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Risk factors for Alzheimer's disease: a prospective analysis from the Canadian Study of Health and Aging
Lindsay J, Laurin D, Verreault R, Hébert R, Helliwell B, Hill GB, McDowell I.. American journal of epidemiology, 2002-09-01
Topic: Amyloid, tau and blood-test diagnosis
A prospective analysis of risk factors for Alzheimer's disease was a major objective of the Canadian Study of Health and Aging, a nationwide, population-based study. Of 6,434 eligible subjects aged 65 years or older in 1991, 4,615 were alive in 1996 and participated in the follow-up study. All participants were cognitively normal in 1991 when they completed a risk factor questionnaire. Their cognitive status was reassessed 5 years later by using a similar two-phase procedure, including a screening interview, followed by a clinical examination when indicated. The analysis included 194 Alzheimer's disease cases and 3,894 cognitively normal controls. Increasing age, fewer years of education, and the apolipoprotein E epsilon4 allele were significantly associated with increased risk of Alzheimer's disease. Use of nonsteroidal anti-inflammatory drugs, wine consumption, coffee consumption, and regular physical activity were associated with a reduced risk of Alzheimer's disease. No statistically significant association was found for family history of dementia, sex, history of depression, estrogen replacement therapy, head trauma, antiperspirant or antacid use, smoking, high blood pressure, heart disease, or stroke. The protective associations warrant further study. In particular, regular physical activity could be an important component of a preventive strategy against Alzheimer's disease and many other conditions.
Key findings
- Increasing age, fewer years of education, and the apolipoprotein E epsilon4 allele were significantly associated with increased risk of Alzheimer's disease.
- Use of nonsteroidal anti-inflammatory drugs, wine consumption, coffee consumption, and regular physical activity were associated with a reduced risk of Alzheimer's disease.
- No statistically significant association was found for family history of dementia, sex, history of depression, estrogen replacement therapy, head trauma, antiperspirant or antacid use, smoking, high blood pressure, heart disease, or stroke.
Why it matters
In this Canadian population study, people aged 65 or older who were cognitively normal in 1991 were reassessed five years later; comparing 194 who had developed Alzheimer's disease with 3,894 who stayed cognitively normal, older age, fewer years of education and the APOE ε4 allele were linked to higher risk, while reported NSAID use, wine, coffee and regular physical activity were linked to lower risk. Family history, sex, depression, estrogen replacement, head trauma, smoking, high blood pressure, heart disease and stroke showed no statistically significant association. These are observational associations reported without effect sizes here; the authors say the protective ones "warrant further study" and that regular physical activity "could be" part of a preventive strategy.
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Study details
- Participants194
- Evidence strengthLow
How this study scored 56/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (American journal of epidemiology) |
| Journal's citation record | 3 / 4 | American Journal of Epidemiology: journal h-index 416 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2002 — older than 20 years, still counted |
| Sample size | 2 / 4 | 194 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,260 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 48.5 citations a year over 26 year(s) since 2002 |
| Impact for its field and year | 5 / 6 | Cited 24.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 58 other studies in this library |
| Still being cited | 2 / 4 | Cited 47 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Joan Lindsay: h-index 31 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Ottawa: institution h-index 908 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12196314) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 56 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Lindsay, J., Laurin, D., Verreault, R., Hébert, R., Helliwell, B., Hill, G. B., et al. (2002). Risk factors for Alzheimer's disease: a prospective analysis from the Canadian Study of Health and Aging. American journal of epidemiology. https://doi.org/10.1093/aje/kwf074
Vancouver
Lindsay J, Laurin D, Verreault R, Hébert R, Helliwell B, Hill GB, et al. Risk factors for Alzheimer's disease: a prospective analysis from the Canadian Study of Health and Aging. American journal of epidemiology. 2002. doi:10.1093/aje/kwf074. PMID: 12196314.
BibTeX
@article{lindsay2002-12196314,
author = {Lindsay, J. and Laurin, D. and Verreault, R. and Hébert, R. and Helliwell, B. and Hill, G. B. and McDowell, I.},
title = {{Risk factors for Alzheimer's disease: a prospective analysis from the Canadian Study of Health and Aging}},
journal = {American journal of epidemiology},
year = {2002},
doi = {10.1093/aje/kwf074},
pmid = {12196314},
url = {https://doi.org/10.1093/aje/kwf074}
}
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