Preventing Alzheimer Disease and Cognitive Decline
Authors: Martha L. Daviglus, Carl C. Bell, Wade Berrettini, Phyllis E. Bowen, E. Sander Connolly, Nancy Jean Cox, Jacqueline M. Dunbar-Jacob, Evelyn C. Granieri, Gail Hunt, Kathleen McGarry, Dinesh Patel, Arnold L. Potosky, Elaine Sanders-Bush, Donald Silberberg, Maurizio Trevisan
Journal: Annals of Internal Medicine (2011)

Letters1 February 2011Preventing Alzheimer Disease and Cognitive DeclineMartha L. Daviglus, MD, PhD, MPH, Carl C. Bell, MD, Wade Berrettini, MD, PhD, Phyllis E. Bowen, PhD, RD, E. Sander Connolly Jr., MD, Nancy Jean Cox, PhD, Jacqueline M. Dunbar-Jacob, PhD, RN, Evelyn C. Granieri, MD, MPH, MSEd, Gail Hunt, BA, Kathleen McGarry, PhD, Dinesh Patel, MD, Arnold L. Potosky, PhD, Elaine Sanders-Bush, PhD, Donald Silberberg, MD, and Maurizio Trevisan, MD, MSMartha L. Daviglus, MD, PhD, MPHFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Carl C. Bell, MDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Wade Berrettini, MD, PhDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Phyllis E. Bowen, PhD, RDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., E. Sander Connolly Jr., MDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Nancy Jean Cox, PhDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Jacqueline M. Dunbar-Jacob, PhD, RNFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Evelyn C. Granieri, MD, MPH, MSEdFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Gail Hunt, BAFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Kathleen McGarry, PhDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Dinesh Patel, MDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Arnold L. Potosky, PhDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Elaine Sanders-Bush, PhDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., Donald Silberberg, MDFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103., and Maurizio Trevisan, MD, MSFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-3-201102010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Qiu and colleagues' comments that the etiology of Alzheimer disease is probably determined by multiple factors over the life span. However, after reviewing the existing scientific evidence, including observational studies, clinical trials, and data presented by experts in this condition, we concluded that the data simply do not demonstrate a consistent, strong association between any modifiable risk factor and Alzheimer disease. Efforts to examine these associations to date have been hampered by numerous problems, including limited follow-up, methodological differences across studies in measurement of exposures, and overreliance on single measurements of exposure variables.In ... Author, Article, and Disclosure InformationAuthors: Martha L. Daviglus, MD, PhD, MPH; Carl C. Bell, MD; Wade Berrettini, MD, PhD; Phyllis E. Bowen, PhD, RD; E. Sander ConnollyJr., MD; Nancy Jean Cox, PhD; Jacqueline M. Dunbar-Jacob, PhD, RN; Evelyn C. Granieri, MD, MPH, MSEd; Gail Hunt, BA; Kathleen McGarry, PhD; Dinesh Patel, MD; Arnold L. Potosky, PhD; Elaine Sanders-Bush, PhD; Donald Silberberg, MD; Maurizio Trevisan, MD, MSAffiliations: From Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; University of Illinois at Chicago, Chicago, IL 60608-1264; Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA 19104; University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL 60612; Columbia University Medical Center, New York, NY 10032; University of Chicago, Chicago, IL 60637; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261; College of Physicians and Surgeons, Columbia University, New York, NY 10034; National Alliance for Caregiving, Bethesda, MD 20814; University of California, Los Angeles, Los Angeles, CA 90095; Charles E. Smith Life Community Hebrew Home of Greater Washington, Rockville, MD 20852; Cancer Control Program, Lombardi Comprehensive Cancer Center, Washington, DC 20007; Vanderbilt University Medical Center, Nashville, TN 37232; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and Health Sciences System of the Nevada System of Higher Education, Las Vegas, NV 89103.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNational Institutes of Health State-of-the-Science Conference Statement: Preventing Alzheimer Disease and Cognitive Decline Martha L. Daviglus , Carl C. Bell , Wade Berrettini , Phyllis E. Bowen , E. Sander Connolly Jr. , Nancy Jean Cox , Jacqueline M. Dunbar-Jacob , Evelyn C. Granieri , Gail Hunt , Kathleen McGarry , Dinesh Patel , Arnold L. Potosky , Elaine Sanders-Bush , Donald Silberberg , and Maurizio Trevisan Preventing Alzheimer Disease and Cognitive Decline Chengxuan Qiu , Miia Kivipelto , and Laura Fratiglioni Preventing Alzheimer Disease and Cognitive Decline Frederick Naftolin and S. Mitchell Harman Metrics Cited byHealth economics and nutrition: a review of published evidence 1 February 2011Volume 154, Issue 3Page: 212-213KeywordsAlzheimer diseaseClinical trialsConflicts of interestHormonal therapyHormonesMedical risk factorsObservational studiesPreventive medicineRisk managementSystematic reviews ePublished: 1 February 2011 Issue Published: 1 February 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...