAs, the latter contribute significantly to the efficiency and specificity of the biological response. We have found that Pep-2/HypNA-pPNA strategy promotes potent antisense effects, which are approximately 25-fold greater than with classical antisense oligonucleotide directed specifically against the same cyclin B1 target. Taken together, these data demonstrate that peptide-mediated delivery of HypNA-pPNAs constitutes a very promising technology for therapeutic applications.

Blood pressure and late-life cognitive function change: A biracial longitudinal population study

OBJECTIVE

To examine the relation of blood pressure (BP) to subsequent decline in cognitive function among persons age 65 or over.

METHODS

All persons age 65 or over in a geographically defined community were invited to participate in a longitudinal study of problems of the elderly. Interviews were conducted in the participants' homes and included two BP measures and four tests of cognitive function. Follow-up interviews 3 and 6 years after baseline repeated the cognitive function tests. These analyses included 4,284 individuals who had baseline and at least one follow-up measure of cognitive function. The average of z scores of the individual cognitive function tests was used as a global measure of cognitive function.

RESULTS

In random effects analyses controlling for age, sex, education, and race, there was no significant linear association of either systolic or diastolic BP with 6-year change in global cognitive function score. There was no significant curvilinear association with systolic BP. In tests for a curvilinear association with diastolic BP, there was a suggestion of increased decline among those with low or high diastolic BP (p = 0.03 for the quadratic diastolic term). At baseline, 50% of participants took some type of medication affecting BP.

CONCLUSION

In this community population where BP treatment was common, there was no association of either high systolic or high diastolic BP at the beginning of the observation interval with 6-year cognitive decline.

Cognitive activity and cognitive decline in a biracial community population

BACKGROUND

Frequent participation in cognitively stimulating activities has been associated with reduced risk of AD in several prospective studies. However, the association of cognitive activity with cognitive decline, the principal manifestation of AD, is not well understood.

METHODS

More than 4,000 older residents of a geographically defined biracial community of Chicago were interviewed at approximately 3-year intervals for an average of 5.3 years. Each interview included administration of four cognitive function tests from which a previously established global measure was derived. At baseline, each person rated frequency of participation in cognitively stimulating activities (e.g., reading a magazine) from which a previously established composite measure of cognitive activity was derived.

RESULTS

Cognitive activity scores ranged from 1 to 5 (mean = 3.14, SD = 0.66), with higher scores indicating more frequent participation. More frequent cognitive activity was associated with reduced cognitive decline during follow-up. In a model that controlled for baseline level of cognition, age, sex, race, and education, a 1-point increase in cognitive activity score was associated with an approximately 19% decrease in annual rate of cognitive decline (p < 0.001). This effect remained when we controlled for depressive symptoms and chronic medical conditions (p < 0.001), and when we excluded persons with evidence of memory impairment at baseline (p < 0.001).

CONCLUSION

Frequent participation in cognitively stimulating activities is associated with reduced cognitive decline in older persons.

Minimizing harm in agricultural animal experiments in New Zealand

Intrusive agricultural experiments published in New Zealand in the last five years are reviewed in terms of the degree of animal suffering involved, and the necessity for this suffering in relation to research findings. When measured against animal welfare criteria of the Ministry of Agriculture, thirty-six studies inflicted "severe" or "very severe" suffering. Many of these experiments had questionable short-term applications, had an application restricted to agricultural production or economic growth, or could have been modified to prevent or reduce suffering.

Cognitive activity and incident AD in a population-based sample of older persons

BACKGROUND

Participation in cognitively stimulating activities is hypothesized to be associated with risk of AD, but knowledge about this association is limited.

METHODS

A biracial community in Chicago was censused, persons aged 65 years and older were asked to participate in an interview, and 6,158 of 7,826 (79%) eligible persons did so. As part of the interview, persons rated current frequency of participation in seven cognitive activities (e.g., reading a newspaper) and nine physical activities (e.g., walking for exercise) from which composite measures of cognitive and physical activity frequency were derived. Four years later, 1,249 of those judged free of AD were sampled for a detailed clinical evaluation of incident disease and 842 (74% of those eligible) participated.

RESULTS

The composite measure of cognitive activity ranged from 1.28 to 4.71 (mean 3.30; SD 0.59), with higher scores indicating more frequent activity. A total of 139 persons met National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for AD on clinical evaluation. In a logistic regression model adjusted for age, education, sex, race, and possession of the APOE epsilon4 allele, a one-point increase in cognitive activity score was associated with a 64% reduction in risk of incident AD (OR 0.36; 95% CI 0.20 to 0.65). By contrast, weekly hours of physical activity (mean 3.5; SD 5.1) was not related to disease risk (OR 1.04; 95% CI 0.98 to 1.10). Education was associated with risk of AD and a similar trend was present for occupation, but these effects were substantially reduced when cognitive activity was added to the model.

CONCLUSION

Frequency of participation in cognitively stimulating activities appears to be associated with risk of AD and may partially explain the association of educational and occupational attainment with disease risk.

