Ascertainment of Dementia Cases in the Spanish European Prospective Investigation into Cancer and Nutrition-Murcia Cohort

Andreu-Reinón, María Encarnación; Gavrila, Diana; Chirlaque, María Dolores; Colorado‐Yohar, Sandra; Amiano, Pilar; Ardanáz, Eva; Navarro‐Mateu, Fernando; Navarro, Carmen; Huerta, José María

doi:10.1159/000493209

Cited by 6 publications

(7 citation statements)

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“…Case ascertainment was organized in two phases and was previously described ( 20 ). In phase I, potential cases were identified by linkage of the EPIC-Spain database and all available health databases that could contain dementia-related clinical information.…”

Section: Methodsmentioning

confidence: 99%

“…The subtype of dementia, such as AD, was determined when competently detailed clinical information about subtypes was available in medical reports. Even though participants in the EPIC study did not undergo baseline cognitive assessment, subjects were demanded to be mentally and physically able to realize extensive questionnaires, which are required to guarantee a normal cognition ( 20 ). The last complete vital status check was in December 2017 for Gipuzkoa, December 2015 for Navarra, and November 2016 for Murcia through record linkage with the Spanish National Death Index.…”

Section: Methodsmentioning

confidence: 99%

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Association Between Egg Consumption and Dementia Risk in the EPIC-Spain Dementia Cohort

et al. 2022

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BackgroundCurrent evidence suggests that egg composition might have potential neuroprotective effects. Our aim was to determine the association between egg consumption and the risk of dementia in a Mediterranean population.MethodsThis study was carried out in 3 centers from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort, i.e., 25,015 participants aged 30–70 years, recruited in 1992–1996, and followed up for a mean of 21.5 years.ResultsA total of 774 incident dementia cases were diagnosed and validated, of which 518 were Alzheimer's disease (AD). Data on egg consumption were estimated using a validated dietary history questionnaire at recruitment. Cox proportional hazards models, adjusted for confounders, were used in the analyses. No association was observed between egg consumption and either total dementia [hazard ratio between extreme quartiles (HRQ4vs.Q1: 1.05; 95% CI 0.85–1.31; p-trend = 0.93)] or AD (HRQ4vs.Q1 0.93; 95% CI 0.72–1.21; p-trend = 0.50) risks. After dividing the population by adherence to the relative Mediterranean diet (rMED) score, a borderline inverse association was found between egg intake and both total dementia (HRQ4vs.Q1: 0.52; 95% CI 0.30–0.90; p-trend = 0.10) and AD (HRQ4vs.Q1: 0.52; 95% CI 0.27–1.01; p-trend = 0.13) risks within participants with low adherence to rMED score. However, no association was observed in participants with medium and high adherence to rMED score.ConclusionThis prospective study suggests that egg consumption is associated with a reduced risk of dementia, and specifically of AD, in the adult population with low adherence to rMED score; whereas it has no impact in subjects with moderate and high MD adherence.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association Between Egg Consumption and Dementia Risk in the EPIC-Spain Dementia Cohort

et al. 2022

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“…This design was feasible because the EPIC cohort assessed the exposure of individuals from the general population to risk factors in mid-life, the incidence of dementia throughout a 20-year follow-up, and the competing risk of death from other causes [ 14, 20, 22 ]. The sample included 25,015 participants (57% women), between 30 and 70 years old, from the three EPIC-Spain Dementia Cohort centers (Gipuzkoa, Navarra, and Murcia) [ 23 ]. The EPIC study protocol was approved by the International Agency for Research on Cancer Ethics Committee and the participants gave written informed consent to update their clinical information from available medical records.…”

Section: Methodsmentioning

confidence: 99%

“…Fulfilling all the requirements for this interview implied that participants had normal cognition and failure to complete it led to exclusion from the study. Incident cases of dementia were identified by searching for this diagnosis in the electronic health record (EHR) and validating it with a protocol that has been described in detail elsewhere [ 23, 24 ]. First, to identify potential cases of dementia the EPIC registries and mortality registries were linked to the organizational databases of the Murcian, Basque, and Navarre Health Services using the dementia codes of the International Classification of Diseases and Related Health Problems 9a and 10a editions (ICD-9 : 290, 331 and ICD-10: F00–F03, G30), International Classification of Primary Care (ICPC2: P20, P70, N29, N99), and the Anatomical Therapeutic Chemical (ATC) classification system (N06DA02 [Donepezil], N06DA03 [Rivastigmine], N06DDA04 [Galantamine], and N06DX01 [Memantine]).…”

