Does vascular burden contribute to the progression of mild cognitive impairment to dementia?

Francesca Clerici, Barbara Caracciolo, Ilaria Cova, Susanna Fusari Imperatori, Laura Maggiore, Daniela Galimberti, Elio Scarpini, Claudio Mariani, Laura Fratiglioni

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To investigate the contribution of vascular risk factors (VRFs), vascular diseases (VDs) and white matter lesions (WMLs) to the progression of mild cognitive impairment (MCI) to dementia and Alzheimer's disease (AD). Methods: Two hundred forty-five consecutive subjects with MCI (age 74.09 ± 6.92 years) were followed for an average of 2.4 years. The Hachinski Ischemic Score and the Framingham Stroke Risk Profile were used to summarize VRFs and VDs. WMLs were graded using the Age-Related White Matter Changes Scale. Results: One hundred twenty-nine (52.6%) out of 245 subjects at risk converted to dementia, including 87 cases of AD. When hypertension occurred in MCI with deep WMLs, a 1.8-fold increased risk of dementia was observed (95% CI = 1.0-3.4). When deep WMLs occurred in MCI with high scores (≥4) on the Hachinski scale, a 3.5-fold (95% CI = 1.6-7.4) and 3.8-fold (95% CI = 1.2-11.5) risk of progression to dementia and AD was observed, respectively. Analogously, the joint effect of WMLs and high scores (≥14) on the Framingham scale nearly doubled the risk of dementia (hazard ratio = 1.9, 95% CI = 1.1-3.3). Conclusions: Accelerated progression of MCI to dementia and AD is to be expected when VRFs and VDs occur together with WMLs.

Original languageEnglish
Pages (from-to)235-243
Number of pages9
JournalDementia and Geriatric Cognitive Disorders
Volume34
Issue number3-4
DOIs
Publication statusPublished - Dec 2012

Keywords

  • Alzheimer's disease
  • Cerebrovascular disease
  • Hypertension
  • Mild cognitive impairment
  • Vascular burden
  • Vascular risk factors

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Cognitive Neuroscience

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