Impact of the presence of select cardiovascular risk factors on cognitive changes among dementia subtypes

Katherine E. Irimata, Brittany Dugger, Jeffrey R. Wilson

Research output: Contribution to journalArticle

Abstract

Background: Studies have shown select associations between cardiovascular risk factors and dementia, but mostly focused on Alzheimer’s Disease (AD). Objective: We enhance these works by evaluating the relationship between the presence of cardiovascular risk factors and the rate of cognitive decline, measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SUM) on four common dementia subtypes (AD, dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VaD), as well as non-demented elderly individuals (normal)). Method: We used generalized linear mixed models with random intercepts to account for correlation at the patient and center levels for each dementia subtype adjusting for time since initial visit, baseline cognitive score, age, and demographic factors. The cardiovascular risk factors evaluated included body mass index, diabetes, years of smoking, atrial fibrillation, hypertension, and hypercholesterolemia. Results: Patients diagnosed with AD (n=1899), DLB (n=65), FTD (n=168), or VaD (n=13); or lacked cognitive impairment (normal) (n=3583) were evaluated using data from the National Alzheimer’s Coordinating Centers. Cardiovascular risk factors were associated with select dementia subtypes including AD and FTD. Using MMSE and CDR-SUM, recent or active hypertension and hypercholesterolemia were associated with a slower cognitive decline for AD patients, while higher body mass index and years of smoking were associated with a slower cognitive decline for FTD patients. However, several cardiovascular factors demonstrated associations with more rapid cognitive decline. Conclusion: These results demonstrate disease specific associations and can provide clinicians guidance on predicted cognitive changes at the group level using information about cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)1032-1044
Number of pages13
JournalCurrent Alzheimer Research
Volume15
Issue number11
DOIs
StatePublished - Jan 1 2018

Fingerprint

Dementia
Alzheimer Disease
Frontotemporal Dementia
Lewy Body Disease
Vascular Dementia
Hypercholesterolemia
Body Mass Index
Smoking
Hypertension
Age Factors
Atrial Fibrillation
Linear Models
Demography
Cognitive Dysfunction

Keywords

  • Alzheimer’s disease
  • Body mass index
  • Dementia with Lewy bodies
  • Frontotemporal dementia
  • Neuropsychological tests
  • Vascular risk factors

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Impact of the presence of select cardiovascular risk factors on cognitive changes among dementia subtypes. / Irimata, Katherine E.; Dugger, Brittany; Wilson, Jeffrey R.

In: Current Alzheimer Research, Vol. 15, No. 11, 01.01.2018, p. 1032-1044.

Research output: Contribution to journalArticle

@article{8202f915891c46eea013cef425666111,
title = "Impact of the presence of select cardiovascular risk factors on cognitive changes among dementia subtypes",
abstract = "Background: Studies have shown select associations between cardiovascular risk factors and dementia, but mostly focused on Alzheimer’s Disease (AD). Objective: We enhance these works by evaluating the relationship between the presence of cardiovascular risk factors and the rate of cognitive decline, measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SUM) on four common dementia subtypes (AD, dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VaD), as well as non-demented elderly individuals (normal)). Method: We used generalized linear mixed models with random intercepts to account for correlation at the patient and center levels for each dementia subtype adjusting for time since initial visit, baseline cognitive score, age, and demographic factors. The cardiovascular risk factors evaluated included body mass index, diabetes, years of smoking, atrial fibrillation, hypertension, and hypercholesterolemia. Results: Patients diagnosed with AD (n=1899), DLB (n=65), FTD (n=168), or VaD (n=13); or lacked cognitive impairment (normal) (n=3583) were evaluated using data from the National Alzheimer’s Coordinating Centers. Cardiovascular risk factors were associated with select dementia subtypes including AD and FTD. Using MMSE and CDR-SUM, recent or active hypertension and hypercholesterolemia were associated with a slower cognitive decline for AD patients, while higher body mass index and years of smoking were associated with a slower cognitive decline for FTD patients. However, several cardiovascular factors demonstrated associations with more rapid cognitive decline. Conclusion: These results demonstrate disease specific associations and can provide clinicians guidance on predicted cognitive changes at the group level using information about cardiovascular risk factors.",
keywords = "Alzheimer’s disease, Body mass index, Dementia with Lewy bodies, Frontotemporal dementia, Neuropsychological tests, Vascular risk factors",
author = "Irimata, {Katherine E.} and Brittany Dugger and Wilson, {Jeffrey R.}",
year = "2018",
month = "1",
day = "1",
doi = "10.2174/1567205015666180702105119",
language = "English (US)",
volume = "15",
pages = "1032--1044",
journal = "Current Alzheimer Research",
issn = "1567-2050",
publisher = "Bentham Science Publishers B.V.",
number = "11",

