Poster Presentations P3 S465

P3-054 HIPPOCAMPAL SCLEROSIS IN THE POPULATION:

REPRESENTATIVE ADULT CHANGES IN

THOUGHT STUDY—PREVALENCE AND

RELATIONSHIP TO OTHER COMMON

NEUROPATHOLOGIES OF AGING

Michelle Christopher1, Eric B. Larson2, Thomas J. Montine1,

Joshua A. Sonnen1, 1University of Washington School of Medicine, Seattle,WA, USA; 2Group Health Research Institute, Seattle, WA, USA.

Contact e-mail: msc1@uw.edu

Background: 85% of the population-attributable risk of dementia in the

Adult Changes in Thought (ACT) study cohort was due to 3 common neu-

ropathologies: Alzheimer’s disease (45%), microvascular ischemic injury

(30%) disease and Lewy body disease (10%). Hippocampal sclerosis (HS)

is a less common neuropathology thought to underlie age-related cognitive

impairment and dementia. It has been suggested that HS is related to other

pathologic processes, specifically Alzheimer’s disease or vascular disease.

Our objective was to determine the prevalence of HS within our autopsy

cohort and determine whether HS correlated with other neuropathologies.

Methods: 323 consecutive autopsy cases from ACT, an ongoing, commu-

nity-based, longitudinal study of brain aging and cognitive decline, were

evaluated. Subjects were ACT participants 65 years or older who were cog-

nitively intact at the time of enrollment in the Group Health Cooperative in

King County, Washington. Hippocampi were sampled in the coronal plane at

the level of the uncus and the lateral geniculate body. Sections were stained

with Hematoxylin & Eosin - Luxol fast blue stained and evaluated by a board

certified Neuropathologist. HS was defined as marked neuronal loss and glio-

sis in the CA-1 region and subiculum of the hippocampus. The sample set

was evaluated for associations between clinical diagnosis of dementia and

multiple neuropathological findings using pairwise correlation analysis.

Results: Complete neuropathologic evaluations were available on 309 cases.

Of these cases, there were 14 (4.5%) with complete HS. 6 individuals with

HS were clinically diagnosed with dementia. Clinical dementia status was

not significantly correlated with postmortem pathologically diagnosed HS.

7 of the cases with HS occurred in the setting of Braak stage V or VI. HS cor-

related with high Braak stage (p> 0.05), but not with any other neuropathol-

ogy. Conclusions: Complete HS was relatively rare in our cohort, but

occurred in the setting of high Braak stage more often than would be pre-

dicted by chance alone. HS was not a strong correlate of dementia. These

findings suggest that HS may be related to Alzheimer’s disease, but appears

to insufficient by itself to cause clinical dementia.

P3-055 INCIDENCE OF DEMENTIA IN ELDERLY

PARKINSON’S DISEASE: A 15-YEAR POPULATION-

BASED COHORT STUDY

Francois Tison1, Catherine Helmer2, Florian Perez1, Sophie Auriacombe3,

Jean-Francois Dartigues4, 1University Hospital of Bordeaux, Pessac,France; 2University of Bordeaux, ISPED, Bordeaux, France; 3University

Hospital of Bordeaux, CMRR, Bordeaux, France; 4University Bordeaux,

ISPED, Bordeaux, France. Contact e-mail: francois.tison@chu-bordeaux.fr

Background: Dementia associated with Parkinson’s disease (PD) is one of

the most common cause of dementia in the elderly after Alzheimer’s disea-

se.We provide new data on the incidence and relative risk of dementia in in-

cident cases of (PD) detected in a population-based cohort of subjects aged

older than 65. Methods: Repetitive systematic screening of dementia

(DSM-IIIR criteria) and incident PD cases (UKPDSBB criteria) in a 15-

year prospective population-based elderly cohort study in South-Western

France (PAQUID). Results: 2991 subjects without any prevalent parkinson-

ism were followed at least once over 15 years. 144 incident cases of parkin-

sonism were detected, among those 44 were diagnosed with PD (24 females,

mean age at 76.7 6 5.6 y, mean follow-up 6.8 6 3.6 y). We diagnosed 18

(41%) cases of incident dementia using DSM-III-R criteria. The mean age

at dementia diagnosis was 82.4 6 4,5 y, with a median delay of 5.15 years

since PD diagnosis. Incidence rate of dementia in PD was 74 in 1000

patient-years. The relative risk for developing dementia in PD compared to

non-PD subjects was 3,34 [1,96-4]95%CI. Conclusions: The incidence

found of dementia in elederly PD falls within the range of previous reported

figures (30-112/1000/year). We found a more than 3 fold relative risk of de-

veloping dementia in PD compared to non PD elderly subjects aged > 65.

