Risk factors for dementia of Alzheimer's type: a case-control, retrospective evaluation.

The possible risk and/or protective factors for Alzheimer's disease (AD) have been investigated in several population studies mostly of prospective-epidemiological type: the results are, at present, discordant and, therefore, not conclusive. We carried out a retrospective evaluation of some risk factors in a population of 228 subjects affected by AD and 228 cognitively intact controls of same age and sex, consecutively evaluated from 1995 to 2000. The following parameters were considered in each patient: family history of dementia, years of school and education level, cigarette smoking, alcohol use, physical activity, history of atria[ fibrillation, hypertension, acute myocardial infarction (AMI), peripheral vascular disease. Apolipoprotein E (ApoE) genotype was determined in a subgroup of 168 subjects (84 affected by AD and 84 without cognitive impairment). Our study is underlining the very close association between AD patients and the presence of dementia in their relatives of first degree. Also the presence of a E4 genotype (either hetero- or homozygote) in the ApoE seems to be the other important factor related to the clinical diagnosis of AD. The other commonly recognized risk factors such as education level, cigarette smoking, alcohol consumption, physical activity were not proven to be associated with AD and influencing the course of the illness.