Background and Purpose:The role of lipoprotein abnormalities in the development of ischemic cerebrovascular disease has not been sufficiently clarified. The aim of this study was to identify the lipoprotein profile in ischemic cerebrovascular disease and the possible role of apolipoprotein E polymorphism.Methods: The relation between the concentrations of lipoprotein(a), intermediate density lipoproteins, apolipoprotein A-I, apolipoprotein B, apolipoprotein E, and other lipoproteins was studied in 100 men with ischemic cerebrovascular disease (48 atherothrombotic, 28 lacunar, and 24 of unknown type) and in 100 healthy age-matched men as a control group.Results: Patients with ischemic cerebrovascular disease had significantly higher levels of lipoprotein (a), lipids carried by intermediate density lipoproteins, and low density lipoprotein cholesterol and lower levels of high density lipoproteins than control subjects. Patients with atherothrombotic infarction had higher total serum cholesterol and low density lipoprotein cholesterol concentrations than patients with lacunar infarction. To assess lipoprotein abnormalities in normolipidemic subjects, a subgroup of 38 patients with ischemic cerebrovascular disease and 53 control subjects, both with serum cholesterol levels <5.2 mmol/l (200 mg/dl) and triglycerides <2.3 mmol/l (200 mg/dl), was analyzed. Serum lipoprotein (a), lipids carried by very low density lipoproteins and intermediate density lipoproteins, and low density lipoprotein triglycerides were significantly higher in normolipidemic patients compared with normolipidemic control subjects, whereas high density lipoprotein cholesterol levels were lower. Apolipoprotein E polymorphism in our ischemic cerebrovascular patients differed from that of the control group, with the e4 allele being more prevalent.Conclusions: Increased serum lipoprotein (a) levels and intermediate density lipoprotein abnormalities together with decreased high density lipoprotein levels are major risk factors for ischemic cerebrovascular disease, even in normocholesterolemic and normotriglyceridemic subjects. Finally, the e4 allele could probably be a predisposing genetic marker for ischemic cerebrovascular disease. (Stroke 1992;23:1556-1562 KEY WORDS • lacunar infarction • lipids • lipoproteins • risk factors

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This study was to investigate the prevalence of dementia in an aging population. A two-phase model was used to obtain information on the socio-demographic, medical and cognitive status of subjects over 65 years of age (n = 516), resident on December 31, 1990, within the general population (n = 3,457) of La Selva del Camp. A diagnostic protocol, following the criteria of DSM-III, was designed for application to all subjects. We diagnosed 64 subjects with dementia, which represented a prevalence of 14.9% of which 3.2% was classified as severe, 4.5% as moderate and 7.3% as slight. The prevalence by age and sex showed a large increase with age and a higher prevalence in females, although the latter was not statistically significant.

We identified 14 door-to-door prevalence surveys on dementia, parkinsonism or stroke in Spanish populations fulfilling specific criteria and combined selected age- and sex-specific data using logistic regression and taking Pamplona as a reference. The prevalence of dementia and of Alzheimer’s disease varied significantly with space. However, the largest variation was seen for vascular dementia: odds ratio (OR) and 95% confidence interval (CI) for Gerona were 6.42 (3.23–12.3) in women and 2.30 (1.10–4.79) in men. Stroke was particularly frequent among Arevalo’s women, with OR 2.10 and 95% CI 1.26–3.49. The prevalence of Parkinson’s disease was twofold higher in Cantalejo. Although differences in methodology make the interpretation of results problematic, the prevalence of stroke and vascular dementia in Spain seems to vary spatially, indicating a space for prevention.

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