We confirm the risk found in other studies with a high level of accuracy

thanks to the inclusion of incident PD cases detected in unbiased and unse-

lected population.

P3-056 THE RISK OF DEMENTIA BY SLEEP

DISTURBANCES, HYPERTENSION, DIABETES,

AND BODY MASS INDEX (BMI) IN GENERAL

ELDERLY POPULATION OF COMMUNITY

Hun-Jeong Eun, Jesus Hospital, Jeon-Ju, Korea. Contact e-mail: pmcnp96

@paran.com

Background: Some dementia risk factors can be treated or controlled and

some cannot. Also, certain risk factors are more likely to increase the risk

for certain types of dementia.The prevention of dementia through and man-

agement of risk factors is of public health importance because of the growth

in the elderly population. This study aims to differentiate the relationship

among age, sex, types of sleep disturbances, hypertension, diabetes, and

BMI as potential risk factors of dementia. Methods: We randomly recruited

and interviewed 59 elderly persons over 65 years old as volunteers in general

population of a middle sized city in Korea. We collected data about demo-

graphic features(sex, age, hypertension, diabetes), Global Assessment Sleep

Questionnaires(GASQ), Snoring Index Epworth Sleepiness Scale. GASQ

composed of 11 items Also we measured cognitive functions by mini-mental

status examination and body mass index by BMI calculator. Independent var-

iable is cognition level by MMSE and dependent variables are Age, sex,

sleep disturbances(GASQ11, SI, ESS), hypertension, diabetes, and BMI

data. Statistical analyses were done by SPSS 12.0 for Window. Multiple re-

gression analyses for hypothesis testing and correlation analyses were done.

Results: 59 elderly volunteers were composed of 31 men and 29 women hav-

ing mean age 73.34 6 6.205. Men show mean scores of 25.74 6 3.966 and

women 24.58 6 4.671 in MMSE. Mean scores of MMSE in all volunteers

was 25.19 6 4.317. Mean scores of MMSE of all volunteers in BMI showed

25.19 6 4.317. Correlation analyses applying pearson correlation coefficient

showed statistical significances among each variables(age, sex, GSAQ11,

HPT, diabetes, BMI) p < 0.001). Multiple regression analyses showed R

0.789, R square 0.622(62.2%), F ¼ 3.562, p ¼ 0.000. IS and SI showed

strongly significant meanings(p ¼ 0.002, p ¼ 0.005) in regression analyses.

Standardized beta coefficient showed the highest value of 0.586 as absolute

one in excessive daytime sleepiness(p ¼ 0.005). Conclusions: This study

showed some relationships among cognition and sleep factors including

insomnia, snoring, and excessive daytime sleep in elderly persons of commu-

nity. Also, recruited elderly population showed relatively low cognition level

with the growth in this study. And this study showed sgnificantly many cor-

relations between cognition and sleep problem factors as risk factors of

dementia. Therefore sleep disturbances as risk factors of dementia have clin-

ically significant.

P3-057 PREVALENCE OF DEMENTIA IN ZARIA,

NORTHWESTERN NIGERIA: RELATIONSHIP TO

AGE, GENDER, EDUCATION, AND LABORATORY

TEST

Johnbull S. Ogboi1, Ademola Adeleye1, Reginald Obiakor2, Kabir Sabitu1,1Ahmadu Bello University, Zaria, Nigeria; 2Ahmadu Bello University

