ABSTRACT
For research on Alzheimer's disease (AD), the neurosciences and epidemiology are now in a position where mutual assistance towards progress is already taking place, a situation which has occurred before in psychiatry on only one occasion: the elucidation of pellagra (Goldberger 1914). The aims of this chapter are to review what is presently known about risk factors for AD and to consider what direction further epidemiological research should take. A stocktaking of the evidence now available may point towards testable hypotheses on aetiology. The information assembled here comes from three sources: surveys of general populations, descriptions of clinical series, and case-control studies. While the latter are the most efficient method for identifying risk factors, those conducted so far have been based on only moderately sized samples, with consequently limited power to identify risk factors with a high base rate in the controls. These are the studies by Bharucha et al. (1983), Heyman et al. (1984), French et al. (1985), Mortimer et al. (1985), Barclay et al. (1985), Amaducci et al. (1986), Shalat et al. (1986), and Chandra et al. (1986a, 1987). In this paper, AD occurring in the elderly will be referred to specifically as senile dementia of Alzheimer type (SDAT). Where no distinction is required, the generic term AD will be used.
