Effect of Vascular Risk Factors on the Progression of Mild Alzheimer’s Disease and Lewy Body Dementia

Bergland, Anne Katrine; Dalen, Ingvild; Larsen, Alf Inge; Aarsland, Dag; Soennesyn, Hogne

doi:10.3233/jad-160847

Cited by 20 publications

(23 citation statements)

References 48 publications

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“…Vascular risk factors and diseases were frequent in the study sample and comparable to other studies [ 11 , 13 ]. In comparison with elderly participants in a Norwegian population study [ 42 ], the prevalence of diabetes and hypercholesterolemia was similar, while hypertension, coronary artery disease and strokes were more common among our study patients.…”

Section: Discussionsupporting

confidence: 90%

Association between vascular comorbidity and progression of Alzheimer’s disease: a two-year observational study in Norwegian memory clinics

et al. 2018

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BackgroundVascular risk factors increase the risk of Alzheimer’s disease (AD), but there is limited evidence on whether comorbid vascular conditions and risk factors have an impact on disease progression. The aim of this study was to examine the association between vascular disease and vascular risk factors and progression of AD.MethodsIn a longitudinal observational study in three Norwegian memory clinics, 282 AD patients (mean age 73.3 years, 54% female) were followed for mean 24 (16–37) months. Vascular risk factors and vascular diseases were registered at baseline, and the vascular burden was estimated by the Framingham Stroke Risk Profile (FSRP). Cerebral medical resonance images (MRIs) were assessed for white matter hyperintensities (WMH), lacunar and cortical infarcts. The associations between vascular comorbidity and progression of dementia as measured by annual change in Clinical Dementia Rating Sum of Boxes (CDR-SB) scores were analysed by multiple regression analyses, adjusted for age and sex.ResultsHypertension occurred in 83%, hypercholesterolemia in 53%, diabetes in 9%, 41% were overweight, and 10% were smokers. One third had a history of vascular disease; 16% had heart disease and 15% had experienced a cerebrovascular event. MRI showed lacunar infarcts in 16%, WMH with Fazekas score 2 in 26%, and Fazekas score 3 in 33%. Neither the vascular risk factors and diseases, the FSRP score, nor cerebrovascular disease was associated with disease progression in AD.ConclusionsAlthough vascular risk factors and vascular diseases were prevalent, no impact on the progression of AD after 2 years was shown.

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Section: Discussionsupporting

confidence: 90%

Association between vascular comorbidity and progression of Alzheimer’s disease: a two-year observational study in Norwegian memory clinics

et al. 2018

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“…This is why we performed a specifically targeted umbrella review to identify the 7 risk factors proven to be associated with VaD and used these factors to estimate our PARs. It is highly probable that each type of dementia is associated with a single specific pattern of risk factors [ 25 , 26 , 27 , 28 ]. Diabetes mellitus, educational level, and depression have, in fact, a quite different weight as risk factors for either AD or VaD (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

An Estimate of Attributable Cases of Alzheimer Disease and Vascular Dementia due to Modifiable Risk Factors: The Impact of Primary Prevention in Europe and in Italy

Mayer

Pucchio

Lacorte

et al. 2018

Dement Geriatr Cogn Disord Extra

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Background: Up to 53.7% of all cases of dementia are assumed to be due to Alzheimer disease (AD), while 15.8% are considered to be due to vascular dementia (VaD). In Europe, about 3 million cases of AD could be due to 7 potentially modifiable risk factors: diabetes, midlife hypertension and/or obesity, physical inactivity, depression, smoking, and low educational level. Aims: To estimate the number of VaD cases in Europe and the number of AD and VaD cases in Italy attributable to these 7 potentially modifiable risk factors. Methods: Assuming the nonindependence of the 7 risk factors, the adjusted combined population attributable risk (PAR) was estimated for AD and VaD. Results: In Europe, adjusted combined PAR was 31.4% for AD and 37.8% for VaD. The total number of attributable cases was 3,033,000 for AD and 873,000 for VaD. In Italy, assuming a 20% reduction of the prevalence of each risk factor, adjusted combined PAR decreased from 45.2 to 38.9% for AD and from 53.1 to 46.6% for VaD, implying a 6.4 and 6.5% reduction in the prevalence of AD and VaD, respectively. Conclusion: A relevant reduction of AD and VaD cases in Europe and Italy could be obtained through primary prevention.

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“…So, this increase is linked to the LBP itself and not always related to the association with CAA [20]. Some previous studies have not found differences in vascular risk factors between AD and LBD patients [21,22]. However, the incidence of arterial hypertension and older age was found to be statistically more frequent in LBD when compared to non-demented patients [11].…”

Section: Discussionmentioning

confidence: 99%

Cerebrovascular Lesions in Mixed Neurodegenerative Dementia: A Neuropathological and Magnetic Resonance Study

Reuck

Deramecourt²,

Auger³

et al. 2017

Eur Neurol

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Background: In elderly brains of demented patients, Alzheimer and Lewy body pathology (LBP) are frequently associated. Cortical microinfarcts (CoMIs) are more observed in Lewy body disease, even in the absence of cerebral amyloid angiopathy (CAA). The present neuropathological and 7.0-tesla MRI studies investigate whether CoMIs are also more frequent in mixed neurodegenerative dementia syndromes. Summary: Both examinations revealed that CoMIs are increased to different degrees in mixed dementia syndromes according to the severity of the LBP. They were mainly associated with a trend of older age and arterial hypertension in the patients with the most severe LBP. Messages: The increased number of CoMIs in mixed dementia syndromes with LBP is mainly due to the associated cerebrovascular pathology, even in the absence of CAA.

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Effect of Vascular Risk Factors on the Progression of Mild Alzheimer’s Disease and Lewy Body Dementia

Abstract: With the exception of smoking, VRF at time of dementia diagnosis were not associated with a more rapid cognitive decline.

Cited by 20 publications

References 48 publications

Association between vascular comorbidity and progression of Alzheimer’s disease: a two-year observational study in Norwegian memory clinics

Association between vascular comorbidity and progression of Alzheimer’s disease: a two-year observational study in Norwegian memory clinics

An Estimate of Attributable Cases of Alzheimer Disease and Vascular Dementia due to Modifiable Risk Factors: The Impact of Primary Prevention in Europe and in Italy

Cerebrovascular Lesions in Mixed Neurodegenerative Dementia: A Neuropathological and Magnetic Resonance Study

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