Do risk factors for Alzheimer's disease predict dementia in Parkinson's disease? An exploratory study
Identifieur interne : 000C18 ( Main/Corpus ); précédent : 000C17; suivant : 000C19Do risk factors for Alzheimer's disease predict dementia in Parkinson's disease? An exploratory study
Auteurs : Gilberto Levy ; Ming-Xin Tang ; Lucien J. Cote ; Elan D. Louis ; Brenda Alfaro ; Helen Mejia ; Yaakov Stern ; Karen MarderSource :
- Movement Disorders [ 0885-3185 ] ; 2002-03.
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Abstract
The extent to which concomitant Alzheimer's disease (AD) is etiologically related to the development of dementia in Parkinson's disease (PD) remains controversial. We explored the association of four risk factors associated with AD, including head injury, smoking, hypertension, and diabetes mellitus, with incident dementia in PD. A cohort of 180 nondemented PD patients from the Washington Heights community in northern Manhattan, New York, completed a risk factor questionnaire at baseline and was followed annually with neurological and neuropsychological evaluations. The association of baseline variables with incident dementia was analyzed by using Cox proportional hazards models. All analyses controlled for age at baseline, gender, years of education, duration of PD, and total Unified Parkinson's Disease Rating Scale (UPDRS) motor score at baseline. Of 180 patients (mean age, 71.0 ± 10.3 years), 52 (29%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. Head injury risk ratio ([RR] 0.9; 95% confidence interval [CI], 0.4–2.2; P = 0.9), hypertension (RR, 0.7; 95% CI, 0.4–1.4, P = 0.3), and diabetes mellitus (RR, 0.8; 95% CI, 0.3–2.3; P = 0.7) were not significantly associated with incident dementia in the Cox models. Patients who reported having ever smoked were at increased risk for the development of dementia compared with nonsmokers (RR, 2.0; 95% CI, 1.0–3.9; P = 0.05). Current smoking was significantly associated with incident dementia (RR, 4.5; 95% CI, 1.2–16.4; P = 0.02), whereas past smoking approached significance (RR, 1.9; 95% CI, 0.9–3.7; P = 0.07). Although an inverse association between smoking and PD has been reported in several studies, our study showed a positive association between smoking and dementia in the setting of PD. The association of smoking with incident dementia in PD deserves further study. © 2002 Movement Disorder Society.
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DOI: 10.1002/mds.10086
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An exploratory study</title><author><name sortKey="Levy, Gilberto" sort="Levy, Gilberto" uniqKey="Levy G" first="Gilberto" last="Levy">Gilberto Levy</name><affiliation><mods:affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Tang, Ming In" sort="Tang, Ming In" uniqKey="Tang M" first="Ming-Xin" last="Tang">Ming-Xin Tang</name><affiliation><mods:affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Biostatistics, School of Public Health, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Cote, Lucien J" sort="Cote, Lucien J" uniqKey="Cote L" first="Lucien J." last="Cote">Lucien J. Cote</name><affiliation><mods:affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Louis, Elan D" sort="Louis, Elan D" uniqKey="Louis E" first="Elan D." last="Louis">Elan D. Louis</name><affiliation><mods:affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Alfaro, Brenda" sort="Alfaro, Brenda" uniqKey="Alfaro B" first="Brenda" last="Alfaro">Brenda Alfaro</name><affiliation><mods:affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Mejia, Helen" sort="Mejia, Helen" uniqKey="Mejia H" first="Helen" last="Mejia">Helen Mejia</name><affiliation><mods:affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Stern, Yaakov" sort="Stern, Yaakov" uniqKey="Stern Y" first="Yaakov" last="Stern">Yaakov Stern</name><affiliation><mods:affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Marder, Karen" sort="Marder, Karen" uniqKey="Marder K" first="Karen" last="Marder">Karen Marder</name><affiliation><mods:affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-03">2002-03</date><biblScope unit="volume">17</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="250">250</biblScope><biblScope unit="page" to="257">257</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">3A9AC214D9F59646B5C6D7A2E94EAEC6D9313F1A</idno><idno type="DOI">10.1002/mds.10086</idno><idno type="ArticleID">MDS10086</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>dementia</term><term>epidemiology</term><term>smoking</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The extent to which concomitant Alzheimer's disease (AD) is etiologically related to the development of dementia in Parkinson's disease (PD) remains controversial. We explored the association