Cited by 829Dementia and Cognitive Impairment ResearchNeurological Disease Mechanisms and TreatmentsAlzheimer's disease research and treatments

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Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population: The Hisayama Study

Yoshitake, T., Kiyohara, Y., Kato, I., Ohmura, T., Iwamoto, H., Nakayama, K., Ohmori, S., Nomiyama, K., Kawano, H., Ueda, K., Sueishi, K., Tsuneyoshi, M., Fujishima, M.·1995·Neurology

DOI 10.1212/wnl.45.6.1161

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Abstract

Article abstract—We followed 828 nondemented residents of Hisayama Town, Kyushu, Japan, aged 65 years or older (88.3% of the elderly population) for 7 years starting in 1985 in order to determine the type-specific incidence of dementia and its risk factors in the general Japanese population. Only two subjects were lost to the follow-up, during which period 103 subjects developed dementia. Morphologic examination of the brains of 89 subjects (86.4%) was made by autopsy or CT. We made the initial diagnosis of dementia based on the DSM-111-R criteria, with the diagnoses of vascular dementia (VD) being based on the NINDS-AIREN criteria and Alzheimer9s disease (AD) on the NINCDS-ADRDA criteria. The incidence of VD and AD increased with age for both sexes. The age-adjusted total incidence (per 1,000 person-years) of dementia was 19.3 for men and 20.9 for women. The corresponding rates for VD were 12.2 for men and 9.0 for women, and for AD, 5.1 for men and 10.9 for women. Among the VD subjects whose brain morphology we examined, the most frequent type of stroke was multiple lacunar infarcts (42%), but half these subjects lacked a stroke episode in their histories. Multivariate analysis showed that age, prior stroke episodes, systolic blood pressure, and alcohol consumption were significant independent risk factors for the occurrence of VD. In contrast, age and a low score on Hasegawa9s dementia scale were significant risk factors for AD, and physical activity was a significant preventive factor for AD. Our findings suggest that asymptomatic stroke is an important factor in the development of VD, with age, prior stroke episodes, systolic blood pressure, and alcohol consumption being independent risk factors for its occurrence. Age and a low scare on Hasegawa9s dementia scale are significant risk factors for AD, with moderate physical activity having a statistically significant preventive effect.

