Back to Browse Journals » Vascular Health and Risk Management » Volume 6

Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review

Authors Suzanne A Ligthart, Eric P Moll van Charante, Willem A Van Gool, et al

Published 17 August 2010 Volume 2010:6 Pages 775—785

DOI https://dx.doi.org/10.2147/VHRM.S7343

Review by Single-blind

Peer reviewer comments 3

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

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 

 

Readers of this article also read:

New class of agents for treatment of hypertension: Focus on direct renin inhibition

Roberto Fogari, Annalisa Zoppi

Vascular Health and Risk Management 2010, 6:869-882

Published Date: 1 October 2010

Urotensin II-induced signaling involved in proliferation of vascular smooth muscle cells

Myriam Iglewski, Stephen R Grant

Vascular Health and Risk Management 2010, 6:723-734

Published Date: 11 August 2010

Transradial approach to lower extremity interventions

Ravikiran Korabathina, Sidharth S Yadav, John T Coppola, et al

Vascular Health and Risk Management 2010, 6:503-509

Published Date: 1 July 2010

Clinical profile of hypertension at a University Teaching Hospital in Nigeria

Arthur C Onwuchekwa, Sunday Chinenye

Vascular Health and Risk Management 2010, 6:511-516

Published Date: 1 July 2010

Role of valsartan, amlodipine and hydrochlorothiazide fixed combination in blood pressure control: an update

Maurizio Destro, Francesca Cagnoni, Antonio D’Ospina, et al

Vascular Health and Risk Management 2010, 6:253-260

Published Date: 14 April 2010

Atorvastatin in stroke: a review of SPARCL and subgroup analysis

Branko N Huisa, Andrew B Stemer, Justin A Zivin

Vascular Health and Risk Management 2010, 6:229-236

Published Date: 30 March 2010

The diagnostic value of endothelial function as a potential sensor of fatigue in health

Yoshiko Ohno, Teruto Hashiguchi, Ryuichi Maenosono, et al

Vascular Health and Risk Management 2010, 6:135-144

Published Date: 9 March 2010

On the antiatherogenic effects of vitamin E: the search for the Holy Grail

Francesco Galli, Dimitrios Kirmizis, Dimitrios Chatzidimitriou

Vascular Health and Risk Management 2010, 6:69-71

Published Date: 16 February 2010

Effect of glitazones on the progression of coronary artery disease in type 2 diabetes patients

Jamison Wyatt, Shailesh Nandish, Rene Oliveros, et al

Vascular Health and Risk Management 2010, 6:1-8

Published Date: 23 December 2009