Teaching Hospital, Zaria, Nigeria. Contact e-mail: ogboijb@yahoo.com

Background: Dementia has become a public health problem in Nigeria due

to the increase in elderly populations and lifestyle modifications leading to

loss of productive life and disability. The prevalence of dementia and its re-

lationship in northern Nigeria are unknown.The aim of the study is to

Poster Presentations P3S466

estimate the prevalence of dementia and its clinical subtypes among north-

erners aged 55 years or older and to examine associations with age, gender,

and laboratory test. Methods: A simple cross-sectional descriptive study was

carried out in Medicine department, Ahmadu Bello university teaching hos-

pital, Zaria, Kaduna Nigeria. Of 147 people screened with a vernacular adap-

tation of the Mini-Mental State Examination (MMSE), all those scoring at or

below the cut-off of 23 were further evaluated. Diagnostic laboratory test in-

vestigations were employed to analyze serum samples tested for HIV anti-

bodies using two sequential rapid HIV tests and one ELISA confirmatory

test kit as recommended by the Nigerian Federal Ministry of Health series

algorithm for rapid HIV testing. Results: A total of 147 patients were

screened with the vernacular adaptation of MMSE comprising of 82%

male and 18 female with a mean age of 62.2 6 4.4. The prevalence of demen-

tia was 34.1%.The condition was early(mild) in 24.5%, middle(moderate) in

68%, and late(severe) in 7.5%.Of the subjects with dementia, 32% had vas-

cular dementia, 1.4% had AIDS-related dementia, and 0.7% had senile

dementia. Age and low education was significantly associated with dementia.

Conclusions: The prevalence of dementia among study group was high and

dementia is an important health problem of the elderly population with intel-

lectual disability. Age and low education are strongly associated with demen-

tia. Identification of risk factors points towards the possibility of prevention

P3-058 POPULATION HISTORY, STARVATION AND

ALZHEIMER’S DISEASE

Amalia G. Diaconeasa1,2, Luiza Spiru2, Ileana Turcu3, 1Qeme Proiect,

Bucharest, Romania; 2‘‘Ana Aslan’’ International Academy of Aging,

Bucharest, Romania; 3Ana Aslan International Academy of Aging, Bu-

charest, Romania. Contact e-mail: ama99dia@gmail.com

Background: There are some hypothesis that link type II diabetes incidence

with the starvation or particular food habits in a population history. Popula-

tions exposed earlier to agriculture (e.g, Europeans), i.e, to a diet rich in car-

bohydrates for a longer time, have a lower incidence of this disease as

compared to the populations that began to practice agriculture later (e.g.,

Pima). Taking into account that cholesterol is an important metabolite, espe-

cially for the brain and during the development, and that the normal cells’

capacity of synthesizing cholesterol is altered during starvation, it can be pre-

dicted that the genes able to maintain a higher cholesterol level during starva-

tion are positively selected and their incidence should be higher in the

populations with a longer history of starvation. The variant e4 (ApoE4) of

the apolipoprotein ApoE, associated with a higher LDL level, could play

such a role. On the other side, a higher cholesterol level, associated or not

to e4 genotype is a risk factor for Alzheimer’s disease. Methods: In order

to test the hypothesis above, the average cholesterol level and the relative

ApoE frequency in different human population were compared based on

the meta-analysis of certain data reported in the literature. Results: The inci-

dence of e4 variant varies between 10-20% in general, being higher in the

Asian and African aborigenes, 25-45%. This variant is very rare in the Eskimo

populations. On the other hand, the variant e2, associated with a low incidence

of Alzheimer’s disease and a low LDL, is almost absent in some Asian and

African populations. An interesting aspect is that the frequency of the

ApoE4 allele is 10-15% in southern European populations, but raises to 40-

50% in northern Europe. Conclusions: The data suggest that the populations

that had no stability in the food supplies or had a diet poor in lipids tend to have

a higher frequency of the allele e4. Alzheimer’s disease could result from an

antagonistic pleiotropy, the genes involved in this risk being advantageous

some time, but they become deleterious later in life, when escaping the selec-

tion. This conclusion can conduct to therapeutic and prevention strategies.

P3-059 WEIGHT VARIATION IN MIDLIFE IS ASSOCIATED

WITH INCREASED RISK OF DEMENTIA THREE

DECADES LATER

Uri Goldbourt1, Michal Schnaider-Beeri2, 1Tel Aviv University, Tel Aviv,

Israel; 2Mount Sinai School of Medicine, New York City, NY, USA.Contact e-mail: michal.berri@mssm.edu

Background: Measures of overweight and obesity have been implicated

in the epidemiology of vascular disease. Whether mid-life weight and its

variance are associated with declining cognitive function remains largely

unknown. Methods: We studied the association between body weight

variability resulting form 3 successive weight recordings, taken from

10,000 tenured civil servants and municipal employee males, aged 40-

65 years in 1963, and the prevalence of dementia 36-37 years later.

