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 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:
Roberto Fogari, Annalisa Zoppi
Published Date: 1 October 2010
Joel A Lardizabal, Prakash C Deedwania
Published Date: 23 September 2010
Myriam Iglewski, Stephen R Grant
Published Date: 11 August 2010
Pioglitazone and alogliptin combination therapy in type 2 diabetes: a pathophysiologically sound treatment
Curtis Triplitt, Eugenio Cersosimo, Ralph A DeFronzo
Published Date: 5 August 2010
Using noncontrast cardiac CT and coronary artery calcification measurements for cardiovascular risk assessment and management in asymptomatic adults
John A Rumberger
Published Date: 7 July 2010
Ravikiran Korabathina, Sidharth S Yadav, John T Coppola, et al
Published Date: 1 July 2010
Influence of demographic and metabolic variables on forearm blood flow and vascular conductance in individuals without overt heart disease
Thiago E Sartori, Rafael AB Nunes, Gisela T da Silva, et al
Published Date: 31 May 2010
Branko N Huisa, Andrew B Stemer, Justin A Zivin
Published Date: 30 March 2010
Yoshiko Ohno, Teruto Hashiguchi, Ryuichi Maenosono, et al
Published Date: 9 March 2010
Jamison Wyatt, Shailesh Nandish, Rene Oliveros, et al
Published Date: 23 December 2009