Abstract TP570: Cerebrovascular Risk Factors in Elderly Patients With Alzheimer’s Disease

Abstract

Background: Since disease modifying therapy is not yet available in our current medical practice against dementia including Alzheimer’s disease (AD), the management of vascular risk factors (VRFs) is regarded as the most practical way in the prevention and treatment of dementias. In this paper, the influence of VRFs including cerebrovascular lesions were analysis in relation to the cognitive function in elderly AD patients. Subjects and Methods: The present study was conducted based on 111 Japanese patients (37 men and 74 women) with probable AD who visited our memory clinic. None of them experience stroke events. Their mean age was 75.7 years, and the mean MMSE was 19.0. All subjects underwent 1.5 Tesla MRI, neuropsychological evaluation and laboratory tests including brain natriuretic peptide (BNP) and APOE status. Hypertension, diabetes, obesity, dyslipidemia, heart failure, coronary artery disease, atrial fibrillation (AF) and frailty were regarded as VRFs. Results: The mean MMSE score was highest in 4 cases who had no VRF, whereas that was lowest in 11 cases (9.1%) who had 4 or more VRFs. On MRI, 56 cases (50.5%) showed old lacunar infracts, and 18 cases (16.2%) had old microbleeds. The mean MMSE score was 17.5 in those with thalamic infarcts, whereas that was 19.3 in those without thalamic lesions. Severe white matter lesions and AF were also associated lower cognitive score. The mean MMSE was 18.5 in the underweight cases (BMI<20), whereas that was 20.5 in overweight subjects. Those with the lowest BNP quartile showed the highest MMSE score, whereas the highest BNP quartile had lowest MMSE score. For both systolic and diastolic blood pressure, those in the lowest tertile showed lower MMSE score as compared with those in the highest tertile. Conclusion: The cerebrovascular risk factors including thalamic infarcts, severe white matter lesions, heart failure, AF, and frailty influenced on the clinical presentation in elderly AD patients.