Background: Studies have shown select associations between cardiovascular risk factors and
dementia, but mostly focused on Alzheimer’s Disease (AD).
Objective: We enhance these works by evaluating the relationship between the presence of cardiovascular
risk factors and the rate of cognitive decline, measured using the Mini-Mental State Examination
(MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SUM) on four common dementia subtypes
(AD, dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VaD),
as well as non-demented elderly individuals (normal)).
Method: We used generalized linear mixed models with random intercepts to account for correlation at
the patient and center levels for each dementia subtype adjusting for time since initial visit, baseline
cognitive score, age, and demographic factors. The cardiovascular risk factors evaluated included body
mass index, diabetes, years of smoking, atrial fibrillation, hypertension, and hypercholesterolemia.
Results: Patients diagnosed with AD (n=1899), DLB (n=65), FTD (n=168), or VaD (n=13); or lacked
cognitive impairment (normal) (n=3583) were evaluated using data from the National Alzheimer’s Coordinating
Centers. Cardiovascular risk factors were associated with select dementia subtypes including
AD and FTD. Using MMSE and CDR-SUM, recent or active hypertension and hypercholesterolemia
were associated with a slower cognitive decline for AD patients, while higher body mass index and
years of smoking were associated with a slower cognitive decline for FTD patients. However, several
cardiovascular factors demonstrated associations with more rapid cognitive decline.
Conclusion: These results demonstrate disease specific associations and can provide clinicians guidance
on predicted cognitive changes at the group level using information about cardiovascular risk factors.