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Results From the Framingham Heart Study

Thomas M. van Himbergen, PhD; Alexa S. Beiser, PhD; Masumi Ai, MD; Sudha Seshadri, MD; Seiko Otokozawa, MT; Rhoda Au, PhD; Nuntakorn Thongtang, MD; Philip A. Wolf, MD; Ernst J. Schaefer, MD

Arch Neurol. Published online January 2, 2012. doi:10.1001/archneurol.2011.670

Objective  To investigate the contribution of biomarkers of glucose homeostasis (adiponectin, glucose, glycated albumin, and insulin levels) and inflammation (high-sensitivity C-reactive protein and lipoprotein-associated phospholipase A₂ levels) to the risk of developing Alzheimer disease (AD) and all-cause dementia.

Design  Prospective cohort study.

Setting  Dementia-free Framingham Heart Study participants had sera measured for these biomarkers at the 19th biennial examination (1985-1988) and were followed up prospectively for the development of AD and all-cause dementia.

Participants  Eight hundred forty (541 women, median age of 76 years) subjects participated in the study.

Main Outcome Measures  We used sex-pooled and sex-specific multivariable Cox proportional hazards models adjusted for age, education, body mass index, recent change in weight, APOE 4 allele status, and plasma docosahexaenoic acid levels to determine association of these biomarkers with the development of all-cause dementia and AD.

Results  Over a mean follow-up period of 13 years, 159 persons developed dementia (including 125 with AD). After adjustment for other risk factors, only adiponectin in women was associated with an increased risk of all-cause dementia (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.00-1.66; P = .054) and AD (HR, 1.33; 95% CI, 1.00-1.76; P = .050) per 1-SD increase in adiponectin level. Women with baseline adiponectin values more than the median had a higher risk of all-cause dementia (HR, 1.63; 95% CI, 1.03-2.56; P = .04) and AD (HR, 1.87; 95% CI, 1.13-3.10; P = .01) as compared with those with values less than the median.

Conclusion  In women, increased plasma adiponectin levels are an independent risk factor for the development of both all-cause dementia and AD.

Author Affiliations: Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging, Tufts University (Drs Van Himbergen, Ai, Thongtang, and Schaefer and Ms Otokozawa), Department of Neurology, School of Medicine (Drs Beiser, Seshadri, Au, and Wolf), and Department of Biostatistics, School of Public Health (Dr Beiser), Boston University, and the National Heart, Lung, and Blood Institute Framingham Heart Study (Drs Beiser, Seshadri, Au, and Wolf), Boston, Massachusetts.

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