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Patients with the Subcortical Small Vessel Type of Dementia Have Disturbed Cardiometabolic Risk Profile

Journal article
Authors Elin Axelsson
Anders Wallin
Johan Svensson
Published in Journal of Alzheimers Disease
Volume 73
Issue 4
Pages 1373-1383
ISSN 1387-2877
Publication year 2020
Published at Institute of Neuroscience and Physiology
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 1373-1383
Language en
Links dx.doi.org/10.3233/jad-191077
Keywords Alzheimer's disease, body mass index, diabetes, hypertension, lipid, pattern, mixed dementia, subcortical small vessel type of dementia, vascular cognitive impairment, alzheimers-disease, blood-pressure, cerebrovascular-disease, follow-up, metabolic syndrome, older-adults, population, obesity, progression, Neurosciences & Neurology
Subject categories Neurology, Internal medicine

Abstract

Background: Population-based studies have shown that cardiometabolic status is associated with the amount of white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI). However, little is known of cardiometabolic risk factors in the subcortical small vessel type of dementia (SSVD), in which WMHs are one of the most prominent manifestations. Objective: To determine whether the profile of cardiometabolic risk factors differed between SSVD, Alzheimer's disease (AD), mixed dementia (combined AD and SSVD), and healthy controls. Methods: This was a mono-center, cross-sectional study of SSVD (n = 40), AD (n = 113), mixed dementia (n = 62), and healthy controls (n = 94). In the statistical analyses, we adjusted for covariates using ANCOVA and binary logistic regression. Results: The prevalence of hypertension was increased in SSVD and mixed dementia (p < 0.001 and p < 0.05 versus controls, respectively). Diabetes was more prevalent in SSVD patients, and body mass index was lower in AD and mixed dementia, compared to the controls (all p < 0.05). Serum total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) were reduced in the SSVD group (both p < 0.05 versus control). These differences remained after adjustment for covariates. In the SSVD group, Trail Making Test A score correlated positively with systolic blood pressure, mean arterial pressure, and pulse pressure. Conclusion: All dementia groups had an altered cardiometabolic risk profile compared to the controls. The SSVD patients showed increased prevalence of hypertension and diabetes, and in line with previous population-based data, TC and LDL-C in serum were reduced.

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