心血管病危险因素的存在对痴呆亚型认知变化的影响

Title:Impact of the Presence of Select Cardiovascular Risk Factors on Cognitive Changes among Dementia Subtypes

Volume: 15 Issue: 11

关键词: 阿尔茨海默病，路易体痴呆，额颞叶痴呆，神经心理测试，血管危险因素，体重指数。

摘要: Background: Studies have shown select associations between cardiovascular risk factors and dementia, but mostly focused on Alzheimer’s Disease (AD).

Objective: We enhance these works by evaluating the relationship between the presence of cardiovascular risk factors and the rate of cognitive decline, measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SUM) on four common dementia subtypes (AD, dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VaD), as well as non-demented elderly individuals (normal)).

Method: We used generalized linear mixed models with random intercepts to account for correlation at the patient and center levels for each dementia subtype adjusting for time since initial visit, baseline cognitive score, age, and demographic factors. The cardiovascular risk factors evaluated included body mass index, diabetes, years of smoking, atrial fibrillation, hypertension, and hypercholesterolemia.

Results: Patients diagnosed with AD (n=1899), DLB (n=65), FTD (n=168), or VaD (n=13); or lacked cognitive impairment (normal) (n=3583) were evaluated using data from the National Alzheimer’s Coordinating Centers. Cardiovascular risk factors were associated with select dementia subtypes including AD and FTD. Using MMSE and CDR-SUM, recent or active hypertension and hypercholesterolemia were associated with a slower cognitive decline for AD patients, while higher body mass index and years of smoking were associated with a slower cognitive decline for FTD patients. However, several cardiovascular factors demonstrated associations with more rapid cognitive decline.

Conclusion: These results demonstrate disease specific associations and can provide clinicians guidance on predicted cognitive changes at the group level using information about cardiovascular risk factors.

Cite this article as:

Impact of the Presence of Select Cardiovascular Risk Factors on Cognitive Changes among Dementia Subtypes, Current Alzheimer Research 2018; 15 (11) . https://dx.doi.org/10.2174/1567205015666180702105119