A total of 82 subjects were diagnosed with Alzheimer’s disease during follow-up (incidence rate, 7.1 per 1,000 person-years at risk). Reviewing the earlier data, the researchers observed an association between lower cystatin C levels and higher risk of Alzheimer’s disease independent of age, APOE genotype, glomerular filtration rate, diabetes, hypertension, stroke, cholesterol, BMI, smoking, education level, and plasma β-amyloid.
The authors also found that a 0.1-µmol/L decrease of serum cystatin C between ages 70 and 77 was associated with a 29% higher risk of developing incident Alzheimer’s disease.
“Although no epidemiologic study can establish causality, our findings strengthen the evidence of a role for cystatin C in Alzheimer’s disease pathogenesis,” Dr. Sundelöf said in an interview with Reuters Health.
“As it has been previously demonstrated that cystatin C inhibits β-amyloid aggregation, it would now be interesting to further evaluate the role of cystatin C in the brain, eg, why there is an increase in the aggregation of cystatin C in neurons affected in the Alzheimer’s disease brain in contrast to cognitively intact individuals,” Dr. Sundelöf said.
Neurology. 2008;71(14):1072-1079.
Intracranial Hypertension Is Strongly Linked to Blindness in Men
NEW YORK, October 21 (Reuters Health)—Although men are much less likely than women to have idiopathic intracranial hypertension (IIH), they are about twice as likely to develop severe vision loss as a result of this condition, according to a report in the October 15 online Neurology.
“Although [gender] has been previously suspected to be an important risk factor for visual loss in IIH, only two studies have specifically compared men versus women with IIH,” Dr. Beau Bruce, from Emory University in Atlanta, and colleagues pointed out.
They added that “although no significant association between male [gender] and visual loss in IIH has been demonstrated previously, these studies were likely underpowered to find such an association, even if one was present.”
As the name indicates, the cause of IIH is unknown. The disease is usually seen in young, obese women, and symptoms typically include headaches, as well as visual and auditory disturbances. Severe vision loss occurs in up to 10% of patients.
The current study featured a review of 721 consecutive IIH patients who were seen at three university hospitals from 1989 to 2007. Ninety-one percent of the patients were female, and 9% were male.
Male patients were older than the female patients (37 vs 28 years, on average) and were more likely to have sleep apnea (24% vs 4%), the report indicated. In addition, men were more likely than women to present with visual disturbances (35% vs 20%), but less likely to report headache (55% vs 75%). All of these values were significant. Men had worse visual acuity and visual fields than women both at presentation and at follow-up. Moreover, men were 2.1 times more likely than women to have severe visual loss in one or both eyes.
“Our findings suggest that men with this condition should have more careful monitoring of their eyesight and likely should be treated more aggressively when they do have evidence of vision loss,” Dr. Bruce said in a statement.
Neurology. 2008 Oct 15; [Epub ahead of print].