Health Conditions Associated with Alzheimer's Disease and Vascular Dementia

Abstract

Objective: We examined medical records to determine health conditions associated with dementia at varied intervals prior to dementia diagnosis in participants from the Baltimore Longitudinal Study of Aging (BLSA). Methods: Data were available for 347 Alzheimer's disease (AD), 76 vascular dementia (VaD), and 811 control participants without dementia. Logistic regressions were performed associating International Classification of Diseases, 9th Revision (ICD-9) health codes with dementia status across all time points, at 5 and 1 year(s) prior to dementia diagnosis, and at the year of diagnosis, controlling for age, sex, and follow-up length of the medical record. Results: In AD, the earliest and most consistent associations across all time points included depression, erectile dysfunction, gait abnormalities, hearing loss, and nervous and musculoskeletal symptoms. Cardiomegaly, urinary incontinence, non-epithelial skin cancer, and pneumonia were not significant until 1 year before dementia diagnosis. In VaD, the earliest and most consistent associations across all time points included abnormal electrocardiogram (EKG), cardiac dysrhythmias, cerebrovascular disease, non-epithelial skin cancer, depression, and hearing loss. Atrial fibrillation, occlusion of cerebral arteries, essential tremor, and abnormal reflexes were not significant until 1 year before dementia diagnosis. Interpretation: These findings suggest that some health conditions are associated with future dementia beginning at least 5 years before dementia diagnosis and are consistently seen over time, while others only reach significance closer to the date of diagnosis. These results also show that there are both shared and distinctive health conditions associated with AD and VaD. These results reinforce the need for medical intervention and treatment to lessen the impact of health comorbidities in the aging population.

Mapping morbidity 10 years prior to a diagnosis of young onset Alzheimer's disease

“… 25 Likewise, a study based on the Baltimore Longitudinal Study of Aging found depression, erectile dysfunction, gait abnormalities, hearing loss, and nervous and musculoskeletal symptoms positively associated with LOAD. 26 While some of these overlap with associations found in the present study (hearing loss, depression, disorders of the urinary system), others were not commonly found in our cohort (disorders of the vestibular system, disorders of refraction etc.).…”

“…Two other studies investigated morbidity preceding LOAD; a Taiwanese study of 4600 LOAD cases and 4600 controls found that anxiety, functional digestive disorder, psychopathology‐specific symptoms, disorders of the vestibular system, concussion, disorders of the urinary system, disorders of refraction and accommodation, and hearing loss were positively associated with LOAD 25 . Likewise, a study based on the Baltimore Longitudinal Study of Aging found depression, erectile dysfunction, gait abnormalities, hearing loss, and nervous and musculoskeletal symptoms positively associated with LOAD 26 . While some of these overlap with associations found in the present study (hearing loss, depression, disorders of the urinary system), others were not commonly found in our cohort (disorders of the vestibular system, disorders of refraction etc.…”

Does Transcranial Direct Current Stimulation Affect Potential P300-Related Events in Vascular Dementia? Considerations from a Pilot Study

“…Its clinical manifestations can vary depending on the location, size, and severity of vascular brain lesions [ 14 ]. Vascular dementia encompasses a range of cognitive disorders, ranging from mild cognitive deficits to severe dementia manifestations [ 15 , 16 ]. This clinical complexity significantly impacts the quality of life for affected individuals and their families [ 17 , 18 , 19 ].…”