874 Modifiable Risk Factors In Conversion Of Mild Cognitive Impairment To Alzheimer Disease

Ioancio I, Spiru L, Trascu R
Background and aims: The 4 'Hyper-s' (i.e., Hypertension, hyperglycaemia, hyperlipidaemia and hyperhomocysteinemia) represent the main risk factors implicated in the conversion of mild cognitive impairment (MCI) to Alzheimer's disease (AD). Part of 'Development of Screening guidelines and Clinical Criteria for Pre-dementia Alzheimer's Disease (DESCRIPA)', our study assessed risk factors and co-morbidities in MCI patients and if it is possible to modify, as part of primary care intervention, their involvement in MCI-to-AD conversion.
Methods: 60 subjects with MCI (75% aged 60-75 years, 77% women, 37% university graduates, 90% from urban area) were included (based on internationally recognized diagnostic criteria) and followed-up. Data collection was performed at baseline, as well as yearly during the 3 years of follow-up.
Results: A 23.3% MCI-to-AD conversion rate was noted after the first year of follow-up. In the next two years, another 6.6%patients developed AD. The vascular factors hypertension and dyslipidaemia exhibit a shape similar to the documented in AD patients. Diabetes type II, senile osteoporosis, transient attack, hypothyroidism and carotid stenosis were the most co-morbidities in our study.
Conclusion: Vascular risk factors (hypertension, angor pectoris and dyslipidaemia, transient ischaemic attack and carotid artery stenosis) were the most prevalent co-morbidities in MCI patients, followed by diabetes type II, senile osteoporosis and hypothyroidism. Depression remains a challenge especially in women, as an independent risk factor. The primary prevention for hypertension, diabetes and hyperlipidaemia is manageable in the near future and can reduce the MCI-to-AD conversion rate.
Modifiable risk factors in conversion of Mild Cognitive Impairment to Alzheimer disease