In Reply: Dr Grant suggests that certain components of diet such as total calorie intake and high fat content may be risk factors for AD. He points out that our study design allows a test of this hypothesis by evaluating the individual diets of the study participants and comparing these to dementia outcomes. Dr Clarke proposes that chronic sensory overload from activities such as watching television may result in increased incidence of AD. An alternative hypothesis, which is consistent with the results from studies he references, is that excessive television watching reflects social disengagement. This, at least in one previous report, is predictive of cognitive decline.1 We are currently evaluating parameters of social and intellectual involvement. While both hypotheses have their merits, it is likely that the etiology of AD will turn out to be much more complex than a single factor and will require simultaneous consideration of both genetic and environmental influences.
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