Vascular risk factors, incidence of MCI, and rates of progression to dementia

Solfrizzi, Vincenzo; Panza, Francesco; Colacicco, Anna M.; D’Introno, Alessia; Capurso, Cristiano; Torres, Francesco; Grigoletto, Francesco; Maggi, Stefania; Parigi, Angelo Del; Reiman, Eric M.; Caselli, Richard J.; Scafato, Emanuele; Farchi, G; Capurso, Antonio

doi:10.1212/01.wnl.0000144281.38555.e3

Cited by 472 publications

(438 citation statements)

References 53 publications

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“…Of the studies having examined whole samples without gender stratification, a number of prospective studies found no significant associations with T-C, LDL-C, HDL-C, and TG (Reitz et al, 2005;Reitz et al, 2008;Solfrizzi et al, 2004;Teunissen et al, 2003;van den Berg et al, 2007). Solomon et al reported positive associations between midlife (but not late-life) T-C and cognitive decline in episodic memory and fluency (Solomon et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Gender-specific associations between lipids and cognitive decline in the elderly

Ancelin

Ripoche

Dupuy

et al. 2014

European Neuropsychopharmacology

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The aim of this study was to examine the associations between serum lipid levels and cognitive function in a community-based sample of non-demented subjects aged 65 years and over.Participants were 2737 men and 4118 women from a population-based cohort recruited from three French cities. Visual memory, verbal fluency, psychomotor speed, and executive abilities were evaluated at baseline, and after 2, 4, and 7 years of follow-up. Lipid levels were evaluated at baseline. Multiadjusted Cox models stratified by gender were adjusted for sociodemographic and lifestyle characteristics, mental and physical health, and genetic vulnerability to dyslipidemia (apolipoprotein E and A, and cholesteryl ester transfer protein) and taking into account baseline vascular pathologies. In men, a hypercholesterolemic pattern in late-life (high total cholesterol (T-C), low HDL-C, high LDL-C levels) was associated with a 25 to 50% increased risk of decline over 7 years in psychomotor speed, executive abilities, and verbal fluency. Specific associations with low T-C and low LDL-C levels were also observed which may depend on genetic vulnerability to dyslipidemia (related to apolipoprotein A5 and cholesteryl exchange transfer protein). In contrast, in women, a 30% higher rate of decline was found in psychomotor speed with high HDL-C levels and in executive abilities with low levels of LDL-C and triglycerides, in interaction with hormonal treatment. For men and women, vascular pathologies only slightly outweighed the risk related to lipids. This suggests a complex gender-specific pattern of cognitive decline involving genetic vulnerability in men and hormonal status in women.

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Section: Discussionmentioning

confidence: 99%

Gender-specific associations between lipids and cognitive decline in the elderly

Ancelin

Ripoche

Dupuy

et al. 2014

European Neuropsychopharmacology

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“…Setting The methods of the Italian Longitudinal Study on Aging (ILSA) and the 1st, 2nd, and 3rd survey data collection have been described in detail elsewhere (Solfrizzi et al 2004(Solfrizzi et al , 2006. A sample of 5,632 subjects aged 65-84 years, free-living or institutionalized, was randomly selected from the electoral rolls of eight Italian municipalities after stratification for age and gender.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical examination and laboratory analyses Cases of coronary artery disease (myocardial infarction or angina pectoris), type 2 diabetes mellitus, hypertension, stroke, and peripheral artery disease were identified with a two-phase procedure, utilizing clinical criteria described in detail elsewhere (Solfrizzi et al 2004; The Italian Longitudinal Study on Aging Working Group 1997). Each participant was administered a screening questionnaire, a series of brief screening tests to identify suspect cases of the above listed diseases for further investigation, and a clinical evaluation (phase 1).…”