}

TY - JOUR

T1 - Impact of the presence of select cardiovascular risk factors on cognitive changes among dementia subtypes

AU - Irimata, Katherine E.

AU - Dugger, Brittany

AU - Wilson, Jeffrey R.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Studies have shown select associations between cardiovascular risk factors and dementia, but mostly focused on Alzheimer’s Disease (AD). Objective: We enhance these works by evaluating the relationship between the presence of cardiovascular risk factors and the rate of cognitive decline, measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SUM) on four common dementia subtypes (AD, dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VaD), as well as non-demented elderly individuals (normal)). Method: We used generalized linear mixed models with random intercepts to account for correlation at the patient and center levels for each dementia subtype adjusting for time since initial visit, baseline cognitive score, age, and demographic factors. The cardiovascular risk factors evaluated included body mass index, diabetes, years of smoking, atrial fibrillation, hypertension, and hypercholesterolemia. Results: Patients diagnosed with AD (n=1899), DLB (n=65), FTD (n=168), or VaD (n=13); or lacked cognitive impairment (normal) (n=3583) were evaluated using data from the National Alzheimer’s Coordinating Centers. Cardiovascular risk factors were associated with select dementia subtypes including AD and FTD. Using MMSE and CDR-SUM, recent or active hypertension and hypercholesterolemia were associated with a slower cognitive decline for AD patients, while higher body mass index and years of smoking were associated with a slower cognitive decline for FTD patients. However, several cardiovascular factors demonstrated associations with more rapid cognitive decline. Conclusion: These results demonstrate disease specific associations and can provide clinicians guidance on predicted cognitive changes at the group level using information about cardiovascular risk factors.

AB - Background: Studies have shown select associations between cardiovascular risk factors and dementia, but mostly focused on Alzheimer’s Disease (AD). Objective: We enhance these works by evaluating the relationship between the presence of cardiovascular risk factors and the rate of cognitive decline, measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SUM) on four common dementia subtypes (AD, dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VaD), as well as non-demented elderly individuals (normal)). Method: We used generalized linear mixed models with random intercepts to account for correlation at the patient and center levels for each dementia subtype adjusting for time since initial visit, baseline cognitive score, age, and demographic factors. The cardiovascular risk factors evaluated included body mass index, diabetes, years of smoking, atrial fibrillation, hypertension, and hypercholesterolemia. Results: Patients diagnosed with AD (n=1899), DLB (n=65), FTD (n=168), or VaD (n=13); or lacked cognitive impairment (normal) (n=3583) were evaluated using data from the National Alzheimer’s Coordinating Centers. Cardiovascular risk factors were associated with select dementia subtypes including AD and FTD. Using MMSE and CDR-SUM, recent or active hypertension and hypercholesterolemia were associated with a slower cognitive decline for AD patients, while higher body mass index and years of smoking were associated with a slower cognitive decline for FTD patients. However, several cardiovascular factors demonstrated associations with more rapid cognitive decline. Conclusion: These results demonstrate disease specific associations and can provide clinicians guidance on predicted cognitive changes at the group level using information about cardiovascular risk factors.

KW - Alzheimer’s disease

KW - Body mass index

KW - Dementia with Lewy bodies

KW - Frontotemporal dementia

KW - Neuropsychological tests

KW - Vascular risk factors

UR - http://www.scopus.com/inward/record.url?scp=85053823183&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053823183&partnerID=8YFLogxK

U2 - 10.2174/1567205015666180702105119

DO - 10.2174/1567205015666180702105119

M3 - Article

VL - 15

SP - 1032

EP - 1044

JO - Current Alzheimer Research

JF - Current Alzheimer Research

SN - 1567-2050

IS - 11

ER -