{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:53Z","timestamp":1787017013945,"version":"build-2736575974"},"reference-count":46,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:00:00Z","timestamp":1605225600000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["National Institute for Health Research (NIHR) Biom"],"award-info":[{"award-number":["National Institute for Health Research (NIHR) Biom"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010767","name":"Innovative Medicines Initiative","doi-asserted-by":"publisher","award":["EMIF grant agreement n\u00b0 115372"],"award-info":[{"award-number":["EMIF grant agreement n\u00b0 115372"]}],"id":[{"id":"10.13039\/501100010767","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,9,17]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of the study is to compare body mass index (BMI), systolic\/diastolic blood pressure (SBP\/DBP) and serum total cholesterol levels between dementia cases and controls at multiple time intervals prior to dementia onset, and to test time interval as a modifying factor for these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Case\u2013control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Six European electronic health records databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>291\u2009780 cases at the date of first-recorded dementia diagnosis, compared with 29\u2009170\u2009549 controls randomly selected from the same databases, age matched and sex matched at this index date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>\n                      The following measures were extracted whenever recorded within each dataset: BMI (kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), SBP and DBP (mm Hg) and serum total cholesterol (mmol\/L). Levels for each of these variables were defined within six 2-year time intervals over the 12 years prior to the index date.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes<\/jats:title>\n                    <jats:p>Case\u2013control differences in exposures of interest were modelled for each time period and adjusted for demographic and clinical factors (ischaemic\/unspecified stroke, type 2 diabetes mellitus, acute myocardial infarction, hypertension diagnosis, antihypertensive medication, cholesterol-lowering medication). Coefficients and interactions with time period were meta-analysed across the six databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean BMI (coefficient \u22121.16\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; 95%\u2009CI \u20131.38 to 0.93) and SBP (\u22122.83\u2009mm Hg; 95% CI \u20134.49 to \u20131.16) were lower in cases at diagnosis, and case\u2013control differences were greater in more recent time periods, as indicated by significant case-x-time interaction and case-x-time-squared interaction terms. Time variations in coefficients for cholesterol levels were less consistent between databases and those for DBP were largely not significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine clinical data show emerging divergence in levels of BMI and SBP prior to the diagnosis of dementia but less evidence for DBP or total cholesterol levels. These divergences should receive at least some consideration in routine dementia risk screening, although underlying mechanisms still require further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-038753","type":"journal-article","created":{"date-parts":[[2020,11,15]],"date-time":"2020-11-15T04:10:41Z","timestamp":1605413441000},"page":"e038753","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Vascular and metabolic risk factor differences prior to dementia diagnosis: a multidatabase case\u2013control study using European electronic health records"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3414-303X","authenticated-orcid":false,"given":"Gayan","family":"Perera","sequence":"first","affiliation":[{"name":"Psychological Medicine, King's College London (Institute of Psychiatry, Psychology and Neuroscience), London, 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Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8274-0357","authenticated-orcid":false,"given":"Talita","family":"Duarte-Salles","sequence":"additional","affiliation":[{"name":"IDIAP Jordi Gol, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark Forrest","family":"Gordon","sequence":"additional","affiliation":[{"name":"Specialty Clinical Development, Neurology and Psychiatry, Teva Pharmaceuticals USA Inc, North Wales, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Lapi","sequence":"additional","affiliation":[{"name":"Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel","family":"Mayer","sequence":"additional","affiliation":[{"name":"Hospital del Mar Institute for Medical Research, Barcelona, 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