PT  - JOURNAL ARTICLE
AU  - Markus Bleckwenn
AU  - Luca Kleineidam
AU  - Michael Wagner
AU  - Frank Jessen
AU  - Siegfried Weyerer
AU  - Jochen Werle
AU  - Birgitt Wiese
AU  - Dagmar Lühmann
AU  - Tina Posselt
AU  - Hans-Helmut König
AU  - Christian Brettschneider
AU  - Edelgard Mösch
AU  - Dagmar Weeg
AU  - Angela Fuchs
AU  - Michael Pentzek
AU  - Tobias Luck
AU  - Steffi G Riedel-Heller
AU  - Wolfgang Maier
AU  - Martin Scherer
TI  - Impact of coronary heart disease on cognitive decline in Alzheimer’s disease: a prospective longitudinal cohort study in primary care
AID  - 10.3399/bjgp16X688813
DP  - 2017 Feb 01
TA  - British Journal of General Practice
PG  - e111--e117
VI  - 67
IP  - 655
4099  - http://bjgp.org/content/67/655/e111.short
4100  - http://bjgp.org/content/67/655/e111.full
SO  - Br J Gen Pract2017 Feb 01; 67
AB  - Background Arteriosclerotic disorders increase the risk of dementia. As they have common causes and risk factors, coronary heart disease (CHD) could influence the course of dementia.Aim To determine whether CHD increases the speed of cognitive decline in Alzheimer’s disease, and to discuss the potential for secondary cardiovascular prevention to modify this decline.Design and setting Prospective multicentre cohort study in general practices in six cities in Germany.Method Participants were patients with probable mild-to-moderate Alzheimer’s dementia or mixed dementia (n = 118; mean age 85.6 [±3.4] years, range 80–96 years). The authors assessed the presence of CHD according to the family physicians’ diagnosis. Cognitive performance was measured during home visits for up to 3 years in intervals of 6 months, using Mini Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SoB). The authors also recorded whether patients died in the observation period.Results At baseline, 65 patients (55%) had CHD and/or a heart condition following a myocardial infarction. The presence of CHD accelerated cognitive decline (MMSE, P<0.05) by about 66%, and reduced cognitive-functional ability (CDR-SoB, P<0.05) by about 83%, but had no impact on survival.Conclusion The study shows that CHD has a significant influence on cognitive decline in older patients with late-onset dementia. The dementia process might therefore be positively influenced by cardiovascular prevention, and this possible effect should be further investigated.