Cardiovascular and Other Risk Factors for Alzheimer's Disease and Vascular Dementia

Abstract

Factors accelerating cerebral degenerative changes represent potentially modifiable risks for cognitive decline. Putative risks accelerating subtle cognitive decline and dementia were correlated with repeated measures of cerebral atrophy, CT densitometry, perfusions, and cognitive testing among 224 neurologically and cognitively normative aging volunteers. After age 60, cerebral atrophy, ventricular enlargement, polioaraiosis, and leukoaraiosis geometrically increased as perfusions declined. Risks accelerating perfusional decline, cerebral atrophy, polioaraiosis, and leukoaraiosis were: transient ischemic attacks (TIAs), hypertension, smoking, hyperlipidemia, male gender. At age 71.5 +/- 11.9, subtle cognitive decline began, accelerated by TIAs, hypertension, and heart disease. Leukoaraiosis began before cognitive decline. TIAs, hypertension, and hyperlipidemia correlated with vascular dementias. Excessive cortical perfusional decreases and cerebral atrophy correlated with cognitive decline. Family history of neurodegenerative disease correlated with Alzheimer's disease. We concluded that TIAs, hypertension, hyperlipidemia, smoking, and male gender accelerate cerebral degenerative changes, cognitive decline, and dementia.

Assessment of nicotine dependence in subjects with vascular dementia

“…[1][2][3][4] Vascular dementia is the second most prevalent dementia 5,6 and the commonest type of preventable dementia. While several factors like hypertension, diabetes, dyslipidaemia, coronary artery disease and nicotine dependence 7 have been known to contribute to vascular dementia, it is nicotine use which is a completely preventable risk factor and should be a focus of clinical intervention as well as public health campaigns.…”

Cardiovascular risk in cognitively preserved elderlies is associated with glucose hypometabolism in the posterior cingulate cortex and precuneus regardless of brain atrophy and apolipoprotein gene variations

“…Such conditions are nowadays recognized as risk factors not only for vascular dementia but also for AD (Launer et al 2000;Meyer et al 2000;Knopman et al 2001;Stuerenburg et al 2005;Rosendorff et al 2007;Irie et al 2008;Xu et al 2009). There are also findings from post mortem and in vivo morphometric magnetic resonance imaging (MRI) studies indicating that brain lesions of vascular origin, such as white matter hyperintensities, stroke, and lacunar infarcts, may be significantly associated with AD (Craft 2009;Erkinjuntti and Gauthier 2009;Teipel et al 2009).…”

Interactive relations of central versus total obesity and blood pressure to cognitive function

“…Obesity is strongly related to higher blood pressure (BP) or hypertension. 9 It is well known that hypertension or higher levels of BP are associated with stroke and dementia, 10,11 and with lower levels of performance across multiple domains of cognitive function (even in the absence of stroke or dementia). [12][13][14] Hypertension is also known to aggregate with central obesity, hyperinsulinemia, glucose intolerance, and dyslipidemia as part of the metabolic syndrome.…”