Vascular risk factors do not affect dementia progression

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  • Smoking may lead to faster disease progression in patients with Alzheimer's disease (AD). Other vascular risk factors (VRF) may not lead to faster progression in AD or Lewy body dementia (LBD).

Why this matters

  • VRF is associated with the risk of developing dementia, but this study suggests most factors have no effect on the progression of AD or LBD.

Key results

  • 187 patients had at least one follow-up; 93 patients died and 10 withdrew by the end of the study period.
  • Patients with hypertension had a slower Mini-Mental State Exam (MMSE) score decline (P=.033), but it did not predict disease progression, as measured by Clinical Dementia Rating Scale Sum of Boxes (CDR-SB).
  • Overweight patients had slower MMSE decline (P<.001) and slower increase in CDR-SB (P<.001).
  • Smokers with AD showed more rapid progression in CDR-SB (P=.045) and slower decline of MMSE in patients with LBD (P=.045).

Study design

  • 200 patients with mild AD or LBD (MMSE ≥ 20) were assessed for VRF (including diabetes mellitus, hypertension, hypercholesterolemia, being overweight, and smoking) and followed for 5 y to assess disease progression.
  • Funding: None disclosed.


  • Blood pressure measurements were not standardized.