Issue: March 2016
February 01, 2016
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CV risk factors increase mortality in patients with dementia

Issue: March 2016
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CHD, congestive HF, diabetes, male sex and smoking may increase the risk for death in older adults with dementia.

Irene E. van de Vorst, MD, of the Julius Center for Health Sciences and Primary Care and the department of geriatrics at the University Medical Center Utrecht, the Netherlands, and colleagues conducted a systematic review and meta-analysis of 12 studies involving 235,865 participants. The goal was to assess the effect of CVD and risk factors (ie, hypertension, diabetes, hypercholesterolemia, smoking, overweight or BMI, MI, stroke, congestive HF) on mortality in individuals diagnosed with dementia. To be included, study populations needed to consist of individuals with dementia with and without CVD and risk factors.

All-cause mortality was the primary outcome.

Male sex (HR = 1.67; 95% CI, 1.56-1.78), diabetes (HR = 1.49; 95% CI = 1.33-1.68), smoking (HR = 1.37; 95% CI, 1.17-1.61), CHD (HR = 1.21; 95% CI, 1.02-1.44) and congestive HF (HR = 1.37; 95% CI, 1.18-1.59) were associated with mortality in this population, according to results of a pooled analysis.

However, the researchers did not find an association between hypertension, hypercholesterolemia and BMI (overweight) and mortality risk in individuals diagnosed with dementia.

“Because evidence-based guidelines for appropriate care in vulnerable elderly adults, including those with dementia, are limited, initiation or continuation of therapy should be based on individual preferences and improvement of quality of life after careful evaluation of the probable benefits and potential risks of the treatment,” van de Vorst and colleagues wrote.

The researchers emphasized the need for randomized controlled trials on frail seniors, especially with dementia, to support better management of their care. – by Tracey Romero

Disclosure: The researchers report no relevant financial disclosures.