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Risk factors for Alzheimer's disease and dementia: a case-control study based on the MRC elderly hypertension trial
Prince M, Cullen M, Mann A.. Neurology, 1994-01-01
Topic: Amyloid, tau and blood-test diagnosis
We surveyed 1,545 subjects--recruited into the UK Medical Research Council elderly hypertension treatment trial between 1982 and 1987--to detect incident cases of dementia, identifying 50 cases of dementia, including 31 cases of probable or possible Alzheimer's disease (AD). These we compared with 223 unimpaired, unmatched controls from the same population for exposure to familial, cardiovascular, educational, and geographic risk factors for dementia. Our study confirms the association of family history of dementia with dementia (odds ratio [OR] = 4.36) and AD (OR = 4.69), and of advanced age with dementia (OR = 2.81). Rural residence exerted a protective effect for dementia (OR = 0.21) and AD (OR = 0.28). We report near-significant associations between AD and dementia and several cardiovascular risk factors (ECG ischemia, systolic hypertension, and smoking) among subjects lacking a family history of dementia. We postulate the existence of a nonfamilial form of dementia transcending traditional categories of multi-infarct dementia and AD, more common among urban residents, and mediated through vascular pathology. Risk factors reported elsewhere but not confirmed in this study were advanced maternal age and winter season of birth.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Prince, M., Cullen, M., & Mann, A. (1994). Risk factors for Alzheimer's disease and dementia: a case-control study based on the MRC elderly hypertension trial. Neurology. https://doi.org/10.1212/wnl.44.1.97
Vancouver
Prince M, Cullen M, Mann A. Risk factors for Alzheimer's disease and dementia: a case-control study based on the MRC elderly hypertension trial. Neurology. 1994. doi:10.1212/wnl.44.1.97. PMID: 8290099.
BibTeX
@article{prince1994-8290099,
author = {Prince, M. and Cullen, M. and Mann, A.},
title = {{Risk factors for Alzheimer's disease and dementia: a case-control study based on the MRC elderly hypertension trial}},
journal = {Neurology},
year = {1994},
doi = {10.1212/wnl.44.1.97},
pmid = {8290099},
url = {https://doi.org/10.1212/wnl.44.1.97}
}
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Key findings
- These we compared with 223 unimpaired, unmatched controls from the same population for exposure to familial, cardiovascular, educational, and geographic risk factors for dementia.
- We report near-significant associations between AD and dementia and several cardiovascular risk factors (ECG ischemia, systolic hypertension, and smoking) among subjects lacking a family history of dementia.
Why it matters
This case-control study confirmed that a family history of dementia and advanced age were associated with dementia and Alzheimer's disease, and found near-significant associations with several cardiovascular risk factors among subjects without a family history. It identifies possible risk factors but does not test any treatment, cure, or prevention.
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Study details
- Participants1,545
- Effect sizeOR = 4.69; OR = 2.81; OR = 0.21
- Evidence strengthLow
How this study scored 52/100
Published in a leading specialty journal. Scored zero for study design and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (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 | 1994 — older than 20 years, still counted |
| Sample size | 3 / 4 | 1,545 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 163 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.8 citations a year over 34 year(s) since 1994 |
| Impact for its field and year | 4 / 6 | Cited 9.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author ANTHONY H. MANN: h-index 45 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | The Royal Free Hospital: institution h-index 743 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 8290099) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 52 / 100 | — |
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