The association of vascular disorders with incident dementia in different age groups

Alzheimer's Research & Therapy

Andrea B. Maier¹  Sven J. van der Lee²  Nienke Legdeur²  Pieter Jelle Visser³  Marcel de Wilde⁴  Johan van der Lei⁴  Majon Muller⁵ 

[1] 0000 0001 2179 088X, grid.1008.9, Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia;0000 0004 1754 9227, grid.12380.38, Department of Human Movement Sciences, @AgeAmsterdam, Research Institute Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands;0000 0004 1754 9227, grid.12380.38, Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, 1007 MB, Amsterdam, the Netherlands;0000 0004 1754 9227, grid.12380.38, Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, 1007 MB, Amsterdam, the Netherlands;0000 0001 0481 6099, grid.5012.6, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands;0000000092621349, grid.6906.9, Institute of Medical Informatics, Erasmus University Rotterdam, Rotterdam, the Netherlands;Department of Internal Medicine, Amsterdam UMC, Amsterdam, the Netherlands;

关键词: Dementia;    Primary care;    Vascular disorders;    Vascular disease;    Cardiovascular risk factors;    Aging;   

DOI  :  10.1186/s13195-019-0496-x

来源: publisher

【 摘 要 】

BackgroundThere is increasing evidence that dementia risk associated with vascular disorders is age dependent. Large population-based studies of incident dementia are necessary to further elucidate this effect. Therefore, the aim of the present study was to determine the association of vascular disorders with incident dementia in different age groups in a large primary care database.MethodsWe included 442,428 individuals without dementia aged ≥ 65 years from the longitudinal primary care Integrated Primary Care Information (IPCI) database. We determined in 6 age groups (from 65–70 to ≥ 90 years) the risk of hypertension, diabetes mellitus, dyslipidemia, stroke, myocardial infarction, heart failure, and atrial fibrillation for all-cause dementia using incidence rate ratios, Cox regression, and Fine and Gray regression models.ResultsThe mean age at inclusion of the total study sample was 72.4 years, 45.7% of the participants were male, and median follow-up was 3.6 years. During 1.4 million person-years of follow-up, 13,511 individuals were diagnosed with dementia. The risk for dementia decreased with increasing age for all risk factors and was no longer significant in individuals aged ≥ 90 years. Adjusting for mortality as a competing risk did not change the results.ConclusionsWe conclude that vascular disorders are no longer a risk factor for dementia at high age. Possible explanations include selective survival of individuals who are less susceptible to the negative consequences of vascular disorders and differences in follow-up time between individuals with and without a vascular disorder. Future research should focus on the identification of other risk factors than vascular disorders, for example, genetic or inflammatory processes, that can potentially explain the strong age-related increase in dementia risk.

【 授权许可】

CC BY