Abstract
BACKGROUND: There is increasing evidence that dementia risk associated with vascular disorders is age dependent. Large population-based studies of incident dementia are necessary to further elucidate this effect. Therefore, the aim of the present study was to determine the association of vascular disorders with incident dementia in different age groups in a large primary care database.
METHODS: We included 442,428 individuals without dementia aged ≥ 65 years from the longitudinal primary care Integrated Primary Care Information (IPCI) database. We determined in 6 age groups (from 65-70 to ≥ 90 years) the risk of hypertension, diabetes mellitus, dyslipidemia, stroke, myocardial infarction, heart failure, and atrial fibrillation for all-cause dementia using incidence rate ratios, Cox regression, and Fine and Gray regression models.
RESULTS: The mean age at inclusion of the total study sample was 72.4 years, 45.7% of the participants were male, and median follow-up was 3.6 years. During 1.4 million person-years of follow-up, 13,511 individuals were diagnosed with dementia. The risk for dementia decreased with increasing age for all risk factors and was no longer significant in individuals aged ≥ 90 years. Adjusting for mortality as a competing risk did not change the results.
CONCLUSIONS: We conclude that vascular disorders are no longer a risk factor for dementia at high age. Possible explanations include selective survival of individuals who are less susceptible to the negative consequences of vascular disorders and differences in follow-up time between individuals with and without a vascular disorder. Future research should focus on the identification of other risk factors than vascular disorders, for example, genetic or inflammatory processes, that can potentially explain the strong age-related increase in dementia risk.
| Original language | English |
|---|---|
| Article number | 47 |
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Alzheimer's Research & Therapy |
| Volume | 11 |
| DOIs | |
| Publication status | Published - 17 May 2019 |
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Keywords
- Aging
- Cardiovascular risk factors
- Dementia
- Primary care
- Vascular disease
- Vascular disorders
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The association of vascular disorders with incident dementia in different age groups. / Legdeur, Nienke; Van Der Lee, Sven J.; De Wilde, Marcel; Van Der Lei, Johan; Muller, Majon; Maier, Andrea B.; Visser, Pieter Jelle.
In: Alzheimer's Research & Therapy, Vol. 11, 47, 17.05.2019, p. 1-8.Research output: Contribution to Journal › Article › Academic › peer-review
TY - JOUR
T1 - The association of vascular disorders with incident dementia in different age groups
AU - Legdeur, Nienke
AU - Van Der Lee, Sven J.
AU - De Wilde, Marcel
AU - Van Der Lei, Johan
AU - Muller, Majon
AU - Maier, Andrea B.
AU - Visser, Pieter Jelle
PY - 2019/5/17
Y1 - 2019/5/17
N2 - BACKGROUND: There is increasing evidence that dementia risk associated with vascular disorders is age dependent. Large population-based studies of incident dementia are necessary to further elucidate this effect. Therefore, the aim of the present study was to determine the association of vascular disorders with incident dementia in different age groups in a large primary care database.METHODS: We included 442,428 individuals without dementia aged ≥ 65 years from the longitudinal primary care Integrated Primary Care Information (IPCI) database. We determined in 6 age groups (from 65-70 to ≥ 90 years) the risk of hypertension, diabetes mellitus, dyslipidemia, stroke, myocardial infarction, heart failure, and atrial fibrillation for all-cause dementia using incidence rate ratios, Cox regression, and Fine and Gray regression models.RESULTS: The mean age at inclusion of the total study sample was 72.4 years, 45.7% of the participants were male, and median follow-up was 3.6 years. During 1.4 million person-years of follow-up, 13,511 individuals were diagnosed with dementia. The risk for dementia decreased with increasing age for all risk factors and was no longer significant in individuals aged ≥ 90 years. Adjusting for mortality as a competing risk did not change the results.CONCLUSIONS: We conclude that vascular disorders are no longer a risk factor for dementia at high age. Possible explanations include selective survival of individuals who are less susceptible to the negative consequences of vascular disorders and differences in follow-up time between individuals with and without a vascular disorder. Future research should focus on the identification of other risk factors than vascular disorders, for example, genetic or inflammatory processes, that can potentially explain the strong age-related increase in dementia risk.
AB - BACKGROUND: There is increasing evidence that dementia risk associated with vascular disorders is age dependent. Large population-based studies of incident dementia are necessary to further elucidate this effect. Therefore, the aim of the present study was to determine the association of vascular disorders with incident dementia in different age groups in a large primary care database.METHODS: We included 442,428 individuals without dementia aged ≥ 65 years from the longitudinal primary care Integrated Primary Care Information (IPCI) database. We determined in 6 age groups (from 65-70 to ≥ 90 years) the risk of hypertension, diabetes mellitus, dyslipidemia, stroke, myocardial infarction, heart failure, and atrial fibrillation for all-cause dementia using incidence rate ratios, Cox regression, and Fine and Gray regression models.RESULTS: The mean age at inclusion of the total study sample was 72.4 years, 45.7% of the participants were male, and median follow-up was 3.6 years. During 1.4 million person-years of follow-up, 13,511 individuals were diagnosed with dementia. The risk for dementia decreased with increasing age for all risk factors and was no longer significant in individuals aged ≥ 90 years. Adjusting for mortality as a competing risk did not change the results.CONCLUSIONS: We conclude that vascular disorders are no longer a risk factor for dementia at high age. Possible explanations include selective survival of individuals who are less susceptible to the negative consequences of vascular disorders and differences in follow-up time between individuals with and without a vascular disorder. Future research should focus on the identification of other risk factors than vascular disorders, for example, genetic or inflammatory processes, that can potentially explain the strong age-related increase in dementia risk.
KW - Aging
KW - Cardiovascular risk factors
KW - Dementia
KW - Primary care
KW - Vascular disease
KW - Vascular disorders
UR - http://www.scopus.com/inward/record.url?scp=85065887913&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065887913&partnerID=8YFLogxK
U2 - 10.1186/s13195-019-0496-x
DO - 10.1186/s13195-019-0496-x
M3 - Article
VL - 11
SP - 1
EP - 8
JO - Alzheimer's Research & Therapy
JF - Alzheimer's Research & Therapy
SN - 1758-9193
M1 - 47
ER -