This was examined in approximately one sixth of them, who survived

until 1999/2000 (minimum age 76 years) and underwent an evaluation

of their cognitive status using screening by the Telephone Interview

for Cognitive Status-modified and established dementia assessment tools.

Weight variation was defined as the between-exam SD, representing

weight variation over three examinations in 1963, 1965 and 1968. Re-

sults: We could not trace a pattern of increasing or declining late-life

dementia prevalence among surviving men with ‘‘lean’’ (BMI<20 Kg/

sqM, 23.6%), ‘‘desirable’’ weight (BMI ¼ 20 to 24.99 Kg/sqM,

17.7%), overweight (25-29.99 Kg/sqM, 17.6%) and obese counterparts

(BMI> ¼ 30kd/sqM, 23.0%), p ¼ 0.42. Survivors’ dementia prevalence

rates in quartiles of weight variation, however, based on 4863 measure-

ments in 1621 survivors who had participated in all three exams, yielded

prevalence rates of 13.4, 18.3, 20.1 and 19.2% in the first to fourth quar-

tiles, respectively (Z ¼ 2.12, p ¼ 0.034 in non-parametric trend test).

Multivariate analysis of odds ratios associated with each of the quartiles

of weight variation adjusted for diabetes mellitus, body height and socio-

economic status. The adjusted odds were 1.42, 1.59 and 1.74, respec-

tively, for quartiles 2, 3 and 4. A trend test for these rates yielded

z ¼ 2.17, p ¼ 0.032. Additional adjustment for initial (1963) weight,

blood pressure, serum cholesterol and smoking habits had a negligible

effect on the results. The area under the ROC curve for this model

was 0.73 and the Hosmer-Lemeshow model fit test yielded chi2 (8) ¼6.77 (associated P ¼ 0.56), consistent with adequate model fit. Conclu-

sions: This is, to our knowledge, the first study indicating that smaller

late-life dementia prevalence is associated importantly with small mid-

life weight variation. Mechanisms linking weight instability at mid-life

etiologically to increased risk for dementia remain unknown. The

presented association marks a research topic with putatively long-term

public health interest.

P3-060 CAROTID ARTERY ATHEROSCLEROSIS IS

ASSOCIATED WITH ALZHEIMER DISEASE AND

VASCULAR DEMENTIA: A POSTMORTEM STUDY

Claudia K. Suemoto1, Lea T. Grinberg2, Renata E. L. Ferretti3,

Paulo R. Menezes4, Jose M. Farfel1, Renata E. P. Leite5, Katia C. Oliveira5,

Edilaine Tampellini5, Wilson Jacob-Filho1, Ricardo Nitrini6,

Carlos A. Pasqualucci5 Brazilian Aging Brain Study Group 1Department of

Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil;2Memory and Aging Center, Department of Neurology, UCSF, San Fran-cisco, CA, USA; 3Department of Geriatric, University of Sao Paulo Medical

School, Sao Paulo, Brazil; 4Department of Preventive Medicine, University

of Sao Paulo Medical School, Sao Paulo, Brazil; 5Department of Pathology,

University of Sao Paulo Medical School, Sao Paulo, Brazil; 6Department ofNeurology, University of Sao Paulo Medical School, Sao Paulo, Brazil.

Contact e-mail: cksuemoto@usp.br

Background: In the last decade, evidence has shown cardiovascular dis-

ease to be associated with Alzheimer’s disease (AD) and vascular demen-

tia (VaD). Cerebral hypoperfusion has been implicated as a possible

mechanism explaining these associations. Carotid artery atherosclerosis

may be a marker of dementia-associated hypoperfusion.Objective: To in-

vestigate the relationship between pathologically-proven carotid artery

atherosclerosis and the presence of AD and VaD, confirmed by neuropath-

ological examination. Methods: 249 autopsy-verified subjects older than

50 years of age, drawn from the Brain Bank of the BABSG, were submit-

ted to neuropathological examination using immunohistochemistry. The

diagnoses were AD (n ¼ 43), VaD (n ¼ 42) and controls (n ¼ 164).