title: Sociodemographic and lifestyle risk factors for incident dementia and cognitive decline in the HYVET.
abstract: BACKGROUND
  previous studies have suggested that smoking, living alone and having a high body mass index may increase risk of developing dementia whereas a normal body mass index, having received education and moderate alcohol consumption may decrease risk. Dementia risk also increases with age and is thought to be higher in hypertensives.
  
  
  METHODS
  we used data collected in the Hypertension in the Very Elderly Trial (HYVET), and cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline and annually. Participants with a fall in MMSE to <24 or with a fall of 3 points in any 1 year were investigated further. The association of baseline sociodemographic, medical and lifestyle factors with incident dementia or decline in MMSE scores was assessed by regression models.
  
  
  RESULTS
  incident dementia occurred in 263 of 3,336 participants over a mean follow-up of 2 years. In multivariate analyses, being underweight, BMI < 18.5 (HR 1.90, 95% CI 1.06-3.39) or obese, BMI >30 (HR 1.84, 95% CI 1.24-2.72), increased risk of incident dementia as did piracetam use (HR 2.72, 95% CI 1.60-4.63). Receiving formal education was associated with a reduced risk (HR 0.59, 95% CI 0.45-0.78). There was no association with smoking, alcohol and gender. Similar results were found when examining mean annual change in the MMSE score.
  
  
  CONCLUSIONS
  our results for BMI and education agree with those from other studies. The increased risk associated with piracetam may reflect awareness of memory problems before any diagnosis of dementia has been made. Trial participants may be healthier than the general population and further studies in the general population are required.
authors: Care of the Elderly, Faculty of Medicine, Imperial College London, W12 0NN, UK. r.peters@imperial.ac.uk
authors: Ruth
authors: R
authors: Peters
authors: Nigel
authors: N
authors: Beckett
authors: Mariela
authors: M
authors: Geneva
authors: Maria
authors: M
authors: Tzekova
authors: Fang Hong
authors: FH
authors: Lu
authors: Ruth
authors: R
authors: Poulter
authors: Nicola
authors: N
authors: Gainsborough
authors: Brian
authors: B
authors: Williams
authors: Marie-Christine
authors: MC
authors: de Vernejoul
authors: Astrid
authors: A
authors: Fletcher
authors: Christopher
authors: C
authors: Bulpitt
mesh_terms: D000369:Aged, 80 and over; D000375:Aging; D000428:Alcohol Drinking / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000188:drug therapy / Q000453:epidemiology; D003704:Dementia / Q000188:drug therapy / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D015994:Incidence; D008019:Life Style; D008297:Male; D018697:Nootropic Agents / Q000627:therapeutic use; D010889:Piracetam / Q000627:therapeutic use; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors
chemical_list: D000959:Antihypertensive Agents; D018697:Nootropic Agents; D010889:Piracetam