De ziekte van Alzheimer en behandeling van vasculaire risicofactoren

- There is increasing evidence that vascular risk factors including hypertension, high cholesterol, hyperhomocysteinaemia and diabetes mellitus are connected to the risk of Alzheimer’s disease (AD).

- The risk of AD may be reduced by the treatment of hypertension prior to onset of cognitive impairment.

- One small randomised clinical trial has provided some evidence of beneficial effects on cognition of cholesterol-lowering drugs such as the statins in patients with AD.

- Treatment of hypertension, hyperhomocysteinaemia and diabetes mellitus with the aim of halting the progression of cognitive decline in AD is still under study and results are awaited.

- For the time being findings from the trials carried out thus far should be interpreted with care due to methodological shortcomings, both in study design and execution.

- In order to investigate the role of vascular risk factors both in the aetiology and treatment of AD, large prospective randomised trials with long-term follow-up of AD patients who have been diagnosed using revised uniform diagnostic criteria that take the heterogeneity of the disease into account, are necessary.

Ned Tijdschr Geneeskd. 2005;149:2844-9