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Abstract
Objective: Growing evidence suggests that vascular risk factors (VRF) contribute to cognitive decline. The aim of this study was to investigate the impact of VRF on the conversion from mild cognitive impairment (MCI) to Alzheimer disease (AD) dementia.
Methods: A total of 837 subjects with MCI were enrolled at baseline and followed up annually for 5 years. The incidence of AD dementia was investigated. A mixed random effects regression model was used to analyze the association between VRF and the progression of MCI assessed with Mini-Mental State Examination and instrumental Activities of Daily Living. Cox proportional hazard models were used to identify the association between VRF and dementia conversion, and to examine whether treatment of VRF can prevent dementia conversion.
Results: At the end of the follow-up, 298 subjects converted to AD dementia, while 352 remained MCI. Subjects with VRF had a faster progression in cognition and function relative to subjects without. VRF including hypertension, diabetes, cerebrovascular diseases, and hypercholesterolemia increased the risk of dementia conversion. Those subjects with MCI in whom all VRF were treated had a lower risk of dementia than those who had some VRF treated. Treatment of individual VRF including hypertension, diabetes, and hypercholesterolemia was associated with the reduced risk of AD conversion.
Conclusion: VRF increased the risk of incident AD dementia. Treatment of VRF was associated with a reduced risk of incident AD dementia. Although our findings are observational, they suggest active intervention for VRF might reduce progression in MCI to AD dementia.
Footnotes
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Study funding: Supported by grant no. 2001-54-23 from the Science and Technology Committee of Chongqing, China.
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The Chongqing Ageing Study Group Coinvestigators are listed in appendix e-1 on the Neurology® Web site at www.neurology.org.
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Disclosure: The authors report no disclosures.
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Supplemental data at www.neurology.org.
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- Aβ
- amyloid-β
- AD
- Alzheimer disease
- ADL
- Activities of Daily Living
- CVD
- cerebrovascular disease
- DSM-IV
- Diagnostic and Statistical Manual of Mental Disorders, fourth edition
- HIS
- Hachinski Ischemic Score
- IDE
- insulin-degrading enzyme
- MCI
- mild cognitive impairment
- MMSE
- Mini-Mental State Examination
- NINDS-AIREN
- National Institute of Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences
- VaD
- vascular dementia
- VRF
- vascular risk factors.
- Received October 9, 2010.
- Accepted January 11, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
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