of four risk factors associated with AD, including head injury, smoking, hypertension, and diabetes mellitus, with incident dementia in PD. A cohort of 180 nondemented PD patients from the Washington Heights community in northern Manhattan, New York, completed a risk factor questionnaire at baseline and was followed annually with neurological and neuropsychological evaluations. The association of baseline variables with incident dementia was analyzed by using Cox proportional hazards models. All analyses controlled for age at baseline, gender, years of education, duration of PD, and total Unified Parkinson's Disease Rating Scale (UPDRS) motor score at baseline. Of 180 patients (mean age, 71.0 ± 10.3 years), 52 (29%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. Head injury risk ratio ([RR] 0.9; 95% confidence interval [CI], 0.4–2.2; P = 0.9), hypertension (RR, 0.7; 95% CI, 0.4–1.4, P = 0.3), and diabetes mellitus (RR, 0.8; 95% CI, 0.3–2.3; P = 0.7) were not significantly associated with incident dementia in the Cox models. Patients who reported having ever smoked were at increased risk for the development of dementia compared with nonsmokers (RR, 2.0; 95% CI, 1.0–3.9; P = 0.05). Current smoking was significantly associated with incident dementia (RR, 4.5; 95% CI, 1.2–16.4; P = 0.02), whereas past smoking approached significance (RR, 1.9; 95% CI, 0.9–3.7; P = 0.07). Although an inverse association between smoking and PD has been reported in several studies, our study showed a positive association between smoking and dementia in the setting of PD. The association of smoking with incident dementia in PD deserves further study. © 2002 Movement Disorder Society.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Gilberto Levy MD</name><affiliations><json:string>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Ming‐Xin Tang PhD</name><affiliations><json:string>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>Division of Biostatistics, School of Public Health, Columbia University, New York, New York, USA</json:string><json:string>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Lucien J. Cote MD</name><affiliations><json:string>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Elan D. Louis MD, MS</name><affiliations><json:string>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Brenda Alfaro MA</name><affiliations><json:string>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Helen Mejia MA</name><affiliations><json:string>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Yaakov Stern PhD</name><affiliations><json:string>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Karen Marder MD, MPH</name><affiliations><json:string>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dementia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>epidemiology</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>smoking</value></json:item></subject><articleId><json:string>MDS10086</json:string></articleId><language><json:string>eng</json:string></language><abstract>The extent to which concomitant Alzheimer's disease (AD) is etiologically related to the development of dementia in Parkinson's disease (PD) remains controversial. We explored the association of four risk factors associated with AD, including head injury, smoking, hypertension, and diabetes mellitus, with incident dementia in PD. A cohort of 180 nondemented PD patients from the Washington Heights community in northern Manhattan, New York, completed a risk factor questionnaire at baseline and was followed annually with neurological and neuropsychological evaluations. The association of baseline variables with incident dementia was analyzed by using Cox proportional hazards models. All analyses controlled for age at baseline, gender, years of education, duration of PD, and total Unified Parkinson's Disease Rating Scale (UPDRS) motor score at baseline. Of 180 patients (mean age, 71.0 ± 10.3 years), 52 (29%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. Head injury risk ratio ([RR] 0.9; 95% confidence interval [CI], 0.4–2.2; P = 0.9), hypertension (RR, 0.7; 95% CI, 0.4–1.4, P = 0.3), and diabetes mellitus (RR, 0.8; 95% CI, 0.3–2.3; P = 0.7) were not significantly associated with incident dementia in the Cox models. Patients who reported having ever smoked were at increased risk for the development of dementia compared with nonsmokers (RR, 2.0; 95% CI, 1.0–3.9; P = 0.05). Current smoking was significantly associated with incident dementia (RR, 4.5; 95% CI, 1.2–16.4; P = 0.02), whereas past smoking approached significance (RR, 1.9; 95% CI, 0.9–3.7; P = 0.07). Although an inverse association between smoking and PD has been reported in several studies, our study showed a positive association between smoking and dementia in the setting of PD. The association of smoking with incident dementia in PD deserves further study. © 2002 Movement Disorder Society.