The changing epidemiological pattern of hepatitis A in England and Wales

Sera from an age-stratified sample of 4188 individuals, submitted for diagnostic purposes to 15 public health laboratories in England and Wales in 1996, were tested for hepatitis A antibody. The serological profiles were consistent with declining incidence in the past. This hypothesis was tested by comparing the serological profiles of Ashford, Leeds and Preston public health laboratories with those from sera collected during a previous study in the same laboratories in 1986/7. A comparison of equivalent 10 year birth cohorts revealed that significant hepatitis A seroconversion had only continued in Ashford. However, it is probable that most seroconversions are due to vaccination and immigration rather than continuing viral transmission. Further population-based surveys collecting more in-depth social and demographic data are needed to confirm the main factors influencing hepatitis A seroprevalence and to explain the regional differences.

Oral fluid collection by post--a pilot study of two approaches

This pilot study aimed to assess the feasibility of the postal collection of oral fluid samples for surveillance purposes and the effect of two different approaches on the response rates. This cross-sectional, antibody prevalence study collected oral fluid samples and questionnaire data from randomly selected individuals, aged under 45 y, through the post. The individuals were recruited from four general practice registers. In a one stage approach patients were sent the oral fluid kit with the initial invitation letter. In a two stage approach the kits were sent out after written consent had been received. There was little difference in the overall response rates between the two approaches (38% two stage and 41% one stage), though the response rate for the one stage approach was 10% higher in the under-20-y-olds in practices from areas of greater deprivation. The low response partly reflected poor uptake in young adults who may need to be approached through more targeted surveys. In the other age groups additional reminders could prove a cost-effective way of increasing the response rate further.

Cerebral vasculitis in a child following post-streptococcal glomerulonephritis

Cerebral vasculitis following acute post-streptococcal glomerulonephritis (APSGN) is a rare neurological complication. An 11-year-old girl with biopsy proven APSGN developed an acute seizure disorder. Clinical and computed tomography findings were consistent with vasculitis.

A peptide carrier for the delivery of biologically active proteins into mammalian cells

The development of peptide drugs and therapeutic proteins is limited by the poor permeability and the selectivity of the cell membrane. There is a growing effort to circumvent these problems by designing strategies to deliver full-length proteins into a large number of cells. A series of small protein domains, termed protein transduction domains (PTDs), have been shown to cross biological membranes efficiently and independently of transporters or specific receptors, and to promote the delivery of peptides and proteins into cells. TAT protein from human immunodeficiency virus (HIV-1) is able to deliver biologically active proteins in vivo and has been shown to be of considerable interest for protein therapeutics. Similarly, the third alpha-helix of Antennapedia homeodomain, and VP22 protein from herpes simplex virus promote the delivery of covalently linked peptides or proteins into cells. However, these PTD vectors display a certain number of limitations in that they all require crosslinking to the target peptide or protein. Moreover, protein transduction using PTD-TAT fusion protein systems may require denaturation of the protein before delivery to increase the accessibility of the TAT-PTD domain. This requirement introduces an additional delay between the time of delivery and intracellular activation of the protein. In this report, we propose a new strategy for protein delivery based on a short amphipathic peptide carrier, Pep-1. This peptide carrier is able to efficiently deliver a variety of peptides and proteins into several cell lines in a fully biologically active form, without the need for prior chemical covalent coupling or denaturation steps. In addition, this peptide carrier presents several advantages for protein therapy, including stability in physiological buffer, lack of toxicity, and lack of sensitivity to serum. Pep-1 technology should be extremely useful for targeting specific protein-protein interactions in living cells and for screening novel therapeutic proteins.

Association of incident Alzheimer disease and blood pressure measured from 13 years before to 2 years after diagnosis in a large community study

BACKGROUND

It is uncertain whether high blood pressure increases the risk of developing Alzheimer disease (AD).

OBJECTIVE

To examine the association between incident AD and blood pressure measured up to 13 years before diagnosis.

DESIGN

Longitudinal cohort study conducted from 1982 to 1988, with blood pressure measured every 3 years in home interviews, and in 1973 for a portion (60%) of the sample.

SETTING

Community of East Boston, Mass.

PARTICIPANTS

Six hundred thirty-four subjects 65 years or older and without AD were selected as a stratified random sample of participants of the East Boston Established Populations for Epidemiologic Studies of the Elderly.

MAIN OUTCOME MEASURE

Alzheimer disease was diagnosed by a neurologist using a structured clinical evaluation.

RESULTS

High blood pressure was not associated with an increased risk of AD in logistic regression models adjusted for age, sex, and level of education. There was no association with systolic pressure measured 13 years before diagnosis (odds ratio = 1.03/10 mm Hg; 95% confidence interval, 0.80-1.32) and an inverse association with systolic pressure measured 4 years before diagnosis (odds ratio = 0.82/10 mm Hg; 95% confidence interval, 0.72-0.95). Associations for diastolic pressure were in the same direction as those for systolic pressure except with wider confidence intervals. The odds ratios were not materially different with further adjustment for cardiovascular risk factors and diseases.

CONCLUSION

In this large community study, high blood pressure was not associated with an increased risk of AD.