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January 1995, Vol 52, No. 1 >
Article | January 1995

The Age at Onset of Alzheimer's Disease and an Intracranial Area Measurement: Title and subTitle BreakA Relationship

Peter W. Schofield, FRACP; Roger E. Mosesson, MD; Yaakov Stern, PhD; Richard Mayeux, MD
Arch Neurol. 1995;52(1):95-98. doi:10.1001/archneur.1995.00540250103019
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Objective: To examine the possibility that premorbid brain size may influence the age at onset of symptoms of Alzheimer's disease (AD).

Design: 

Retrospective case series. 

Setting:  Outpatients attending a memory disorders clinic in a tertiary referral center.

Patients:  Twenty-eight female patients with the diagnosis of probable AD, selected for the availability of informant derived estimates of age at onset of symptoms and computed tomographic scans of the head satisfying angulation criteria.

Main Outcome Measure:  An average intracranial area of two adjacent computed tomographic scan sections appropriately angled was used as a correlate of premorbid brain size. Strict intracranial volume measurement was not performed.

Results:  Age at onset of symptoms of AD correlated positively (r=.48, P=.009) with our measure of premorbid brain size. There was no confounding by education, height, or ethnicity.

Conclusion:  Premorbid brain size may be an important determinant of the age at onset of symptoms of AD. Epidemiologic studies of AD may need to assess the relationship between brain size and putative risk factors, eg, low educational attainment, since there is evidence that brain size is not distributed uniformly across populations.

