Paper

Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study

BMJ 2001; 322 doi: 10.1136/bmj.322.7300.1447 (Published 16 June 2001)
Cite this as: BMJ 2001;322:1447
  1. Miia Kivipelto, research fellow (miia.kivipelto{at}uku.fi)a,
  2. Eeva-Liisa Helkala, neuropsychologistb,
  3. Mikko P Laakso, research fellow, Academy of Finlandc,
  4. Tuomo Hänninend, neuropsychologist,
  5. Merja Hallikainen, research fellowa,
  6. Kari Alhainen, department head physiciane,
  7. Hilkka Soininen, professord,
  8. Jaakko Tuomilehto, professorf,
  9. Aulikki Nissinen, professorb
  1. a Department of Neuroscience and Neurology, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland
  2. b Department of Public Health and General Practice, University of Kuopio
  3. c Department of Clinical Radiology, Kuopio University Hospital, PO Box 1777, 70211, Kuopio, Finland
  4. d Department of Neurology, Kuopio University Hospital
  5. e North Karelia Central Hospital, 80210 Joensuu, Finland
  6. f National Public Health Institute, 00300 Helsinki, Finland
  1. Correspondence to: M Kivipelto
  • Accepted 19 March 2001

Abstract

Objective: To examine the relation of midlife raised blood pressure and serum cholesterol concentrations to Alzheimer's disease in later life.

Design: Prospective, population based study.

Setting: Populations of Kuopio and Joensuu, eastern Finland.

Participants: Participants were derived from random, population based samples previously studied in a survey carried out in 1972, 1977, 1982, or 1987. After an average of 21 years' follow up, a total of 1449 (73%) participants aged 65–79 took part in the re-examination in 1998.

Main outcome measures: Midlife blood pressure and cholesterol concentrations and development of Alzheimer's disease in later life.

Results: People with raised systolic blood pressure (≥160 mm Hg) or high serum cholesterol concentration (≥6.5 mmol/l) in midlife had a significantly higher risk of Alzheimer's disease in later life, even after adjustment for age, body mass index, education, vascular events, smoking status, and alcohol consumption, than those with normal systolic blood pressure (odds ratio 2.3, 95% confidence interval 1.0 to 5.5) or serum cholesterol (odds ratio 2.1, 1.0 to 4.4). Participants with both of these risk factors in midlife had a significantly higher risk of developing Alzheimer's disease than those with either of the risk factors alone (odds ratio 3.5, 1.6 to 7.9). Diastolic blood pressure in midlife had no significant effect on the risk of Alzheimer's disease.

Conclusion: Raised systolic blood pressure and high serum cholesterol concentration, and in particular the combination of these risks, in midlife increase the risk of Alzheimer's disease in later life.

What is already known on this topic

What is already known on this topic Vascular risk factors may play an important part as risk factors for Alzheimer's disease

No population based studies have evaluated prospectively the impact of both midlife blood pressure and cholesterol concentration in both men and women on the subsequent development of Alzheimer's disease

What this study adds

What this study adds Raised systolic blood pressure and high serum cholesterol concentration, and in particular the combination of these risks, in midlife increased the risk of Alzheimer's disease in later life

Raised systolic blood pressure and hypercholesterolaemia may have a role in the pathogenesis of Alzheimer's disease; more emphasis should be placed on identification and appropriate treatment of these conditions

Footnotes

  • Funding Academy of Finland grants 37573 and 63645 and EVO grant 477268.

  • Competing interests None declared.

  • Embedded Image Figure showing the study design appears on the BMJ's website

  • Accepted 19 March 2001

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