Section: Methodsmentioning

confidence: 99%

Dementia Risk Score for a Population in Southern Europe Calculated Using Competing Risk Models

Ibarrondo

Huerta

Amiano

et al. 2022

JAD

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Background: Dementia prevention can be addressed if the intervention is applied early. Objective: The objective of this study was to develop and validate competing risk models to predict the late risk of dementia based on variables assessed in middle age in a southern European population. Methods: We conducted a prospective observational study of the EPIC-Spain cohort that included 25,015 participants. Dementia cases were identified from electronic health records and validated by neurologists. Data were gathered on sociodemographic characteristics and cardiovascular risk factors. To stratify dementia risk, Fine and Gray competing risk prediction models were constructed for the entire sample and for over-55-year-olds. Risk scores were calculated for low (the 30% of the sample with the lowest risk), moderate (> 30% –60%), and high (> 60% –100%) risk. Results: The 755 cases of dementia identified represented a cumulative incidence of 3.1% throughout the study period. The AUC of the model for over-55-year-olds was much higher (80.8%) than the overall AUC (68.5%) in the first 15 years of follow-up and remained that way in the subsequent follow-up. The weight of the competing risk of death was greater than that of dementia and especially when the entire population was included. Conclusion: This study presents the first dementia risk score calculated in a southern European population in mid-life and followed up for 20 years. The score makes it feasible to achieve the early identification of individuals in a southern European population who could be targeted for the prevention of dementia based on the intensive control of risk factors.

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“…A two-phase validation protocol was designed to ascertain incident dementia cases occurring in the cohort based on medical records, as detailed previously [28]. In brief, potential cases were identified by record linkage of the EPIC database with primary care records, hospital discharge databases, and regional mortality registries.…”

Section: Ascertainment Of Dementia Casesmentioning

confidence: 99%

Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study

et al. 2021

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The Mediterranean diet (MD) has shown to reduce the occurrence of several chronic diseases. To evaluate its potential protective role on dementia incidence we studied 16,160 healthy participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort study recruited between 1992–1996 and followed up for a mean (±SD) of 21.6 (±3.4) years. A total of 459 incident cases of dementia were ascertained through expert revision of medical records. Data on habitual diet was collected through a validated diet history method to assess adherence to the relative Mediterranean Diet (rMED) score. Hazard ratios (HR) of dementia by rMED levels (low, medium and high adherence levels: ≤6, 7–10 and ≥11 points, respectively) were estimated using multivariable Cox models, whereas time-dependent effects were evaluated using flexible parametric Royston-Parmar (RP) models. Results of the fully adjusted model showed that high versus low adherence to the categorical rMED score was associated with a 20% (HR = 0.80, 95%CI: 0.60–1.06) lower risk of dementia overall and HR of dementia was 8% (HR = 0.92, 0.85–0.99, p = 0.021) lower for each 2-point increment of the continuous rMED score. By sub-types, a favorable association was also found in women for non-AD (HR per 2-points = 0.74, 95%CI: 0.62–0.89), while not statistically significant in men for AD (HR per 2-points = 0.88, 0.76–1.01). The association was stronger in participants with lower education. In conclusion, in this large prospective cohort study MD was inversely associated with dementia incidence after accounting for major cardiovascular risk factors. The results differed by dementia sub-type, sex, and education but there was no significant evidence of effect modification.

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Ascertainment of Dementia Cases in the Spanish European Prospective Investigation into Cancer and Nutrition-Murcia Cohort

Cited by 6 publications

References 29 publications

Association Between Egg Consumption and Dementia Risk in the EPIC-Spain Dementia Cohort

Association Between Egg Consumption and Dementia Risk in the EPIC-Spain Dementia Cohort

Dementia Risk Score for a Population in Southern Europe Calculated Using Competing Risk Models

Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study

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