Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review
Suzanne A Ligthart1, Eric P Moll van Charante1, Willem A Van Gool2, Edo Richard2
1Department of General Practice, 2Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Background: Over the last decade, evidence has accumulated that vascular risk factors increase the risk of Alzheimer disease (AD). So far, few randomized controlled trials have focused on lowering the vascular risk profile to prevent or postpone cognitive decline or dementia.
Objective: To systematically perform a review of randomized controlled trials (RCTs) evaluating drug treatment effects for cardiovascular risk factors on the incidence of dementia or cognitive decline.
Selection criteria: RCTs studying the effect of treating hypertension, dyslipidemia, hyperhomocysteinemia, obesity, or diabetes mellitus (DM) on cognitive decline or dementia, with a minimum follow-up of 1 year in elderly populations.
Outcome measure: Cognitive decline or incident dementia.
Main results: In the identified studies, dementia was never the primary outcome. Statins (2 studies) and intensified control of type II DM (1 study) appear to have no effect on prevention of cognitive decline. Studies on treatment of obesity are lacking, and the results of lowering homocysteine (6 studies) are inconclusive. There is some evidence of a preventive effect of antihypertensive medication (6 studies), but results are inconsistent.
Conclusion: The evidence of a preventive treatment effect aimed at vascular risk factors on cognitive decline and dementia in later life is scarce and mostly based on secondary outcome parameters. Several important sources of bias such as differential dropout may importantly affect interpretation of trial results.
Keywords: cardiovascular risk factors, cognitive decline, dementia, prevention
This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php
Readers of this article also read:
Published Date: 19 November 2013
Litzendorf ME, Satiani B
Published Date: 31 August 2011
Mohammad Hassan Nemati, Behrooz Astaneh
Published Date: 3 December 2010
Published Date: 11 October 2010
Prevention of the renarrowing of coronary arteries using drug-eluting stents in the perioperative period: an update
Juan V Llau, Raquel Ferrandis, Pilar Sierra, et al
Published Date: 29 September 2010
Michael McGillion, Allison Cook, J Charles Victor, et al
Published Date: 26 August 2010
Domenico Galzerano, Cristina Capogrosso, Sara Di Michele, et al
Published Date: 22 June 2010
Managing hypercholesterolemia and its correlation with carotid plaque morphology in patients undergoing carotid endarterectomy
Kittipan Rerkasem, Patrick J Gallagher, Robert F Grimble, Philip C Calder, Clifford P Shearman
Published Date: 12 September 2008
Published Date: 30 June 2008
Ovidio De Freitas, Oliver Lenz, Alessia Fornoni, Barry J Materson
Published Date: 25 January 2006