Inflammation, nutrition and risk of dementia : the Rotterdam Study

The aim of the research described in this thesis was to further investigate the relation between inflammatory factors, antioxidants and lipids, and dementia and to examine whether these associations could be explained by atherosclerosis. All studies in this thesis were based on the Rotterdam Study, an ongoing prospective population-based study among 7983 subjects of 55 years and over, who were living in Ommoord, a suburb in Rotterdam, the Netherlands. At baseline (1990-1993), 7525 participants of the Rotterdam Study underwent extensive screening for dementia, of whom 482 were diagnosed as having dementia. Of these, 353 (73%) suffered from Alzheimer's disease and 72 from vascular dementia (15%). The 7043 subjects who were dementia-free at baseline were followed up for 5. 7 yea:rs on average. During this period, 395 participants developed dementia, of whom 293 (7 4%) had Alzheimer's disease and 57 (14%) vascular dementia. In this general discussion, I will give an overview of the main findings in this thesis in the light of current knowledge regarding dementia pathogenesis. In addition, some methodological issues will be discussed as well as the clinical relevance of our findings. Finally, I will give some recommendations for future research.