title: Vascular risk factors promote conversion from mild cognitive impairment to Alzheimer disease.
abstract: OBJECTIVE
  Growing evidence suggests that vascular risk factors (VRF) contribute to cognitive decline. The aim of this study was to investigate the impact of VRF on the conversion from mild cognitive impairment (MCI) to Alzheimer disease (AD) dementia.
  
  
  METHODS
  A total of 837 subjects with MCI were enrolled at baseline and followed up annually for 5 years. The incidence of AD dementia was investigated. A mixed random effects regression model was used to analyze the association between VRF and the progression of MCI assessed with Mini-Mental State Examination and instrumental Activities of Daily Living. Cox proportional hazard models were used to identify the association between VRF and dementia conversion, and to examine whether treatment of VRF can prevent dementia conversion.
  
  
  RESULTS
  At the end of the follow-up, 298 subjects converted to AD dementia, while 352 remained MCI. Subjects with VRF had a faster progression in cognition and function relative to subjects without. VRF including hypertension, diabetes, cerebrovascular diseases, and hypercholesterolemia increased the risk of dementia conversion. Those subjects with MCI in whom all VRF were treated had a lower risk of dementia than those who had some VRF treated. Treatment of individual VRF including hypertension, diabetes, and hypercholesterolemia was associated with the reduced risk of AD conversion.
  
  
  CONCLUSIONS
  VRF increased the risk of incident AD dementia. Treatment of VRF was associated with a reduced risk of incident AD dementia. Although our findings are observational, they suggest active intervention for VRF might reduce progression in MCI to AD dementia.
authors.affiliation: Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, No. 10 Changjiang Branch Road, Daping, Chongqing, China.
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: Y J
authors.initials: YJ
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: Zhang
authors.forename: Z Q
authors.initials: ZQ
authors.lastname: Xu
authors.forename: C Y
authors.initials: CY
authors.lastname: Gao
authors.forename: C Q
authors.initials: CQ
authors.lastname: Fang
authors.forename: J C
authors.initials: JC
authors.lastname: Yan
authors.forename: H D
authors.initials: HD
authors.lastname: Zhou
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000503:physiopathology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D003072:Cognition Disorders / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D036341:Intercellular Signaling Peptides and Proteins; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010455:Peptides; D012044:Regression Analysis; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric
chemical_list: D036341:Intercellular Signaling Peptides and Proteins; D010455:Peptides; C021266:vascular factor