title: Fibrinogen is associated with an increased risk of Alzheimer disease and vascular dementia.
abstract: OBJECTIVE
  Vascular and inflammatory factors may play an important role in the pathogenesis of dementia. Studies reported an association between plasma levels of inflammation markers and the risk of dementia. Both fibrinogen and C-reactive protein are considered inflammatory markers. Fibrinogen also has important hemostatic properties. We investigated the association of fibrinogen and C-reactive protein with dementia.
  
  
  METHODS
  The study was based on the prospective population-based Rotterdam Study. Fibrinogen was measured in a random sample of 2835 persons. High-sensitivity C-reactive protein was measured in the total cohort of 6713 persons. We identified 395 incident dementia cases during follow-up (mean, 5.7 years). We estimated the associations of fibrinogen and C-reactive protein with dementia using Cox proportional hazard models.
  
  
  RESULTS
  Persons with higher levels of fibrinogen had an increased risk of dementia. The hazard ratio for dementia per SD increase of fibrinogen was 1.26 (95% CI, 1.11 to 1.44), adjusted for age and gender, and 1.30 (95% CI, 1.13 to 1.50) after additional adjustment for cardiovascular factors and stroke. For Alzheimer disease, the adjusted hazard ratio was 1.25 (95% CI, 1.04 to 1.49), and for vascular dementia it was 1.76 (95% CI, 1.34 to 2.30). High levels of C-reactive protein were not associated with an increased risk of dementia.
  
  
  CONCLUSIONS
  High fibrinogen levels were associated with an increased risk of both Alzheimer disease and vascular dementia, but levels of C-reactive protein were not. This suggests that the increased risk of dementia associated with fibrinogen is because of the hemostatic rather than the inflammatory properties of fibrinogen.
authors.affiliation: Department of Epidemiology and Biostatistics, Erasmus University Medical Center, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: van Oijen
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Witteman
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Koudstaal
authors.forename: Monique M B
authors.initials: MM
authors.lastname: Breteler
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D015140:Dementia, Vascular / Q000097:blood*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D005340:Fibrinogen; D002097:C-Reactive Protein