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Vascular risk factors increase risk for Alzheimer's disease

Recent findings indicated a higher number of midlife vascular risk factors, such as diabetes and higher BMI, was associated with increased risk for brain amyloid deposition, a marker of Alzheimer’s disease.

“Increasing evidence supports a role of vascular risk factors and markers in the development and etiology of Alzheimer’s disease. Most major vascular risk factors, including hypertension, diabetes, smoking, and hypercholesterolemia, particularly when measured in midlife, have been associated with risk of dementia generally and [Alzheimer’s disease] specifically,” Rebecca F. Gottesman, MD, PhD, of Johns Hopkins University School of Medicine, and colleagues wrote. “Whether these risk factors directly increase the neurodegeneration specifically associated with [Alzheimer’s disease] (such as through increasing amyloid deposition) or lead to other cerebral changes that, in conjunction with ongoing neurodegeneration, might worsen cognitive performance is not yet known.”

To assess associations between midlife vascular factors and late-life brain amyloid deposition, researchers evaluated florbetapir PET scans for 346 individuals without dementia. Study participants were aged 45 to 64 years at baseline, were evaluated for vascular risk factors since 1987 and underwent PET scans from 2011 to 2013. Standardized uptake value ratios were measured at a median follow-up of 23.5 years.

Higher midlife BMI was associated with increased standardized uptake value ratio (OR = 2.06; 95% CI, 1.16-3.65).

A higher number of midlife vascular risk factor at baseline was associated with increased amyloid standardized uptake value ratio at follow-up.

Adjusted analysis indicated participants with one vascular risk factor had an odds ratio of 1.88 (95% CI, 0.95-3.72) and those with two or more vascular risk factors had an odds ratio of 2.88 (95% CI, 1.46-5.69).

Late-life vascular risk factors were not associated with late-life brain amyloid deposition, according to researchers.

“An increasing number of midlife vascular risk factors was significantly associated with elevated amyloid [standardized uptake value ratios]; this association was not significant for late-life risk factors. These findings are consistent with a role of vascular disease in the development of [Alzheimer’s disease],” the researchers concluded. – by Amanda Oldt

Disclosure: Gottesman reports serving as associate editor for Neurology and receiving research support from the NIH. Please see the study for a full list of relevant financial disclosures.