</abstract><qualityIndicators><score>8.5</score><pdfVersion>1.4</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1898</abstractCharCount><pdfWordCount>5483</pdfWordCount><pdfCharCount>35433</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>290</abstractWordCount></qualityIndicators><title>Do risk factors for Alzheimer's disease predict dementia in Parkinson's disease? 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Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Division of Biostatistics, School of Public Health, Columbia University, New York, New York, USA</affiliation><affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</affiliation></author><author><persName><forename type="first">Lucien J.</forename><surname>Cote</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation></author><author><persName><forename type="first">Elan D.</forename><surname>Louis</surname></persName><roleName type="degree">MD, MS</roleName><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation></author><author><persName><forename type="first">Brenda</forename><surname>Alfaro</surname></persName><roleName type="degree">MA</roleName><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation></author><author><persName><forename type="first">Helen</forename><surname>Mejia</surname></persName><roleName type="degree">MA</roleName><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation></author><author><persName><forename type="first">Yaakov</forename><surname>Stern</surname></persName><roleName type="degree">PhD</roleName><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</affiliation></author><author><persName><forename type="first">Karen</forename><surname>Marder</surname></persName><roleName type="degree">MD, MPH</roleName><note type="correspondence"><p>Correspondence: G.H. Sergievsky Center, 630 West 168th Street, New York, New York, 10032</p></note><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-03"></date><biblScope unit="volume">17</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="250">250</biblScope><biblScope unit="page" to="257">257</biblScope></imprint></monogr><idno type="istex">3A9AC214D9F59646B5C6D7A2E94EAEC6D9313F1A</idno><idno type="DOI">10.1002/mds.10086</idno><idno type="ArticleID">MDS10086</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2002</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The extent to which concomitant Alzheimer's disease (AD) is etiologically related to the development of dementia in Parkinson's disease (PD) remains controversial. We explored the association of four risk factors associated with AD, including head injury, smoking, hypertension, and diabetes mellitus, with incident dementia in PD. A cohort of 180 nondemented PD patients from the Washington Heights community in northern Manhattan, New York, completed a risk factor questionnaire at baseline and was followed annually with neurological and neuropsychological evaluations. The association of baseline variables with incident dementia was analyzed by using Cox proportional hazards models. All analyses controlled for age at baseline, gender, years of education, duration of PD, and total Unified Parkinson's Disease Rating Scale (UPDRS) motor score at baseline. Of 180 patients (mean age, 71.0 ± 10.3 years), 52 (29%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. Head injury risk ratio ([RR] 0.9; 95% confidence interval [CI], 0.4–2.2; P = 0.9), hypertension (RR, 0.7; 95% CI, 0.4–1.4, P = 0.3), and diabetes mellitus (RR, 0.8; 95% CI, 0.3–2.3; P = 0.7) were not significantly associated with incident dementia in the Cox models. Patients who reported having ever smoked were at increased risk for the development of dementia compared with nonsmokers (RR, 2.0; 95% CI, 1.0–3.9; P = 0.05). Current smoking was significantly associated with incident dementia (RR, 4.5; 95% CI, 1.2–16.4; P = 0.02), whereas past smoking approached significance (RR, 1.9; 95% CI, 0.9–3.7; P = 0.07). Although an inverse association between smoking and PD has been reported in several studies, our study showed a positive association between smoking and dementia in the setting of PD. The association of smoking with incident dementia in PD deserves further study. © 2002 Movement Disorder Society.