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Vascular dementia : incidence and risk factors in the Canadian study of health and aging
Hébert R, Lindsay J, Verreault R, Rockwood K, Hill G, Dubois MF.. Stroke, 2000-07-01
Topic: Risk, prevention and care in population studies
Background and purpose Very few population-based studies have systematically examined incident vascular dementia (VaD). From the Canadian Study of Health and Aging cohort, incidence rates of VaD were determined and risk factors analyzed. Methods This was a cohort incidence study that followed 8623 subjects presumed to be free of dementia over a 5-year period. The risk factors were examined with a nested prospective case-control study. Exposure was determined by means of a risk factor questionnaire administered to the subject or a proxy at the beginning of the study. Results On the basis of 38 476 person-years at risk, the annual incidence rate was estimated to be 2.52 per thousand undemented Canadians (95% CI 2. 02 to 3.02). Including an estimation of the probability of VaD among the decedents, this figure rose to 3.79. For the risk factors study, 105 incident cases of VaD according to the NINCDS-AIREN criteria were compared with 802 control subjects. Significant risk factors were: age (OR=1.05), residing in a rural area (2.03), living in an institution (2.33), diabetes (2.15), depression (2.41), apolipoprotein E epsilon4 (2.34), hypertension for women (2.05), heart problems for men (2.52), taking aspirin (2.33), and occupational exposure to pesticides or fertilizers (2.05). Protective factors were eating shellfish (0.46) and regular exercise for women (0.46). There was no relation with sex, education, or alcohol. Conclusions The study confirmed some previously reported risk factors but also suggested new ones. It raised concerns about the prescription of aspirin and perhaps other factors related to rural life.
Key findings
- Results On the basis of 38 476 person-years at risk, the annual incidence rate was estimated to be 2.52 per thousand undemented Canadians (95% CI 2. 02 to 3.02).
- For the risk factors study, 105 incident cases of VaD according to the NINCDS-AIREN criteria were compared with 802 control subjects.
- Significant risk factors were: age (OR=1.05), residing in a rural area (2.03), living in an institution (2.33), diabetes (2.15), depression (2.41), apolipoprotein E epsilon4 (2.34), hypertension for women (2.05), heart problems for men (2.52), taking aspirin (2.33), and occupational exposure to pesticides or fertilizers (2.05).
Why it matters
This population study found that age, rural residence, living in an institution, diabetes, depression, the apolipoprotein E epsilon4 allele, hypertension in women, heart problems in men, taking aspirin, and occupational exposure to pesticides or fertilizers were associated with higher risk of vascular dementia, while eating shellfish and regular exercise in women were associated with lower risk. These are associations from a case-control study, not proof that changing any of these factors prevents vascular dementia.
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Study details
- Study designcase-control study
- Participants8,623
- Effect sizeOR=1.05
- Evidence strengthModerate
How this study scored 64/100
Published in a peer-reviewed journal, and it is a case-control study. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 6 / 12 | A case-control study |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2000 — older than 20 years, still counted |
| Sample size | 3 / 4 | 8,623 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 326 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.6 citations a year over 28 year(s) since 2000 |
| Impact for its field and year | 4 / 6 | Cited 8.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 25 other studies in this library |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Marie‐France Dubois: h-index 38 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Université Laval: institution h-index 823 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 10884442) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 100 | — |
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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. Check the citation against the original before you use it.
APA 7th
Hébert, R., Lindsay, J., Verreault, R., Rockwood, K., Hill, G., & Dubois, M. F. (2000). Vascular dementia : incidence and risk factors in the Canadian study of health and aging. Stroke. https://doi.org/10.1161/01.str.31.7.1487
Vancouver
Hébert R, Lindsay J, Verreault R, Rockwood K, Hill G, Dubois MF. Vascular dementia : incidence and risk factors in the Canadian study of health and aging. Stroke. 2000. doi:10.1161/01.str.31.7.1487. PMID: 10884442.
BibTeX
@article{hebert2000-10884442,
author = {Hébert, R. and Lindsay, J. and Verreault, R. and Rockwood, K. and Hill, G. and Dubois, M. F.},
title = {{Vascular dementia : incidence and risk factors in the Canadian study of health and aging}},
journal = {Stroke},
year = {2000},
doi = {10.1161/01.str.31.7.1487},
pmid = {10884442},
url = {https://doi.org/10.1161/01.str.31.7.1487}
}
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