Alzheimer’s disease: risk factors affect disease progression | Alzheimer Dis Assoc Disord

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  • Identified risk factors for Alzheimer’s disease (AD) progression suggest interactions among genetic and hormonal factors, cognitive reserve, and cerebral perfusion affecting mechanisms of neurodegeneration.


Study design/methods

  • This 44-month cohort study enrolled 214 consecutive outpatients with late-onset AD (146 women).
  • Clinical Dementia Rating (CDR) and Mini-Mental State Examination (MMSE) measured cognitive and functional decline.
  • Investigators were blinded to APOE status (52.8% APOE4+ carriers).


Key Results

  • Mean age of AD onset was 73.4±6.5, negatively correlated with time to CDR >1.0 (P<.001), MMSE=20 (P<.001), and MMSE=15 (P=.003), more significantly for women and APOE4+ carriers.
  • Mean schooling was 4.18±3.7 years, correlated with time to MMSE=20 and MMSE=15 for women and APOE4+ carriers.
  • For men only, body mass index correlated with time to MMSE=20 (P=.006).
  • For APOE4+ carriers only, 10-year coronary heart disease Framingham risk score correlated with time to MMSE=20 (P=.015).



  • Findings may not apply to non-Brazilian populations or to those with higher educational level.


Why this matters

  • AD risk factors may interact to affect disease progression, ultimately facilitating development of algorithms to determine an individual’s risk for progression and to suggest interventions to delay progression.