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Background: Since increased oxidative stress may impair cognition and be a risk factor for dementia, there has been interest in determining whether use of antioxidants could protect against such events., Objective: To determine whether supplement use of vitamins C and/or E in a community-based sample of older African American and white individuals delayed incident dementia or Alzheimer's disease (AD)., Methods: We selected a subgroup from the Duke Established Populations for Epidemiologic Studies of the Elderly, a longitudinal study of community-representative persons aged 65-105 years living in 5 adjacent counties in North Carolina, and followed them for dementia (1986-1987 through June 2000). Information gathered during in-home interviews included sociodemographic characteristics, health status, health service use, and vitamin use. Diagnosis of dementia and AD was based on evaluations using the clinical and neuropsychological batteries of the Consortium to Establish a Registry for Alzheimer's Disease, with final determination by consensus agreement of specialists using Diagnostic and Statistical Manual of Mental Disorders, third revision, and National Institute for Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders criteria., Results: Of 616 persons initially dementia-free (mean age 73 y; 62% female; 62% African American), 141 developed dementia, of whom 93 developed AD. Increased age and mobility problems were risk factors for dementia (only age for AD), while an increased number of outpatient visits reduced the likelihood of developing dementia. Neither use of any vitamins C and/or E (used by 8% of subjects at baseline) nor high-dose use reduced the time to dementia or AD., Conclusions: In this community in the southeastern US where vitamin supplement use is low, use of vitamins C and/or E did not delay the incidence of dementia or AD.

Norms for cognitive measures used to assess dementia are scant for minority groups, in particular for older Japanese Americans. Using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychology Battery, we compared the baseline performance of demented and nondemented Japanese Americans. Participants came from two harmonized epidemiological studies of dementia which were examined separately: the Kame Project, Seattle (350 men and women; 201 nondemented), age 65 and older; Honolulu-Asia Aging Study (HAAS), Hawaii (418 men; 120 nondemented), age 71 and older. The measures examined were Verbal Fluency; abbreviated Boston Naming; constructional praxis; and Word List Learning, Recall, and Recognition. Within each study, the CERAD measures distinguished between nondemented participants and those with mild cognitive impairment. Among persons with dementia, average level of performance decreased as severity of dementia increased. Determinants of score (age, education, language of administration, stage of dementia) varied between the two studies. Among Japanese Americans, the CERAD Neuropsychology Battery distinguished nondemented persons from those with dementia, but was less consistent in distinguishing levels of severity of dementia. This battery is useful for comparative epidemiological studies of dementia in minority populations.

Objectives To systematically review longitudinal studies examining the association between oral health and cognitive decline. Design Studies published between January 1993 and March 2013 were identified by search of English language publications in PubMed/Medline using relevant Medical Subject Heading terms and title and abstract keywords and from CINAHL using relevant subject headings. After applying eligibility criteria and adding four studies identified from article references, 56 of the 1,412 articles identified remained; 40 were cross-sectional, and 16 were longitudinal; 11 of the latter examined the effect of oral health on change in cognitive health or dementia incidence, five examined the reverse. Setting Sources of information included administrative data, subject evaluations in parent studies, medical and dental records, self-reports, and in-person evaluations. Participants Older adults. Measurements Most studies used subjects whose oral or cognitive status was known, using standard approaches to impute for missing information. The oral health information most frequently studied included number of teeth, periodontal and caries problems, and denture use. Cognition was most frequently evaluated using the Mini-Mental State Examination or according to a diagnosis of dementia. Results Some studies found that oral health measures such as number of teeth and periodontal disease were associated with risk of cognitive decline or incident dementia, whereas others did not find an association. Similarly, cognitive decline was not consistently associated with greater loss of teeth or number of decayed teeth. It is likely that methodological limitations play a major role in explaining the inconsistent findings. Conclusion It is unclear how or whether oral health and cognitive status are related. Additional research is needed in which there is greater agreement on how oral health and cognitive states are assessed to better examine the linkages between these two health outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine whether there are racial/ethnic differences regarding the relationship of level of blood pressure to change in cognitive function in older people. DESIGN: Longitudinal data 1986 to 1989 on representative, older, community-residing African Americans and whites. Blood pressure levels were assessed and a brief screen of cognitive functioning, the Short Portable Mental Status Questionnaire (SPMSQ), was performed at baseline and 3 years later. SETTING: Five contiguous counties in the Piedmont area of North Carolina. PARTICIPANTS: African-American (n = 2,260) and white (n = 1,876) participants in the Duke Established Populations for Epidemiologic Studies of the Elderly, aged 65 to 105 at baseline. MEASUREMENTS: The outcome measure was change in SPMSQ score over 3 years. Covariates included age; education; gender; self-reported diabetes mellitus, stroke, heart attack, current smoking, and depressive symptomatology; and use of antihypertensive medication. The primary independent variable was measured blood pressure. RESULTS: In unadjusted analyses, a statistically significant U-shaped relationship was found between systolic (but not diastolic) blood pressure levels and change in SPMSQ score over a 3-year period for older white men and women. No such relationships were found between these blood pressure measurements and change in SPMSQ score in older African Americans. These findings remained after adjustment for initial SPMSQ score, demographic characteristics, and use of antihypertensive medication. There were no significant interactions between race and blood pressure on change in cognitive function. CONCLUSION: Decline in cognitive function was associated with extremes of systolic blood pressure in older white people. Although a similar but muted nonsignificant association was found in older African Americans, the curves for the two groups were not significantly different. Further studies in older African Americans are needed. J Am Geriatr... [ABSTRACT FROM AUTHOR]

Attempts to maximize respondent participation in a study of the prevalence, incidence and natural history of dementia. Development of a standardized assessment for Alzheimer's Disease; Agreement on dementia status between nurse evaluation and diagnosis consensus committee evaluation for 105 participants; Agreement on type of dementia for 57 participants with dementia.

Examines whether medication use patterns vary with the level of cognitive function such as cognitive impairment, dementia and intact cognition, in a sample of the Duke Established Populations for Epidemiologic Studies of the Elderly. Criteria used to refer a participant for a clinical dementia evaluation; Information on cognitive impairment; Comparison between the cognitive intact, cognitively impaired and demented participants.