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Treatment of vascular risk factors is associated with slower decline in Alzheimer disease.

Abstract

BACKGROUND

There is growing evidence that vascular risk factors (VRF) contribute to cognitive decline. Whether their treatment can slow down the progression of Alzheimer disease (AD) remains unsettled. The aim of this observational study was to evaluate whether the treatment of VRF is associated with a slower cognitive decline in patients who have AD without cerebrovascular disease (CVD).

METHODS

We recruited 301 consecutive patients who had AD without CVD (mean age 71.7 years; 69.4% women; first Mini-Mental State Examination [MMSE] mean score 21.6; mean follow-up 2.3 years), who had attended a memory clinic between 1997 and 2003. VRF sought were high blood pressure, dyslipidemia, diabetes mellitus, tobacco smoking, and atherosclerotic disease. Only 21 patients (7.0%) had no VRF. Others were classified as having no VRF treated (n = 72; 25.7%), some VRF treated (n = 119; 42.5%), or all VRF treated (n = 89; 31.8%). We compared MMSE progression over time among these 3 groups using a mixed random effects regression model.

RESULTS

Baseline MMSE scores were similar in the 3 groups. With adjustment for confounding factors, MMSE progression over time differed significantly between groups (p = 0.002). Patients with all their VRF treated declined less than those with none of their VRF treated. Those with some VRF treated tended to have an intermediate decline.

CONCLUSIONS

In patients who have Alzheimer disease without CVD, treatment of vascular risk factors (VRF) is associated with a slower decline in Mini-Mental State Examination score. Randomized controlled trials are needed to confirm this association, but our data suggest that dementia should not prevent treatment of VRF.

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  • Authors+Show Affiliations

    ,

    Université Lille Nord de France, INSERM UMR 744, Institut Pasteur de Lille, 1 rue Calmette, 59019 Lille Cedex, France.

    , ,

    Source

    Neurology 73:9 2009 Sep 01 pg 674-80

    MeSH

    Aged
    Alzheimer Disease
    Cerebral Arteries
    Cerebrovascular Disorders
    Disease Progression
    Female
    Humans
    Hypolipidemic Agents
    Intracranial Arteriosclerosis
    Longitudinal Studies
    Male
    Neuropsychological Tests
    Risk Factors
    Risk Management
    Risk Reduction Behavior
    Time
    Time Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19720973

    Citation

    Deschaintre, Yan, et al. "Treatment of Vascular Risk Factors Is Associated With Slower Decline in Alzheimer Disease." Neurology, vol. 73, no. 9, 2009, pp. 674-80.
    Deschaintre Y, Richard F, Leys D, et al. Treatment of vascular risk factors is associated with slower decline in Alzheimer disease. Neurology. 2009;73(9):674-80.
    Deschaintre, Y., Richard, F., Leys, D., & Pasquier, F. (2009). Treatment of vascular risk factors is associated with slower decline in Alzheimer disease. Neurology, 73(9), pp. 674-80. doi:10.1212/WNL.0b013e3181b59bf3.
    Deschaintre Y, et al. Treatment of Vascular Risk Factors Is Associated With Slower Decline in Alzheimer Disease. Neurology. 2009 Sep 1;73(9):674-80. PubMed PMID: 19720973.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Treatment of vascular risk factors is associated with slower decline in Alzheimer disease. AU - Deschaintre,Yan, AU - Richard,Florence, AU - Leys,Didier, AU - Pasquier,Florence, PY - 2009/9/2/entrez PY - 2009/9/2/pubmed PY - 2009/10/14/medline SP - 674 EP - 80 JF - Neurology JO - Neurology VL - 73 IS - 9 N2 - BACKGROUND: There is growing evidence that vascular risk factors (VRF) contribute to cognitive decline. Whether their treatment can slow down the progression of Alzheimer disease (AD) remains unsettled. The aim of this observational study was to evaluate whether the treatment of VRF is associated with a slower cognitive decline in patients who have AD without cerebrovascular disease (CVD). METHODS: We recruited 301 consecutive patients who had AD without CVD (mean age 71.7 years; 69.4% women; first Mini-Mental State Examination [MMSE] mean score 21.6; mean follow-up 2.3 years), who had attended a memory clinic between 1997 and 2003. VRF sought were high blood pressure, dyslipidemia, diabetes mellitus, tobacco smoking, and atherosclerotic disease. Only 21 patients (7.0%) had no VRF. Others were classified as having no VRF treated (n = 72; 25.7%), some VRF treated (n = 119; 42.5%), or all VRF treated (n = 89; 31.8%). We compared MMSE progression over time among these 3 groups using a mixed random effects regression model. RESULTS: Baseline MMSE scores were similar in the 3 groups. With adjustment for confounding factors, MMSE progression over time differed significantly between groups (p = 0.002). Patients with all their VRF treated declined less than those with none of their VRF treated. Those with some VRF treated tended to have an intermediate decline. CONCLUSIONS: In patients who have Alzheimer disease without CVD, treatment of vascular risk factors (VRF) is associated with a slower decline in Mini-Mental State Examination score. Randomized controlled trials are needed to confirm this association, but our data suggest that dementia should not prevent treatment of VRF. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/19720973/Treatment_of_vascular_risk_factors_is_associated_with_slower_decline_in_Alzheimer_disease_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=19720973 DB - PRIME DP - Unbound Medicine ER -