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History of stroke may increase risk for late-onset Alzheimer’s disease
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Patients with a history of stroke have double the risk for late-onset Alzheimer’s disease in its familial and sporadic forms, researchers reported in JAMA Neurology.
However, according to the researchers, the effect of CV risk factors on Alzheimer’s disease was mediated by stroke.
Using data from the National Institute on Aging Late-Onset Alzheimer’s Disease/National Cell Repository for Alzheimer’s Disease family study (NIA-LOAD), the researchers assessed the contribution of CV risk factors and history of stroke to late-onset Alzheimer’s disease in large families with multiple family members affected by late-onset Alzheimer’s disease. Data from the Washington Heights-Inwood Columbia Aging Project were used to replicate findings.
The primary endpoint was probable or possible late-onset Alzheimer’s disease based on the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) criteria. The CV risk factors included in the study were hypertension, type 2 diabetes and CHD.
Giuseppe Tosto, MD, PhD, from Columbia University College of Physicians and Surgeons and NewYork-Presbyterian Hospital, and colleagues calculated a genetic risk score for late-onset Alzheimer’s disease using genome-wide significant single nucleotide polymorphisms except for APOE E4.
Of the 6,553 participants (mean age, 77 years; 62% women) included in the analyses from NIA-LOAD, 3,468 were diagnosed with late-onset Alzheimer’s disease. Of the 5,972 participants (mean age, 77 years; 68% women) in the replication sample, 2,684 had late-onset Alzheimer’s disease.
In the NIA-LOAD analysis, hypertension was associated with a lower risk for late-onset Alzheimer’s disease (OR = 0.63; 95% CI, 0.55-0.72), whereas a history of stroke was associated with twice the risk for late-onset Alzheimer’s disease (OR = 2.23; 95% CI, 1.75-2.83). No associations were observed between late-onset Alzheimer’s disease and type 2 diabetes or CHD.
In the replication study, hypertension did not have an association with late-onset Alzheimer’s disease, nor did any of the other CV risk factors. However, a relationship was again found between late-onset Alzheimer’s disease and history of stroke (OR = 1.96; 95% CI, 1.56-2.46).
According to the researchers, these results highlight the “complex relationship between hypertension and [late-onset Alzheimer’s disease]” as well as the “importance of interventions targeting modifiable risk factors in [late-onset Alzheimer’s disease]. Further studies with longitudinal assessment and a larger set of variables (eg, different classes of treatments) are currently needed.” – by Tracey Romero
Disclosure: Tosto reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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