title: Vascular risk factors and progression in Alzheimer's disease.
abstract: OBJECTIVE
  To determine whether vascular risk factors such as hypertension, diabetes and hypercholesterolemia affect the progression of Alzheimer's disease (AD).
  
  
  METHODS
  We followed up 150 consecutive outpatients with probable AD for 24-60 months. Severity of cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). We investigated the influence of vascular risk factors and other demographic and clinical conditions (including age, sex, education, initial MMSE score and follow-up time) on annual MMSE score changes.
  
  
  RESULTS
  Multiple regression analysis revealed that age, education and hypertension were significant variables associated with annual MMSE score changes. Younger, more educated patients with hypertension showed greater decline in annual MMSE scores. There were no significant correlations of annual MMSE score changes with other vascular factors or demographics, including sex, initial MMSE score, diabetes or hypercholesterolemia.
  
  
  CONCLUSIONS
  Younger, more educated patients are more likely to have faster cognitive decline. In addition, hypertension may also be associated with a greater rate of disease progression. Our results suggest the importance of prevention and treatment for hypertension in patients with AD.
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan. sakurah@tokyo-med.ac.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Sakurai
authors.forename: Haruo
authors.initials: H
authors.lastname: Hanyu
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Sato
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kanetaka
authors.forename: Soichiro
authors.initials: S
authors.lastname: Shimizu
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hirao
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kikukawa
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Iwamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000503:physiopathology; D003072:Cognition Disorders / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D014652:Vascular Diseases / Q000453:epidemiology* / Q000503:physiopathology