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>dementia</term></item><item><term>epidemiology</term></item><item><term>smoking</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2001-03-22">Received</change><change when="2001-08-21">Registration</change><change when="2002-03">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/3A9AC214D9F59646B5C6D7A2E94EAEC6D9313F1A/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>New York</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="20"><doi origin="wiley" registered="yes">10.1002/mds.v17:2</doi><numberingGroup><numbering type="journalVolume" number="17">17</numbering><numbering type="journalIssue">2</numbering></numberingGroup><coverDate startDate="2002-03">March/April 2002</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="40" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.10086</doi><idGroup><id type="unit" value="MDS10086"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Article</title></titleGroup><copyright ownership="thirdParty">Copyright © 2002 Movement Disorders Society</copyright><eventGroup><event type="manuscriptReceived" date="2001-03-22"></event><event type="manuscriptRevised" date="2001-08-08"></event><event type="manuscriptAccepted" date="2001-08-21"></event><event type="publishedOnlineEarlyUnpaginated" date="2002-02-06"></event><event type="firstOnline" date="2002-02-06"></event><event type="publishedOnlineFinalForm" date="2002-03-18"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-09"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">250</numbering><numbering type="pageLast">257</numbering></numberingGroup><correspondenceTo>G.H. Sergievsky Center, 630 West 168th Street, New York, New York, 10032</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS10086.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="59"></count><count type="wordTotal" number="5231"></count></countGroup><titleGroup><title type="main" xml:lang="en">Do risk factors for Alzheimer's disease predict dementia in Parkinson's disease? An exploratory study</title><title type="short" xml:lang="en">Risk Factors for Parkinson's Disease Dementia</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Gilberto</givenNames><familyName>Levy</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1 #af4 #af5"><personName><givenNames>Ming‐Xin</givenNames><familyName>Tang</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Lucien J.</givenNames><familyName>Cote</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Elan D.</givenNames><familyName>Louis</familyName><degrees>MD, MS</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Brenda</givenNames><familyName>Alfaro</familyName><degrees>MA</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Helen</givenNames><familyName>Mejia</familyName><degrees>MA</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1 #af2 #af3 #af5"><personName><givenNames>Yaakov</givenNames><familyName>Stern</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1 #af2 #af5" corresponding="yes"><personName><givenNames>Karen</givenNames><familyName>Marder</familyName><degrees>MD, MPH</degrees></personName><contactDetails><email>marderk@sergievsky.cpmc.columbia.edu</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="US" type="organization"><unparsedAffiliation>Division of Biostatistics, School of Public Health, Columbia University, New York, New York, USA</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="US" type="organization"><unparsedAffiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">dementia</keyword><keyword xml:id="kwd3">epidemiology</keyword><keyword xml:id="kwd4">smoking</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>The extent to which concomitant Alzheimer's disease (AD) is etiologically related to the development of dementia in Parkinson's disease (PD) remains controversial. We explored the association of four risk factors associated with AD, including head injury, smoking, hypertension, and diabetes mellitus, with incident dementia in PD. A cohort of 180 nondemented PD patients from the Washington Heights community in northern Manhattan, New York, completed a risk factor questionnaire at baseline and was followed annually with neurological and neuropsychological evaluations. The association of baseline variables with incident dementia was analyzed by using Cox proportional hazards models. All analyses controlled for age at baseline, gender, years of education, duration of PD, and total Unified Parkinson's Disease Rating Scale (UPDRS) motor score at baseline. Of 180 patients (mean age, 71.0 ± 10.3 years), 52 (29%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. Head injury risk ratio ([RR] 0.9; 95% confidence interval [CI], 0.4–2.2; <i>P</i> = 0.9), hypertension (RR, 0.7; 95% CI, 0.4–1.4, <i>P</i> = 0.3), and diabetes mellitus (RR, 0.8; 95% CI, 0.3–2.3; <i>P</i> = 0.7) were not significantly associated with incident dementia in the Cox models. Patients who reported having ever smoked were at increased risk for the development of dementia compared with nonsmokers (RR, 2.0; 95% CI, 1.0–3.9; <i>P</i> = 0.05). Current smoking was significantly associated with incident dementia (RR, 4.5; 95% CI, 1.2–16.4; <i>P</i> = 0.02), whereas past smoking approached significance (RR, 1.9; 95% CI, 0.9–3.7; <i>P</i> = 0.07). Although an inverse association between smoking and PD has been reported in several studies, our study showed a positive association between smoking and dementia in the setting of PD. The association of smoking with incident dementia in PD deserves further study. © 2002 Movement Disorder Society.