title: Effect of Vascular Risk Factors on the Progression of Mild Alzheimer's Disease and Lewy Body Dementia.
abstract: Vascular risk factors (VRF) are associated with an increased risk of neurodegenerative disease.
  
  
  
  To examine the association between VRF and cognitive decline in patients with Alzheimer's disease (AD) and Lewy body dementia (LBD).
  
  
  
  We included consecutive referrals with mild AD or LBD to dementia clinics in western Norway from 2005 to 2013. The Mini-Mental Status Exam (MMSE) and Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) were administered at baseline and then annually for up to five years. The VRF include diabetes mellitus, hypertension, hypercholesterolemia, overweight and smoking. Generalized Estimating Equations (GEE) were used to examine the potential association between VRF scores and the change in MMSE and CDR-SB scores, adjusting for age, sex, and the apolipoprotein ɛ4 allele (APOE4).
  
  
  
  A total of 200 patients were included (113 AD, 87 LBD) (mean age 76 years, mean baseline MMSE 24.0, mean follow-up time 3.5 years). Smoking was the only VRF significantly associated with a more rapid cognitive decline, however only in the AD group. Being overweight at baseline was associated with a slower cognitive decline. Moreover, hypertension at baseline predicted a slower decline in MMSE scores. In the LBD group diabetes mellitus was found to be associated with a slower increase in CDR-SB scores.
  
  
  
  With the exception of smoking, VRF at time of dementia diagnosis were not associated with a more rapid cognitive decline.
authors.affiliation: Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.|Department of Clinical Sciences, University of Bergen, Bergen, Norway.
authors.forename: Anne Katrine
authors.initials: AK
authors.lastname: Bergland
authors.affiliation: Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Dalen
authors.affiliation: Department of Clinical Sciences, University of Bergen, Bergen, Norway.|Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Alf Inge
authors.initials: AI
authors.lastname: Larsen
authors.affiliation: Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.|Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.
authors.forename: Dag
authors.initials: D
authors.lastname: Aarsland
authors.affiliation: Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Hogne
authors.initials: H
authors.lastname: Soennesyn
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020961:Lewy Body Disease / Q000453:epidemiology* / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D000073216:Mental Status and Dementia Tests; D015999:Multivariate Analysis; D050177:Overweight / Q000453:epidemiology; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
keywords: Alzheimer’s disease; Lewy body dementia; dementia; progression; vascular 
  risk factors