Science

Thomas M. van Himbergen, PhD; Alexa S. Beiser, PhD; Masumi Ai, MD; Sudha Seshadri, MD; Seiko Otokozawa, MT; Rhoda Au, PhD; Nuntakorn Thongtang, MD; Philip A. Wolf, MD; Ernst J. Schaefer, MD

Objective: To investigate the contribution of biomarkers of glucose homeostasis (adiponectin, glucose, glycated albumin, and insulin levels) and inflammation (high-sensitivity C-reactive protein and lipoprotein- associated phospholipase A2 levels) to the risk of developing Alzheimer disease (AD) and all-cause dementia.
Design:Prospective cohort study.
Setting: Dementia-free Framingham Heart Study participants had sera measured for these biomarkers at the 19th biennial examination (1985-1988) and were followed up prospectively for the development of AD and all-cause dementia.
Participants: Eight hundred forty (541 women, median age of 76 years) subjects participated in the study.
Main Outcome Measures: We used sex-pooled and sex-specific multivariable Cox proportional hazards models adjusted for age, education, body mass index, recent change in weight, APOE ε4 allele status, and plasma doco- sahexaenoic acid levels to determine association of these
biomarkers with the development of all-cause dementia and AD.
Results: Over a mean follow-up period of 13 years, 159 persons developed dementia (including 125 with AD). After adjustment for other risk factors, only adiponectin in women was associated with an increased risk of all-cause dementia (hazard ratio [HR], 1.29; 95% confi- dence interval [CI], 1.00-1.66; P = .054) and AD (HR, 1.33; 95% CI, 1.00-1.76; P=.050) per 1-SD increase in adiponectin level. Women with baseline adiponectin values more than the median had a higher risk of all-cause dementia (HR, 1.63; 95% CI, 1.03-2.56; P = .04) and AD (HR, 1.87; 95% CI, 1.13-3.10; P = .01) as compared with those with values less than the median.
Conclusion: In women, increased plasma adiponectin levels are an independent risk factor for the development of both all-cause dementia and AD.