The influence of vascular risk factors on cognitive decline in patients with Alzheimer's Disease

Maturitas ◽  
2014 ◽  
Vol 79 (1) ◽  
pp. 96-99 ◽  
Author(s):  
Kim Blom ◽  
Ilonca Vaartjes ◽  
Sanne A.E. Peters ◽  
Huiberdina L. Koek
Aging ◽  
2020 ◽  
Vol 12 (14) ◽  
pp. 15058-15076
Author(s):  
Qing Wang ◽  
Cancan He ◽  
Yao Zhu ◽  
Qianqian Zhang ◽  
Zhijun Zhang ◽  
...  

2016 ◽  
Vol 12 ◽  
pp. P1059-P1061
Author(s):  
Isabelle Bos ◽  
Stephanie J.B. Vos ◽  
Lutz Frölich ◽  
Johannes Kornhuber ◽  
Jens Wiltfang ◽  
...  

2021 ◽  
Author(s):  
João Pedro Ferrari-Souza ◽  
Wagner S. Brum ◽  
Lucas A. Hauschild ◽  
Lucas U. Da Ros ◽  
Pâmela C. L. Ferreira ◽  
...  

Understanding whether vascular risk factors synergistically potentiate Alzheimer's disease progression is important in the context of emerging treatments for preclinical Alzheimer's disease. The existence of a synergistic relationship could suggest that the combination of therapies targeting Alzheimer's disease pathophysiology and vascular risk factors might potentiate treatment outcomes. In the present retrospective cohort study, we tested whether vascular risk factor burden interacts with Alzheimer's disease pathophysiology to accelerate neurodegeneration and cognitive decline in cognitively unimpaired subjects. We evaluated 503 cognitively unimpaired participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study. Baseline vascular risk factor burden was calculated considering the history of cardiovascular disease, hypertension, diabetes mellitus, hyperlipidemia, stroke or transient ischemic attack, smoking, atrial fibrillation, and left ventricular hypertrophy. Alzheimer's disease pathophysiology was evaluated using cerebrospinal fluid (CSF) amyloid-β1-42 (Aβ1-42) reflecting brain amyloidosis (A) and tau phosphorylated at threonine 181 (p-tau181) reflecting brain tau pathology (T). Individuals were dichotomized as having an elevated vascular risk factor burden (V+ if having two or more vascular risk factors) and as presenting preclinical Alzheimer's disease [(AT)+ if having abnormal CSF p-tau181 and Aβ1-42 levels]. Neurodegeneration was assessed with plasma neurofilament light (NfL) and global cognition with the modified version of the Preclinical Alzheimer's Cognitive Composite. Linear mixed-effects models revealed that an elevated vascular risk factor burden synergistically interacted with Alzheimer's disease pathophysiology to drive longitudinal increases in plasma NfL levels (β = 5.08, P = 0.016) and cognitive decline (β = -0.43, P = 0.020). Additionally, we observed that vascular risk factor burden was not associated with CSF Aβ1-42 or p-tau181 changes over time. Survival analysis demonstrated that individuals with preclinical Alzheimer's disease and elevated vascular risk factor burden [(AT)+V+] had a significantly greater risk of clinical progression to cognitive impairment (adjusted Hazard Ratio = 3.5, P < 0.001). Our results support the notion that vascular risk factor burden and Alzheimer's disease pathophysiology are independent processes; however, they synergistically lead to neurodegeneration and cognitive decline. These findings can help in providing the blueprints for the combination of vascular risk factor management and Alzheimer's disease pathophysiology treatment in preclinical stages. Moreover, we observed plasma NfL as a robust marker of disease progression that may be used to track therapeutic response in future trials.


2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Márcia L. Chaves ◽  
Ana L. Camozzato ◽  
Cristiano Köhler ◽  
Jeffrey Kaye

Introduction. This study evaluates the progression of dementia and identifies prognostic risk factors for dementia.Methods. A group of 80 Brazilian community residents with dementia (34 with Alzheimer's disease and 46 with vascular dementia) was assessed over the course of 2 years. Data were analyzed with Cox regression survival analysis.Results. The data showed that education predicted cognitive decline (HR=1.2;P<.05) when analyzed without controlling for vascular risk factors. After the inclusion of vascular risk factors, education (HR=1.32;P<.05) and hypertension were predictive for cognitive decline (HR=38;P<.05), and Alzheimer's disease diagnosis was borderline predictive (P=.055).Conclusion.Vascular risk factors interacted with the diagnosis of vascular dementia. Education was a strong predictor of decline.


US Neurology ◽  
2010 ◽  
Vol 05 (02) ◽  
pp. 18 ◽  
Author(s):  
Simon Forstmeier ◽  
Andreas Maercker ◽  
◽  

This article summarises empirical findings on major potentially modifiable risk factors in the development of Alzheimer’s disease (AD), drawing on data from longitudinal epidemiological studies on the incidence of AD or any-cause dementia. Risk factors investigated to date include cognitive ability, motivational ability, emotional health, physical activity, social activity and social network, vascular risk factors and nutrition. The authors find most empirical support for two main clusters of risk factors that also represent potential targets for prevention. First, an active and stimulating lifestyle including cognitive, social, and physical activities reduces the risk of AD. Second, the absence of vascular risk factors such as diabetes, hypertension, hypercholesterol and obesity reduces the risk of AD. More prevention trials are warranted to investigate the preventative effects of an active and stimulating lifestyle on the one hand, and vascular health on the other, in delaying the onset of AD or slowing its progression.


2019 ◽  
Vol 67 (1) ◽  
pp. 291-302 ◽  
Author(s):  
Gali H. Weissberger ◽  
Tamar H. Gollan ◽  
Mark W. Bondi ◽  
Daniel A. Nation ◽  
Lawrence A. Hansen ◽  
...  

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Toshioki Matsuzawa ◽  
Toshihiro Takata ◽  
Koichi Yokono ◽  
Hiroo Ueda ◽  
Kensuke Moriwaki ◽  
...  

Background/Aims. Diabetes might increase the risk of Alzheimer’s disease (AD). For detecting dementia, it is typical to obtain informants’ perceptions of cognitive deficits, but such interviews are usually difficult in routine care. We aimed to develop a model for predicting mild to moderate AD using a self-reported questionnaire and by evaluating vascular risk factors for dementia in elderly subjects with diabetes.Methods. We recruited 286 diabetic and 155 nondiabetic elderly subjects. There were 25 patients with AD and 261 cognitively normal individuals versus 30 with AD and 125 normal subjects, respectively. Each participant answered subjective questions on memory deficits and daily functioning. Information on vascular risk factors was obtained from clinical charts, and multivariate logistic regression was used to develop a model for predicting AD.Results. The predicted probabilities used in screening for AD in diabetic subjects constituted age, education, lower diastolic blood pressure, subjective complaints of memory dysfunction noticeable by others, and impaired medication, shopping, and travel outside a familiar locality. Receiver operating characteristic analysis revealed a satisfactory discrimination for AD specific for diabetic elderly subjects, with 95.2% sensitivity and 90.6% specificity.Conclusion. This is the first useful index that can prescreen for AD in elderly subjects with diabetes.


Sign in / Sign up

Export Citation Format

Share Document