Late life vascular risk factors and their association with dementia and Alzheimer’s disease

Abstract

Background : Epidemiological studies have demonstrated associations between higher levels of vascular risk factors in midlife and later development of dementia, particularly Alzheimer's disease (AD). However, in elderly subjects with dementia, some studies have shown that these associations may decrease or even reverse. Therefore , our study aimed to find the association between late life cardiovascular risk factors and neurodegenerative dementia in general and AD in particular. Methods :It is a retrospective case control study using electronic medical records that included elderly patients that were reviewed in Ahmadi hospital geriatric clinic , Kuwait , from the period of 1/7/2019 to 1/2/2020. Two hundred and three (203) elderly patients with neurodegenerative dementia (study group) were recruited for this retrospective study and compared to two hundred and one (201) controls with normal cognition for the presence of vascular risk factors.Results :The study included 404 subjects .Age ranged from 60 to 107 years (mean age 78.79, ± 8.13 SD). AD was found to be the most prevalent type of dementia in the study group , as 49.3 % (100/203) of the demented patients were diagnosed with AD. No significant statistical association was found between vascular risk factors and dementia (P>0.05) , except for obesity which showed negative association (P<0.001). Regarding AD , no statistical significance was found between AD and diabetes, hyperlipidemia, smoking nor atrial fibrillation. On the other hand, we found obesity and hypertension more prevalent in the normal cognition group (negative association with P value <0.001,0.05 respectively). Conclusion : The results of our study support an emerging concept that, while elevated levels of vascular risk factors in midlife increase the risk of development of dementia and AD later in life, once dementia begins , these associations may be diminished or reversed in the elderly