The Canadian Study of Health and Aging

BACKGROUND AND PURPOSE: The Canadian Study of Health and Aging (CSHA) was conducted in communities and institutions in 10 Canadian provinces. One objective of the study was to study risk factors for vascular dementia (VaD). METHODS: This was a population-based case-control study. It included 129 patients clinically diagnosed with VaD with duration of symptoms no more than 3 years and 535 control subjects, frequency matched by age group, study center, and residence in community or institution, who were clinically confirmed to be cognitively normal. Odds ratios (ORs) were calculated using unconditional logistic regression for potential risk factors for VaD. RESULTS: Risk of VaD was associated with history of arterial hypertension (OR, 2.08; 95% confidence interval, 1.29 to 3.35). Other significantly elevated ORs were seen for history of alcohol abuse (2.45), history of heart condition (1.71), use of aspirin (3.10), and occupational exposure to pesticides and herbicides (2.60), as well as liquid plastic or rubber (2.59). The OR for less than 6 years of education compared with 10 or more years was 4.02. CONCLUSIONS: The study confirmed some previously reported risk factors for VaD, such as history of heart disease. Higher levels of education seemed to lower the risk or delay onset of symptoms of VaD. Use of aspirin may be a predictor of survival rather than a risk factor. The occupational associations, particularly with pesticides and fertilizers, need further study.