Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Sep 7:6:775-85.
doi: 10.2147/vhrm.s7343.

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

Suzanne A Ligthart  1 , Eric P Moll van Charante, Willem A Van Gool, Edo Richard
Affiliations

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

Suzanne A Ligthart et al. Vasc Health Risk Manag. .

Abstract

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.

PubMed Disclaimer

References

    1. Fratiglioni LM, Launer LJP, Andersen KM, et al. Incidence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurology. 2000;54:S10–S15. - PubMed
    1. Viswanathan A, Rocca WA, Tzourio C. Vascular risk factors and dementia: how to move forward. Neurology. 2009;72:368–374. - PMC - PubMed
    1. Matthews FE, Brayne C, Lowe J, McKeith I, Wharton SB, Ince P. Epidemiological pathology of dementia: attributable-risks at death in the Medical Research Council Cognitive Function and Ageing Study. PLoS Med. 2009;6:e1000180. - PMC - PubMed
    1. Savva GM, Wharton SB, Ince PG, et al. Age, neuropathology, and dementia. N Engl J Med. 2009;360:2302–2309. - PubMed
    1. Schneider JA, Arvanitakis Z, Bang W, Bennett DA. Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology. 2007;69:2197–2204. - PubMed

Publication types