REFERENCES

1 +
Katzman R, Terry R, DeTeresa R, et al.  Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques . Ann Neurol . 1988;;23:138-144.
2 +
Moss ML.  Functional cranial analysis and the functional matrix . Int J Orthod . 1979;;17:21-31.
3 +
Davis PJM, Wright EA.  A new method for measuring cranial cavity volume and its application to the assessment of cerebral atrophy at autopsy . Neuropathol Appl Neurobiol . 1977;;3:341-358.
4 +
McKhann G, Drachman D, Folstein M, et al.  Clinical diagnosis of Alzheimer's disease: report on the NINCDS-ADRDA work group under the auspices of the Dept of Health and Human Services Task Force on Alzheimer's Disease . Neurology . 1984;;34:939-944.
5 +
Burke WJ, Miller JP, Rubin EH, et al.  The reliability of the Washington University Clinical Dementia Rating . Arch Neurol . 1988;;45:31-32.
6 +
Ho K-C, Roessmann U, Straumfjord JV, Monroe G.  Analysis of brain weight, I: adult brain weight in relation to sex, race, and age . Arch Pathol Lab Med . 1980;; 104:635-639.
7 +
Neter J, Wasserman W, Kutner MH. Applied Linear Regression Models . 2nd ed. Homewood, Ill: Richard D Irwin Inc; 1989;.
8 +
Willerman L, Schultz R, Rutledge JN, Bigler ED.  In vivo brain size and intelligence . Intelligence . 1991;;15:223-228.
9 +
Andreasen NC, Flaum M, Swayze V II, et al.  Intelligence and brain structure in normal individuals . Am J Psychiatry . 1993;;150:130-134.
10 +
Jencks C, Smith M, Acland H, et al.  Path models of intergenerational mobility . In: Jencks C, ed. Inequality: a Reassessment of the Effect of Family and Schooling in America . New York, NY: Basic Books Inc; 1972;:320-350.
11 +
Pearlson GD, Kim WS, Kubos KL, et al.  Ventricle-brain ratio, computed tomographic density, and brain area in 50 schizophrenics . Arch Gen Psychiatry . 1989;;46:690-697.
12 +
Liberatos P, Link BG, Kelsey JL.  The measurement of social class in epidemiology . Epidemiol Rev . 1988;;10:87-121.
13 +
Zhang M, Katzman R, Salmon D, et al.  The prevalence of dementia and Alzheimer's disease in Shanghai, China: impact of age, gender, and education . Ann Neurol . 1990;;27:428-437.
14 +
Snowden DA, Ostwald SK, Kane RL.  Education, survival, and independence in elderly Catholic sisters, 1936-1988 . Am J Epidemiol . 1989;;130:999-1012.
15 +
Banaiuto S, Rocca WA, Lippi A, et al.  Impact of education and occupation on prevalence of Alzheimer's disease (AD) and multi-infarct dementia (MID) in Appignano, Macerata Province, Italy . Neurology . 1990;;40( (suppl 1) ):346.
16 +
Fratigloni L, Grut M, Forsell Y, et al.  Prevalence of Alzheimer's disease and other dementias in an elderly urban population: relationship with age, sex, and education . Neurology . 1991;;41:1886-1892.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Katzman R, Terry R, DeTeresa R, et al.  Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques . Ann Neurol . 1988;;23:138-144.
2 +
Moss ML.  Functional cranial analysis and the functional matrix . Int J Orthod . 1979;;17:21-31.
3 +
Davis PJM, Wright EA.  A new method for measuring cranial cavity volume and its application to the assessment of cerebral atrophy at autopsy . Neuropathol Appl Neurobiol . 1977;;3:341-358.
4 +
McKhann G, Drachman D, Folstein M, et al.  Clinical diagnosis of Alzheimer's disease: report on the NINCDS-ADRDA work group under the auspices of the Dept of Health and Human Services Task Force on Alzheimer's Disease . Neurology . 1984;;34:939-944.
5 +
Burke WJ, Miller JP, Rubin EH, et al.  The reliability of the Washington University Clinical Dementia Rating . Arch Neurol . 1988;;45:31-32.
6 +
Ho K-C, Roessmann U, Straumfjord JV, Monroe G.  Analysis of brain weight, I: adult brain weight in relation to sex, race, and age . Arch Pathol Lab Med . 1980;; 104:635-639.
7 +
Neter J, Wasserman W, Kutner MH. Applied Linear Regression Models . 2nd ed. Homewood, Ill: Richard D Irwin Inc; 1989;.
8 +
Willerman L, Schultz R, Rutledge JN, Bigler ED.  In vivo brain size and intelligence . Intelligence . 1991;;15:223-228.
9 +
Andreasen NC, Flaum M, Swayze V II, et al.  Intelligence and brain structure in normal individuals . Am J Psychiatry . 1993;;150:130-134.
10 +
Jencks C, Smith M, Acland H, et al.  Path models of intergenerational mobility . In: Jencks C, ed. Inequality: a Reassessment of the Effect of Family and Schooling in America . New York, NY: Basic Books Inc; 1972;:320-350.
11 +
Pearlson GD, Kim WS, Kubos KL, et al.  Ventricle-brain ratio, computed tomographic density, and brain area in 50 schizophrenics . Arch Gen Psychiatry . 1989;;46:690-697.
12 +
Liberatos P, Link BG, Kelsey JL.  The measurement of social class in epidemiology . Epidemiol Rev . 1988;;10:87-121.
13 +
Zhang M, Katzman R, Salmon D, et al.  The prevalence of dementia and Alzheimer's disease in Shanghai, China: impact of age, gender, and education . Ann Neurol . 1990;;27:428-437.
14 +
Snowden DA, Ostwald SK, Kane RL.  Education, survival, and independence in elderly Catholic sisters, 1936-1988 . Am J Epidemiol . 1989;;130:999-1012.
15 +
Banaiuto S, Rocca WA, Lippi A, et al.  Impact of education and occupation on prevalence of Alzheimer's disease (AD) and multi-infarct dementia (MID) in Appignano, Macerata Province, Italy . Neurology . 1990;;40( (suppl 1) ):346.
16 +
Fratigloni L, Grut M, Forsell Y, et al.  Prevalence of Alzheimer's disease and other dementias in an elderly urban population: relationship with age, sex, and education . Neurology . 1991;;41:1886-1892.

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