Vers une prévention de la démence ?

Risk factors for dementia of the Alzheimer and vascular type

The current study was aimed at examining the risk factors in 30 patients with Alzheimer's dementia and 30 patients with vascular dementia. The reports of the caregivers and the medical documentation were used to estimate the risk factors. The condition for the patients to enter this study was the age above 60 years. The results showed that the average age in the patients with dementia of the Alzheimer type was statistically significantly higher than in the patients with vascular dementia (p<0.0043), which is the confirmation that the most potential risk factor for Alzheimer's disease is aging, and for vascular dementia it is an additional factor. The incomplete education is more common in patients with Alzheimer's disease than in the group with vascular dementia and the difference had statistical significance (p=0.0199). The patients with vascular dementia have higher rate of heart disease (p=0.0002), hypertension (p=0.0005) and diabetes mellitus (p=0.0228) than in the group with Alzheimer's disease with a statistically significant difference. In regard to marital status, head injury and smoking, the difference had no significance in either groups.

Vascular dementia prevention: a risk factor analysis

Brain injury from ischemic or hemorrhagic cerebrovascular disease (CVD) produces decline in cognitive functions and vascular dementia (VaD). Likewise, CVD may cause VaD from hypoperfusion of susceptible brain areas. CVD may also worsen degenerative dementias such as Alzheimer's disease. Significant advances have been made in the identification and control of risk factors for stroke and cardiovascular disease. The main risk factors for VaD include age, hypertension and absence of antihypertensive medication, diabetes, cigarette smoking, history of cardiovascular disease (coronary heart disease, congestive heart failure, peripheral vascular disease), atrial fibrillation, left ventricular hypertrophy, hyperhomocysteinemia, orthostatic hypotension, cardiac arrhythmias, hyperfibrinogenemia, and sleep apnea. Recently identified risk factors include chronic infection and elevation of C-reactive protein, particularly in patients with diabetes. Evidence from controlled clinical trials strongly suggests that control of vascular risk factors, in particular hypertension, could prevent the development of dementia.