Nonstroke cardiovascular disease and risk of Alzheimer disease and dementia

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Ulrika K Eriksson1, Anna M Bennet, Margaret Gatz

  • 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Ulrika.Eriksson@ki.se

Alzheimer Disease and Associated Disorders
|May 18, 2010
PubMed

Insights

Cardiovascular disease (CVD) elevates dementia risk, particularly Alzheimer disease (AD) in individuals with the ApoE4 gene. Familial factors do not explain the link between CVD and dementia.

Area of Science:

  • Neuroscience
  • Cardiology
  • Genetics
  • Epidemiology

Background:

  • The relationship between nonstroke cardiovascular disease (CVD) and Alzheimer disease (AD) remains unclear.
  • The role of familial factors (genetics, early life environment) in the CVD-dementia association needs further investigation.

Purpose of the Study:

  • To investigate the association between nonstroke cardiovascular disease (CVD) and Alzheimer disease (AD).
  • To determine if familial factors mediate the relationship between CVD and dementia.

Main Methods:

  • A longitudinal co-twin control study involving 2214 Swedish twins with clinical dementia evaluation and apolipoprotein E (ApoE) genotyping.
  • Replication of analyses in a large register-based cohort of 18,405 individuals.

Main Results:

  • CVD significantly increases AD risk in ApoE4 allele carriers (HR 2.39), but not in noncarriers.
  • CVD is associated with a nearly 2-fold increased risk of late-life dementia (HR 1.83).
  • Within twin pairs, CVD was more prevalent in the dementia-affected twin (OR 1.86), suggesting a non-familial link.

Conclusions:

  • Nonstroke CVD is a risk factor for late-life dementia and specifically for AD in ApoE4 carriers.
  • The association between CVD and dementia is not explained by shared genetic or early-life environmental factors.

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