Metabolic risk factors, but not vascular lesions and β‐amyloid, are associated with functional connectivity across the Alzheimer’s disease spectrum

The oldest-old and dementia at the end of life describes what is known about the prevalence, incidence, and risk factors for dementia in people aged 90 and older, the fastest growing segment of the population in much of the world. It reviews the main neuropathological abnormalities found during autopsy, including Alzheimer’s disease (AD), vascular lesions, and hippocampal sclerosis and discusses how these abnormalities are related to dementia in very elderly individuals. The chapter highlights differences in risk and protective factors, and underlying neuropathologies associated with dementia compared to younger elderly. Taking into consideration the rapid increase in the number of oldest-old by the middle of the century, it reviews the potential impact of interventions to reduce Alzheimer’s disease pathology on the prevalence of dementia in this age group. Finally, it presents methodological challenges in studying this age group and offers potential strategies to address some of these challenges.

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Metabolic Risk Factors of Alzheimer’s Disease, Dementia with Lewy Bodies, and Normal Elderly: A Population-Based Study

Behavioural Neurology ◽

10.1155/2018/8312346 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Chih-Kuang Cheng ◽

Yu-Chien Tsao ◽

Yuan-Chih Su ◽

Fung-Chang Sung ◽

Hsu-Chih Tai ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Ischemic Stroke ◽

Lower Risk ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Population Based ◽

Metabolic Risk Factors ◽

Metabolic Risk ◽

Population Based Study

Background. Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) share many risk factors. Evidence suggests that metabolic risk factors are important to AD; however, their association with DLB is unclear. The risk of cardiovascular diseases (CVD) associated with AD and DLB is also uncertain. Thus, this nationwide, population-based study was designed to evaluate the metabolic and CVD risks in AD and DLB. Materials and Methods. Data were obtained from the Taiwan National Health Insurance Research Database. AD patients, DLB patients, and normal control (NC) individuals from 1996 to 2013 were enrolled for risk assessment. Results. In total, 7544 NC individuals, 1324 AD patients, and 562 DLB patients were enrolled. Participants with one or more metabolic risk factors had significantly higher odds of AD or DLB. No significant differences in metabolic risk factors were observed between DLB and AD patients. AD patients had a lower risk of CVD (aHR = 0.67, 95% CI = 0.59–0.76, p value < 0.001) and coronary artery disease (CAD) (aHR = 0.59, 95% CI = 0.51–0.69, p value < 0.001) than NC. DLB patients had a higher risk of ischemic stroke (aHR = 2.27, 95% CI = 1.68–3.06, p value < 0.001) than NC. Conclusion. Metabolic risk factors are important in AD and DLB. Patients with AD might have a lower risk of CAD and ischemic strokes. Patients with DLB might have a higher risk of ischemic stroke.

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