Abstract
BackgroundThe clinical guidelines related to the primary prevention of Alzheimer’s disease (AD) have focused on the management of vascular risk factors. However, the link between vascular risk factors and AD in older adults remains unclear. This study aimed to determine the association between vascular risk factors and subsequent AD in 178,586 older adults (age ≥ 65 years).MethodsParticipants were recruited from 2009 through 2010 and followed up for 6 years. We assessed various vascular risk factors (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], fasting glucose [FG], systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and body mass index [BMI]) and their association with AD incidence, categorizing each vascular factor using current clinical guidelines.ResultsAD was observed in 6.0% of participants at follow-up. All lipid profiles (TC, LDL-C, HDL-C and TG) were positively associated with the risk of AD. SBP and PP were in negative associations with AD, and DBP was positively associated with AD. BMI exhibited a negative association with AD incidence. We found no significant association between FG and AD risk. The sex difference was observed to have effects on vascular risk factors.ConclusionsIn this study, we comprehensively investigated the association between eight vascular risk factors and the risk of incident AD. Our findings suggest that multiple vascular risk factors are related to the development of AD in older adults. These results can help inform future guidelines for reducing AD risk.
Highlights
The clinical guidelines related to the primary prevention of Alzheimer’s disease (AD) have focused on the management of vascular risk factors
Current guidelines related to the primary prevention of AD focus on the modification of vascular risk factors [3,4,5,6,7]
Systolic blood pressure (SBP) and Body mass index (BMI) exhibited a negative association with AD incidence, except for the highest group
Summary
The clinical guidelines related to the primary prevention of Alzheimer’s disease (AD) have focused on the management of vascular risk factors. This study aimed to determine the association between vascular risk factors and subsequent AD in 178,586 older adults (age ≥ 65 years). Midlife hypertension has been reported to increase AD dementia risk [9], while late-life hypertension has an inconsistent association with AD dementia risk in the same research. Midlife obesity is an established risk factor for AD, whereas late-life obesity has been proposed as a protective state, exhibiting reverse causation [16]. As it could be supported by these complex reports in midlife and late-life vascular risk factor studies, the preventive effect of modifying vascular risk factors in older adults is still insufficient
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