Nonstroke Cardiovascular Disease and Risk of Alzheimer Disease and Dementia

Unresolved issues in dementia research include (1) the association between nonstroke cardiovascular disease (CVD) and Alzheimer disease (AD) and (2) whether the association between CVD and dementia is mediated by familial factors (ie, genes and early life environment). We therefore conducted a study with both a longitudinal and a co-twin control design in 2214 Swedish twins with clinical dementia evaluation and apolipoprotein E (ApoE) genotyping. The analyses were then replicated in a register-based cohort of 18,405 individuals. Results show that CVD increases the risk of AD in carriers (but not noncarriers) of the ApoE4 allele (hazard ratio 2.39, 95% confidence interval 1.15-4.96). CVD was also associated with an almost 2-fold increased risk of developing late-life dementia (hazard ratio 1.83, 95% confidence interval 1.23-2.72). Within twin pairs, the dementia-affected twin was more…

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