title: Alzheimer's disease and head circumference.
abstract: OBJECTIVE
  Larger brains may contain more neurons and synaptic connections, providing a greater reserve against cognitive decline in Alzheimer's disease (AD). Larger head circumference (HC) may therefore be associated with later detection and diagnosis of AD. We investigated HC in nondemented individuals and AD patients using cross-sectional and prospective analyses.
  
  
  METHODS
  The cross sectional analysis compared mean HC between 592 AD patients and 459 nondemented controls. Prospective analysis was based on the same initially normal controls who were followed longitudinally for conversion to dementia. Diagnosis of AD was made by neurologists using NINDS-ADRDA criteria.
  
  
  RESULTS
  When compared to AD patients, controls had a significantly larger mean HC by 0.58 cm in men and by 0.31 cm in women, but these differences were no longer significant after adjustment for age and years of education. HC varied inversely with age and directly with years of education but did not vary with presence/absence of dementia in first-degree relatives or with apolipoprotein-E (ApoE) genotype. In the prospective analysis, the hazard ratio for time to conversion to AD was not significant for HC when adjusted for age at entry, ApoE allele status, family history of dementia, gender, and years of education. ApoE allele status, first degree relative with dementia, and baseline age conferred an increased risk for conversion to AD, consistent with other studies.
  
  
  CONCLUSIONS
  We observed a smaller HC in AD patients compared to nondemented individuals, but AD per se accounted for little of this difference. HC was not a statistically significant predictor for conversion to AD in our longitudinal group.
authors.affiliation: Department of Neurology, Sanders- Brown Center on Aging - University of Kentucky Alzheimer's Disease Research Center, Lexington, KY 40536-0284, USA. psespi2@uky.edu
authors.forename: Patricio S
authors.initials: PS
authors.lastname: Espinosa
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kryscio
authors.forename: Marta S
authors.initials: MS
authors.lastname: Mendiondo
authors.forename: Fred A
authors.initials: FA
authors.lastname: Schmitt
authors.forename: David R
authors.initials: DR
authors.lastname: Wekstein
authors.forename: William R
authors.initials: WR
authors.lastname: Markesbery
authors.forename: Charles D
authors.initials: CD
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006257:Head; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D012307:Risk Factors