Can Alzheimer Type of Dementia be Prevented? Part 1. Vascular Risk Factors

Abstract

Scientific Background: Clinical and laboratory investigations have revealed that Alzheimer's disease should not be regarded as a single nosological entity. Within the category of late-onset disease, considerable heterogeneity also exists, in terms of risk factor profiles, pathogenesis, and neuropathological findings. In elderly patients, increasing evidence suggests a link between Alzheimer's disease, and both vascular risk factors and atherosclerosis. The prevalence of Alzheimer's disease increased with the degree of atherosclerosis. Alzheimer's disease accounts for more than 70 percent of all cases of dementia, so it is important to identify modifiable risk factors for the disease. During the past decade, there has been growing interest in vascular factors that may underlie Alzheimer's disease. It is now recognized that subjects with cardiovascular risk factors and a history of stroke have an increased risk of both vascular dementia and Alzheimer's disease. lndividual cardiovascular risk factors including smoking, hypertension, high cholesterol, and diabetes were each associated with a 20 to 40% increased risk of developing dementia.
The risk factors for Alzheimer's disease reported thus far include the following: diabetes mellitus, high serum homocysteine, smoking, low level of education, atherosclerosis, high intake of saturated fat, presence of APOE ? 4 allele, high serum cholesterol levels, sistolic hypertension, hypotension, ischemic stroke, head injury, and, most importantly, aging. Most of these risk factors are present not only in the early stages of Alzheimer's disease but often decades before any cognitive symptoms develop. Conclusion: lf indeed Alzheimer's disease has a vascular etiology, identification and treatment of vascular risk factors at midlife may lower risk of dementia