Abstract
ABSTRACT.Dementia and vascular mild cognitive impairment (VaMCI) currently impose a tremendous human and economic burden on patients from aging populations and their families worldwide. Understanding the interplay of cardiometabolic risk factors and apolipoprotein E (APOE) may direct us to a more personalized medicine and preventative care in MCI and dementia.Objective:To evaluate the relationship of cardiometabolic risk factors with MCI and assess the APOE genotype’s role in an elderly cohort in the Dominican Republic.Methods:We studied a cohort of 180 participants 65 years of age and older using a combined assessment of cardiometabolic risk factors, neuropsychological battery tests, and APOE genotyping. We used the number of failed tests as a proxy to predict MCI.Results:We found that patients with the ε3-ε4 APOE genotype had 2.91 higher number of failed cognitive tests (p=0.027) compared to patients with the ε3-ε3 genotyped. The rate of test failures increased 10% (p=0.025) per unit increase in HbA1c percentage.Conclusions:Increased Hemoglobin A1c levels and ε3-ε4 APOE genotypes seem to have an association with the development of VaMCI.
Highlights
Dementia and vascular mild cognitive impairment (VaMCI) currently impose a tremendous human and economic burden on patients from aging populations and their families worldwide.[1]
VaMCI encompasses the cerebrovascular continuum from MCI to dementia,[2] beginning with cardiometabolic risk factors leading to cerebral vascular disease (CVD) of the large and small arteries
Age ranges from 65 to 77 years, with 30.11% males and 69.3% females. 58.86% of patients had a history of HTN, 25.5% had a history of diabetes, and 68.18% completed primary education
Summary
Dementia and vascular mild cognitive impairment (VaMCI) currently impose a tremendous human and economic burden on patients from aging populations and their families worldwide.[1] VaMCI encompasses the cerebrovascular continuum from MCI to dementia,[2] beginning with cardiometabolic risk factors leading to cerebral vascular disease (CVD) of the large and small arteries. This disease will lead to different types of cognitive impairments depending on the location of the damage produced.[3,4,5] Associated risk factors comprise the entire cluster of classical vascular risks: Hypertension (HTN), hyperlipidemia, Diabetes Mellitus Type 2 (DM2), metabolic syndrome (MetS), smoking, and age and the emerging risk factors:[6] high sensitivity C-reactive protein and homocysteine, behaving as pro-inflammatory markers and prothrombotic status, respectively. HTN seems to have a strong influence when developed during mid-adulthood as compared to its appearance in an older age.[8]
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