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Do risk factors for Alzheimer's disease predict dementia in Parkinson's disease? An exploratory study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Risk Factors for Parkinson's Disease Dementia</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Do risk factors for Alzheimer's disease predict dementia in Parkinson's disease? An exploratory study</title></titleInfo><name type="personal"><namePart type="given">Gilberto</namePart><namePart type="family">Levy</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ming‐Xin</namePart><namePart type="family">Tang</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Division of Biostatistics, School of Public Health, Columbia University, New York, New York, USA</affiliation><affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lucien J.</namePart><namePart type="family">Cote</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elan D.</namePart><namePart type="family">Louis</namePart><namePart type="termsOfAddress">MD, MS</namePart><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Brenda</namePart><namePart type="family">Alfaro</namePart><namePart type="termsOfAddress">MA</namePart><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Helen</namePart><namePart type="family">Mejia</namePart><namePart type="termsOfAddress">MA</namePart><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yaakov</namePart><namePart type="family">Stern</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karen</namePart><namePart type="family">Marder</namePart><namePart type="termsOfAddress">MD, MPH</namePart><affiliation>Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, New York, USA</affiliation><description>Correspondence: G.H. Sergievsky Center, 630 West 168th Street, New York, New York, 10032</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">New York</placeTerm></place><dateIssued encoding="w3cdtf">2002-03</dateIssued><dateCaptured encoding="w3cdtf">2001-03-22</dateCaptured><dateValid encoding="w3cdtf">2001-08-21</dateValid><copyrightDate encoding="w3cdtf">2002</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="references">59</extent><extent unit="words">5231</extent></physicalDescription><abstract lang="en">The extent to which concomitant Alzheimer's disease (AD) is etiologically related to the development of dementia in Parkinson's disease (PD) remains controversial. We explored the association of four risk factors associated with AD, including head injury, smoking, hypertension, and diabetes mellitus, with incident dementia in PD. A cohort of 180 nondemented PD patients from the Washington Heights community in northern Manhattan, New York, completed a risk factor questionnaire at baseline and was followed annually with neurological and neuropsychological evaluations. The association of baseline variables with incident dementia was analyzed by using Cox proportional hazards models. All analyses controlled for age at baseline, gender, years of education, duration of PD, and total Unified Parkinson's Disease Rating Scale (UPDRS) motor score at baseline. Of 180 patients (mean age, 71.0 ± 10.3 years), 52 (29%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. Head injury risk ratio ([RR] 0.9; 95% confidence interval [CI], 0.4–2.2; P = 0.9), hypertension (RR, 0.7; 95% CI, 0.4–1.4, P = 0.3), and diabetes mellitus (RR, 0.8; 95% CI, 0.3–2.3; P = 0.7) were not significantly associated with incident dementia in the Cox models. Patients who reported having ever smoked were at increased risk for the development of dementia compared with nonsmokers (RR, 2.0; 95% CI, 1.0–3.9; P = 0.05). Current smoking was significantly associated with incident dementia (RR, 4.5; 95% CI, 1.2–16.4; P = 0.02), whereas past smoking approached significance (RR, 1.9; 95% CI, 0.9–3.7; P = 0.07). Although an inverse association between smoking and PD has been reported in several studies, our study showed a positive association between smoking and dementia in the setting of PD. The association of smoking with incident dementia in PD deserves further study. © 2002 Movement Disorder Society.</abstract><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>dementia</topic><topic>epidemiology</topic><topic>smoking</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. 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