Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13195-019-0496-x
Title: The association of vascular disorders with incident dementia in different age groups
Authors: Legdeur, Nienke
van der Lee, Sven J
de Wilde, Marcel
van der Lei, Johan
Muller, Majon
Maier, Andrea B 
Visser, Pieter Jelle
Keywords: Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Neurosciences
Neurosciences & Neurology
Dementia
Primary care
Vascular disorders
Vascular disease
Cardiovascular risk factors
Aging
MODIFIABLE RISK-FACTORS
OLDEST-OLD
LATE-LIFE
ATRIAL-FIBRILLATION
COGNITIVE DECLINE
ALZHEIMER-DISEASE
POPULATION
PREVALENCE
EPIDEMIOLOGY
HYPERTENSION
Issue Date: 17-May-2019
Publisher: BMC
Citation: Legdeur, Nienke, van der Lee, Sven J, de Wilde, Marcel, van der Lei, Johan, Muller, Majon, Maier, Andrea B, Visser, Pieter Jelle (2019-05-17). The association of vascular disorders with incident dementia in different age groups. ALZHEIMERS RESEARCH & THERAPY 11 (1). ScholarBank@NUS Repository. https://doi.org/10.1186/s13195-019-0496-x
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.
Source Title: ALZHEIMERS RESEARCH & THERAPY
URI: https://scholarbank.nus.edu.sg/handle/10635/234982
ISSN: 1758-9193
DOI: 10.1186/s13195-019-0496-x
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