Bergland Anne Katrine, Dalen Ingvild, Larsen Alf Inge, Aarsland Dag, Soennesyn Hogne
Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
Department of Clinical Sciences, University of Bergen, Bergen, Norway.
J Alzheimers Dis. 2017;56(2):575-584. doi: 10.3233/JAD-160847.
Vascular risk factors (VRF) are associated with an increased risk of neurodegenerative disease.
To examine the association between VRF and cognitive decline in patients with Alzheimer's disease (AD) and Lewy body dementia (LBD).
We included consecutive referrals with mild AD or LBD to dementia clinics in western Norway from 2005 to 2013. The Mini-Mental Status Exam (MMSE) and Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) were administered at baseline and then annually for up to five years. The VRF include diabetes mellitus, hypertension, hypercholesterolemia, overweight and smoking. Generalized Estimating Equations (GEE) were used to examine the potential association between VRF scores and the change in MMSE and CDR-SB scores, adjusting for age, sex, and the apolipoprotein ɛ4 allele (APOE4).
A total of 200 patients were included (113 AD, 87 LBD) (mean age 76 years, mean baseline MMSE 24.0, mean follow-up time 3.5 years). Smoking was the only VRF significantly associated with a more rapid cognitive decline, however only in the AD group. Being overweight at baseline was associated with a slower cognitive decline. Moreover, hypertension at baseline predicted a slower decline in MMSE scores. In the LBD group diabetes mellitus was found to be associated with a slower increase in CDR-SB scores.
With the exception of smoking, VRF at time of dementia diagnosis were not associated with a more rapid cognitive decline.
血管危险因素（VRF）与神经退行性疾病风险增加相关。
研究VRF与阿尔茨海默病（AD）和路易体痴呆（LBD）患者认知功能下降之间的关联。
纳入2005年至2013年挪威西部痴呆门诊连续转诊的轻度AD或LBD患者。在基线时进行简易精神状态检查（MMSE）和临床痴呆评定量表总盒数（CDR-SB）评估，之后每年评估一次，共持续五年。VRF包括糖尿病、高血压、高胆固醇血症、超重和吸烟。采用广义估计方程（GEE）来研究VRF评分与MMSE和CDR-SB评分变化之间的潜在关联，并对年龄、性别和载脂蛋白ɛ4等位基因（APOE4）进行校正。
共纳入200例患者（113例AD，87例LBD）（平均年龄76岁，平均基线MMSE为24.0，平均随访时间3.5年）。吸烟是唯一与认知功能下降更快显著相关的VRF，但仅在AD组中。基线时超重与认知功能下降较慢相关。此外，基线时高血压预示着MMSE评分下降较慢。在LBD组中，发现糖尿病与CDR-SB评分升高较慢相关。
除吸烟外，痴呆诊断时的VRF与更快的认知功能下降无关。
