Risk Factors for Dementia Associated With Multiple Cerebral Infarcts

Gorelick, Philip B.; Brody, Jacob A.; Cohén, Donna; Freels, Sally; Levy, Paul S.; Dollear, Winnie; Forman, Herbert; Harris, Yvonne

doi:10.1001/archneur.1993.00540070034011

Cited by 83 publications

(10 citation statements)

References 50 publications

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“…Since cerebrovascular infarction is the key pathophysiological mechanism for vascular dementia, the risk factors of cerebrovascular diseases, which include smoking,43, 44 are also considered to be risk factors of vascular dementia. As smoking cessation reduces the risk of cardiovascular disease due to decreased inflammatory markers and oxidative stress45, 46, 47 upon smoking cessation, similar mechanisms may contribute to the decreased risk of vascular dementia.…”

Section: Discussionmentioning

confidence: 99%

Effect of smoking cessation on the risk of dementia: a longitudinal study

Choi

Park

2018

Ann Clin Transl Neurol

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ObjectiveTo determine the risk of developing dementia in relation to duration of smoking cessation by using a nationwide health claims database.MethodsThis cohort study included 46,140 men aged 60 years or older from Korean National Health Insurance System – National Health Screening Cohort, a population‐based national health screening program from 2002 to 2013. The changes in smoking habit from a questionnaire during the first (2002 and 2003) and second (2004 and 2005) health examination periods, participants were divided into continual smokers, short‐term (less than 4 years) quitters, long‐term (4 years or more) quitters, and never smokers. Participants were followed‐up for 8 years from January 1, 2006 for the development of overall dementia, Alzheimer's disease, and vascular dementia.ResultsCompared to continual smokers, long‐term quitters and never smokers had decreased risk of overall dementia (hazard ratio, HR 0.86 95% CI, confidence interval 0.75–0.99 and HR: 0.81; 95% CI: 0.71–0.91, respectively). Never smokers had decreased risk of Alzheimer's disease (HR: 0.82; 95% CI: 0.70–0.96) compared to continual smokers. Finally, both long‐term quitters (HR: 0.68; 95% CI: 0.48–0.96) and never smokers (HR: 0.71; 95% CI: 0.54–0.95) had decreased risk of vascular dementia compared to continual smokers.InterpretationSmoking was associated with increased risk of dementia. Smokers who quit for a prolonged period of time may benefit from reduced risk of dementia. Therefore, smokers should be encouraged to quit in order to reduce the risk of developing dementia, especially in the elderly population who are already at risk.

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Section: Discussionmentioning

confidence: 99%

Effect of smoking cessation on the risk of dementia: a longitudinal study

Choi

Park

2018

Ann Clin Transl Neurol

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“…There is evidence that orthostatic hypotension may be more common in both vascular dementia and Alzheimer's disease than in non-demented subjects (Passant et al, 1997), although this is only one cause of falls in demented subjects. Gorelick et al (1993) found history of myocardial infarction to be an independent risk factor for dementia in association with multiple cerebral infarcts. However, in our study, despite a slightly greater proportion of subjects in the vascular dementia group than in the Alzheimer's disease group reporting a history of heart attack, this was not statistically signi®cant.…”

Section: Discussionmentioning

confidence: 88%

“…Vascular dementia is one of the commonest causes of dementia (Skoog et al, 1993;Gorelick et al, 1993). There are a number of diagnostic criteria for establishing a diagnosis of vascular dementia, including DSM-IV and ICD-10 criteria, but there has been no clear agreement on the most appropriate system to use (HeÂ bert and Brayne, 1995;Drachman, 1993).…”

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confidence: 99%

“…The risk factors for vascular dementia have generally been considered to be the same as those for stroke disease, but there have been relatively few studies speci®cally investigating this (Gorelick et al, 1993). In a review, HeÂ bert and Brayne (1995) described evidence that the major risk factors are hypertension, diabetes, heart disease and stroke, but cerebrovascular risk factors have also been associated with Alzheimer's disease (Skoog, 1994;Yoshitake et al, 1995).…”

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confidence: 99%

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Factors associated with vascular dementia in an elderly community population

Boston¹,

Dennis

Jagger

1999

Int. J. Geriat. Psychiatry

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Objective Examination of associated factors for vascular dementia in comparison with Alzheimer's disease and a non‐demented control population. Setting A semi‐rural geographically defined population, in Melton Mowbray and the surrounding area, consisting of elderly patients aged 75 and over from a 13‐doctor general practice. Method 438 subjects, sampled according to results of initial screening with the Mini‐Mental State Examination (MMSE), were examined using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX), which was also used to classify the subtypes of dementia. Results 34 subjects had vascular dementia, 222 had Alzheimer's disease and 140 were non‐demented according to the clinician's diagnosis based on the CAMDEX criteria. Significant factors associated with vascular dementia, when compared to the Alzheimer's disease and non‐demented groups, were family history of stroke and diabetes. Stroke was also significant, but this factor is one of those defining the criteria for diagnostic grouping. There were no significant differences between groups for falls, heart attack, hypertension, head injury, substance abuse or lipid levels. Conclusion The results are broadly consistent with the published literature and emphasize the importance of diabetes as a key risk factor for vascular dementia. Copyright © 1999 John Wiley & Sons, Ltd.

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“…Importantly, but not surprisingly, patients with stroke and cognitive impairment were significantly less likely to live independently, and this was regardless of their physical impairment or age 44. Other studies have focused on comparing patients with multiinfarct dementia with similar groups of patients with multiple cerebral infarcts but no evidence of dementia 45 46. The box at left shows some of the risk factors associated with vascular dementia.…”

Section: Dementia After Strokementioning

confidence: 99%

Fortnightly Review: Vascular dementia

Amar

Wilcock

1996

BMJ

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Summary points Symptomatic stroke increases the risk of dementia more than ninefold Vascular dementia is one of the three commonest causes of dementia Above the age of 85 years it may be commoner than Alzheimer's disease Vascular dementia may be caused by multiple infarcts, white matter ischaemia, or a strategically placed infarct All patients with possible vascular dementia need careful assessment to detect any underlying causes and risk factors that might be remediable

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Risk Factors for Dementia Associated With Multiple Cerebral Infarcts

Cited by 83 publications

References 50 publications

Effect of smoking cessation on the risk of dementia: a longitudinal study

Effect of smoking cessation on the risk of dementia: a longitudinal study

Factors associated with vascular dementia in an elderly community population

Fortnightly Review: Vascular dementia

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