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Iso‐Markku, P., Waller, K. L., Kujala, U. M., & Kaprio, J. A. (2015) · Annals of Medicine · doi:10.3109/07853890.2014.994675 · Cited by 57
Midlife Metabolic Profile and the Risk of Late-Life Cognitive Decline
Tortelli, R., Lozupone, M., Guerra, V., Barulli, M. R., Imbimbo, B. P., Capozzo, R., Grasso, A. C., Tursi, M., Dio, C. D., Sardone, R., et al. (2017) · Journal of Alzheimer s Disease · doi:10.3233/jad-170153 · Cited by 52
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“Yoshitake and coworkers [11] showed that asymptomatic small infarctions were an important factor in the development of vascular dementia in a 7-year follow-up study of normal elderly residents of Hisayama town.”
Background
Prevalencia de demencia en una población urbana de Lima-Perú: estudio puerta a puerta
Custodio, N., García, A. F., Montesinos, R., Escobar, J., & Bendezú, L. (2013) · Anales de la Facultad de Medicina · doi:10.15381/anales.v69i4.1110 · Cited by 50
“En el estudio en Hisayama, la tasa de pacientes con DV comparado con EA varían de 1,8:1 a 1,1:1 durante los años del estudio, 85 al 92 (28).”
Background
Quantitative analysis of neurofibrillary pathology in a general population to reappraise neuropathological criteria for senile dementia of the neurofibrillary tangle type (tangle‐only dementia): The Hisayama study
Noda, K., Sasaki, K., Fujimi, K., Wakisaka, Y., Tanizaki, Y., Wakugawa, Y., Kiyohara, Y., Iida, M., Aizawa, H., & Iwaki, T. (2006) · Neuropathology · doi:10.1111/j.1440-1789.2006.00722.x · Cited by 49
Self-citation
Are tobacco and alcohol use related to Alzheimer's disease? A critical assessment of the evidence and its implications
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Mechanistic Insights for Drug Repurposing and the Design of Hybrid Drugs for Alzheimer’s Disease
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Altered Expression of COX-2 in Subdivisions of the Hippocampus during Aging and in Alzheimer’s Disease: The Hisayama Study
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Self-citation
Potential hippocampal region atrophy in diabetes mellitus type 2: a voxel-based morphometry VSRAD study
Kamiyama, K., Wada, A., SUGIHARA, M., Kurioka, S., Hayashi, K., Hayashi, T., Yoshisako, T., Yamamoto, N., Tsuchie, Y., Yamaguchi, S., et al. (2010) · Japanese Journal of Radiology · doi:10.1007/s11604-009-0416-2 · Cited by 46
Sequential Abnormalities in Type 1 Diabetic Encephalopathy and the Effects of C-Peptide
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“Several studies have demonstrated an association between type 2 diabetes and Alzheimer’s disease [6-11].”
Background
Alcohol Intake and the Risk of Stroke
Hillbom, M., Juvela, S., & Numminen, H. (1999) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/204748739900600406 · Cited by 46
Non-pharmacologic prevention of Alzheimer’s disease: nutritional and life-style risk factors
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Renin–angiotensin–aldosterone system has a pivotal role in cognitive impairment
Yagi, S., Akaike, M., Ise, T., Ueda, Y., Iwase, T., & Sata, M. (2013) · Hypertension Research · doi:10.1038/hr.2013.51 · Cited by 44
The complex interplay of cardiovascular system and cognition: How to predict dementia in the elderly?
Kerola, T. V., Kettunen, R., & Nieminen, T. V. M. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2010.10.018 · Cited by 46
“dinal study in a population over 65 years, the study with longest follow up, associated high systolic blood pressure to VaD, but not to AD [50].”
Background
Prevention of Dementia
Savica, R., & Petersen, R. C. (2011) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2010.11.006 · Cited by 51
Effect of Diabetes on Brain Structure: The Action to Control Cardiovascular Risk in Diabetes MR Imaging Baseline Data
Bryan, R. N., Bilello, M., Davatzikos, C. A., Lazar, R. M., Murray, A. M., Horowitz, K. R., Lovato, J. F., Miller, M. E., Williamson, J. D., & Launer, L. J. (2014) · Radiology · doi:10.1148/radiol.14131494 · Cited by 43
Gradual cerebral hypoperfusion in spontaneously hypertensive rats induces slowly evolving white matter abnormalities and impairs working memory
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Pharmacological treatment of hypertension in people without prior cerebrovascular disease for the prevention of cognitive impairment and dementia
Cunningham, E. L., Todd, S. A., Passmore, P., Bullock, R., & McGuinness, B. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004034.pub4 · Cited by 45
Prevalence of delirium among outpatients with dementia
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“As suggested by a number of previous studies (Bennett et al., 1990; Román et al., 1993; Yoshitake et al., 1995; Leys et al., 1999), we used a semistandardized measure and classified CVD on the basis of computed tomography (CT) findings as follows (Ikeda et al., 2001): multiple lacunar infarcts,…”
Method
Vascular cognitive impairment: Today and tomorrow
Chui, H. C. (2006) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2006.03.003 · Cited by 44
Characterizing Brain Iron Deposition in Patients with Subcortical Vascular Mild Cognitive Impairment Using Quantitative Susceptibility Mapping: A Potential Biomarker
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Impaired Glucose Tolerance and Reduced Plasma Insulin Precede Decreased AKT Phosphorylation and GLUT3 Translocation in the Hippocampus of Old 3xTg-AD Mice
Griffith, C. M., Macklin, L. N., Cai, Y., Sharp, A. A., Yan, X., Reagan, L. P., Strader, A. D., Rose, G. M., & Patrylo, P. R. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-180707 · Cited by 44
Relationship Between Late-Life Hypertension, Blood Pressure, and Alzheimer’s Disease
Yang, Y., Roe, C. M., & Morris, J. C. (2011) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317511421779 · Cited by 41
Incidence of Dementia, Alzheimer Disease, and Vascular Dementia in a Japanese Population: Radiation Effects Research Foundation Adult Health Study
Yamada, M., Mimori, Y., Kasagi, F., Miyachi, T., Ohshita, T., Sudoh, S., Ikeda, J., Matsui, K., Nakamura, S., Matsumoto, M., et al. (2008) · Neuroepidemiology · doi:10.1159/000122332 · Cited by 44

Authors: Yoshitake, T., Kiyohara, Y., Kato, I., Ohmura, T., Iwamoto, H., Nakayama, K., Ohmori, S., Nomiyama, K., Kawano, H., Ueda, K., Sueishi, K., Tsuneyoshi, M., & Fujishima, M.
Affiliations: Kyushu University (JP)
ORCID: Nakayama, K.
Kawano, H.
Ueda, K.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1995-06
Volume: 45
Issue: 6
Pages: 1161-1168
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.45.6.1161
OpenAlex: W2147954981
Cited by: 829
References: 0
Citations by year: 2026: 10 · 2025: 16 · 2024: 14 · 2023: 11 · 2022: 22 · 2021: 18 · 2020: 24 · 2019: 20 · 2018: 16 · 2017: 31 · 2016: 27 · 2015: 29 · 2014: 27 · 2013: 28 · 2012: 35
FWCI: 13.01
Type: journal article
Language: en
Open access: closed
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Neurological Disorders and Stroke
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
Keywords: vascular dementia, Alzheimer's disease, dementia incidence, risk factors, asymptomatic stroke, lacunar infarction, systolic blood pressure, alcohol consumption, physical activity, Hasegawa Dementia Scale
MeSH terms: Aged, Aged, 80 and over, Alzheimer Disease, Cerebrovascular Disorders, Female, Humans, Japan, Male, Risk Factors, Dementia, Vascular

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Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population: The Hisayama Study

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