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      Smoking and Obesity as Risk Factors in Frontotemporal Dementia and Alzheimer’s Disease: The HUNT Study

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          Abstract

          Background: Few studies have assessed smoking and obesity together as risk factors for frontotemporal dementia (FTD) and Alzheimer’s disease (AD). Objective: To study smoking and obesity as risk factors for FTD and AD. Methods: Ninety patients with FTD and 654 patients with AD were compared with 116 cognitively healthy elderly individuals in a longitudinal design with 15–31 years between measurements of risk factors before the dementia diagnosis. Results: There were no associations between smoking and FTD ( p = 0.218; odds ratio [OR]: 0.990; 95% confidence interval [CI]: 0.975–1.006). There were significant associations between obesity and FTD ( p = 0.049; OR: 2.629; 95% CI: 1.003–6.894). There were significant associations between both smoking ( p = 0.014; OR: 0.987; 95% CI: 0.977–0.997) and obesity ( p = 0.015; OR: 2.679; 95% CI: 1.211–5.928) and AD. Conclusion: Our findings suggest that obesity is a shared risk factor for FTD and AD, while smoking plays various roles as a risk factor for FTD and AD.

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          The epidemiology of frontotemporal dementia.

          Frontotemporal dementia, a heterogeneous neurodegenerative disorder, is a common cause of young onset dementia (i.e. dementia developing in midlife or earlier). The estimated point prevalence is 15-22/100,000, and incidence 2.7-4.1/100,000. Some 25% are late-life onset cases. Population studies show nearly equal distribution by gender, which contrasts with myriad clinical and neuropathology reports. FTD is frequently familial and hereditary; five genetic loci for causal mutations have been identified, all showing 100% penetrance. Non-genetic risk factors are yet to be identified. FTD shows poor life expectancy but with survival comparable to that of Alzheimer's disease. Recent progress includes the formulation of up-to-date diagnostic criteria for the behavioural and language variants, and the development of new and urgently needed instruments for monitoring and staging the illness. There is still need for descriptive population studies to fill gaps in our knowledge about minority groups and developing regions. More pressing, however, is the need for reliable physiological markers for disease. There is a present imperative to develop a translational science to form the conduit for transferring neurobiological discoveries and insights from bench to bedside.
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            Cardiovascular risk factors and future risk of Alzheimer’s disease

            Alzheimer’s disease (AD) is the most common neurodegenerative disorder in elderly people, but there are still no curative options. Senile plaques and neurofibrillary tangles are considered hallmarks of AD, but cerebrovascular pathology is also common. In this review, we summarize findings on cardiovascular disease (CVD) and risk factors in the etiology of AD. Firstly, we discuss the association of clinical CVD (such as stroke and heart disease) and AD. Secondly, we summarize the relation between imaging makers of pre-clinical vascular disease and AD. Lastly, we discuss the association of cardiovascular risk factors and AD. We discuss both established cardiovascular risk factors and emerging putative risk factors, which exert their effect partly via CVD.
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              Medical and environmental risk factors for sporadic frontotemporal dementia: a retrospective case-control study.

              A retrospective case-control study was carried out on 80 patients with sporadic frontotemporal dementia and 124 age, sex, and surrogate informant matched controls with respect to various medical and environmental risk factors. Head trauma was associated with an odds ratio of 3.3 (95% confidence interval (CI), 1.3 to 8.1). Although recall bias may play a role, the frontal lobes are known to be especially vulnerable to even mild head trauma. Thyroid disease was associated with a 2.5 times increased risk of frontotemporal dementia (95% CI, 0.9 to 7.9), which was not statistically significant (p = 0.09) owing to limited power. As altered thyroid hormone status has been observed before in frontotemporal dementia, future studies will be important to confirm this observation.
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                Author and article information

                Journal
                DEE
                DEE
                10.1159/issn.1664-5464
                Dementia and Geriatric Cognitive Disorders Extra
                S. Karger AG
                1664-5464
                2019
                January – April 2019
                09 January 2019
                : 9
                : 1
                : 1-10
                Affiliations
                [_a] aClinic for Mental Health and Substance Abuse, Namsos Hospital, North-Trøndelag Hospital Trust, Namsos, Norway
                [_b] bDepartment of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
                [_c] cFaculty of Mathematics and Natural Sciences, School of Pharmacy, University of Oslo, Oslo, Norway
                [_d] dDepartment of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
                [_e] eDepartment of Research, Levanger Hospital, North-Trøndelag Hospital Trust, Levanger, Norway
                Author notes
                *Hege Rasmussen Eid, North-Trøndelag Hospital Trust, Postbox 453 Sentrum, NO–7801 Namsos (Norway), E-Mail hege.rasmussen@hnt.no
                Author information
                https://orcid.org/0000-0001-8636-8487
                Article
                495607 PMC6381906 Dement Geriatr Cogn Disord Extra 2019;9:1–10
                10.1159/000495607
                PMC6381906
                30792733
                ead6d3e8-c005-4c14-a1d3-0bf6b2f0200d
                © 2019 The Author(s) Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 09 November 2018
                : 20 November 2018
                Page count
                Figures: 1, Tables: 4, Pages: 10
                Categories
                Original Research Article

                Geriatric medicine,Neurology,Cardiovascular Medicine,Neurosciences,Clinical Psychology & Psychiatry,Public health
                Frontal lobe,Psychiatric symptoms,Longitudinal studies,Epidemiology,Neurodegenerative diseases,Dementia,Case-control studies

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