Section: Methodsmentioning

confidence: 99%

Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging

Solfrizzi

Scafato

Frisardi

et al. 2011

AGE

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Cognition has already been considered as a component of frailty, and it has been demonstrated that it is associated with adverse health outcomes. We estimated the prevalence of frailty syndrome in an Italian older population and its predictive role on allcause mortality and disability in nondemented subjects and in demented patients. We evaluated 2,581 individuals recruited from the Italian Longitudinal Study on Aging, a population-based sample of 5,632 subjects, aged 65-84 years old. Participants received identical baseline evaluation at the 1st survey (1992)(1993) and were followed at 2nd (1995)(1996) and 3rd survey (2000)(2001). A phenotype of frailty according to partially modified measurement of Cardiovascular Health Study criteria was operationalized. The overall prevalence of frailty syndrome in this populationbased study was 7.6% (95% confidence interval (CI) 6.55-8.57). Frail individuals noncomorbid or nondisable were 9.1% and 39.3%, respectively, confirming an overlap but not concordance in the cooccurrence among these conditions. Frailty was associated with a significantly increased risk of allcause mortality over a 3-year follow-up (hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.52-2.60) and over a 7-year follow-up (HR 1.74, 95% CI 1.44-2.16), but with significant increased risk of disability only over a 3-year follow-up (HR 1.32, 95% CI 1.06-1.86 over a 3-year follow-up and HR 1.16, 95% CI 0.88-1.56 over a 7-year follow-up). Frail demented patients were at higher risk of all-cause mortality over 3-(HR 3.33, 95% CI 1.28-8.29) and 7-year follow-up periods (HR 1.89, 95% CI 1.10-3.44), but not of disability. Frailty syndrome was a short-term predictor of disability in nondemented older subjects and short-and long-term predictor of all-cause mortality in nondemented and demented patients.

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“…46 Among the studies with cognitive impairment as a categorical end point (Table 2), 42,48 -61 those using a dichotomized test score 53,57 classified from 15% 53 to 50% 57 of the participants as cognitively impaired and reported positive associations with hypertension. Two studies 50,56 found no association of mild cognitive impairment with hypertension earlier in life. Studies with dementia, 48,52,54 AD, 42,49,51,52,54,55,58 -61 or VaD 49,54,59 as the end point demonstrated a significantly positive association with Ն1 blood pressure index, if follow-up started from middle age rather than old age.…”

Section: Longitudinal Cohort Studiesmentioning

confidence: 99%

Less Atherosclerosis and Lower Blood Pressure for a Meaningful Life Perspective With More Brain

2007

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T raditional teaching subdivides the dementia syndrome into neurodegenerative Alzheimer's disease (AD), vascular dementia (VaD), and mixed variants. In spite of the vast and continuing literature on the dichotomy between AD and VaD, new emerging concepts highlight the role of cardiovascular risk factors in the pathogenesis of AD, especially in older patients. 1,2 Hypertension is the major player in the pathogenesis of stroke, poststroke dementia, and VaD. AD is the most common cause of dementia, contributing from 45% to Ͼ75% of the cases in Asians and whites, respectively. 3 This review will focus on the role of hypertension as a reversible risk factor in the development of dementia, in particular AD. To set the stage, we will first summarize current insights in the epidemiology of AD, the pathogenesis of VaD and AD, and the association between neurodegeneration and atherosclerosis. Epidemiology of DementiaAcross 36 cross-sectional studies, the prevalence of dementia increased exponentially from 0.3% to 1.0% in subjects aged 60 to 64 years to 10% to 20% in octogenarians and to Ͼ40% in the ninth decade of life. 3 In 15 longitudinal studies, the incidence of dementia showed a similar age-related dependency with rates expressed in new cases per 1000 personyears ranging from 0.4 to 4 at 60 to 64 years to 20 to Ͼ40 at 80 to 85 years. 3 Currently, 24.3 million people have dementia with an annual worldwide incidence of 4.6 million new cases. 4

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Vascular risk factors, incidence of MCI, and rates of progression to dementia

Abstract: In this population, among those who progressed to dementia, 60% progressed to AD and 33% to VaD. Vascular risk factors influence incident mild cognitive impairment and the rate of progression to dementia.

Cited by 472 publications

References 53 publications

Gender-specific associations between lipids and cognitive decline in the elderly

Gender-specific associations between lipids and cognitive decline in the elderly

Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging

Less Atherosclerosis and Lower Blood Pressure for a Meaningful Life Perspective With More Brain

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