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KMID : 1039620170070050770
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Korean Journal of Family Practice
2017 Volume.7 No. 5 p.770 ~ p.776
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Risk Factors for Rapid Cognitive Decline in Alzheimer’s Disease
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Kim Myung-Chul
Jeong Eun-Hye
Lee Hyun-Keun
Park Young-Kyu
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Abstract
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Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disease. However, the rate of cognitive decline in AD varies among individuals, with some patients showing rapid cognitive decline in a relatively short time. The purpose of our study was to identify the risk factors for rapid cognitive decline in AD.
Methods: One-hundred and fourteen patients with AD who were followed up for at least one year and had undergone at least two neuropsychological tests were included in the study. The patients were divided into two groups based on whether they obtained a decrease of 4 points or greater per year on the Korean version of the mini-mental state examination. We assessed baseline characteristics, including vascular risk factors (age, sex, education level, hypertension, diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, history of stroke, ischemic heart disease, atrial fibrillation, smoking or alcohol consumption, and history of dementia medication use) and brain magnetic resonance imaging findings.
Results: Approximately 35.1% of the patients with AD showed rapid cognitive decline. No significant differences were found between the groups in the factors analyzed, except for hypercholesterolemia. The prevalence of hypercholesterolemia was higher in the rapidly progressive group than in the classic group (40.0% vs. 20.3%, P=0.029). Logistic regression analysis revealed that hypercholesterolemia was the only risk factor for rapid cognitive decline in AD (odds ratio, 3.218; 95% confidential interval, 1.386?7.471; P〈0.007).
Conclusion: Hypercholesterolemia was a significant risk factor for rapid cognitive decline in AD. We suggest that the patients with AD with hypercholesterolemia should be closely observed for the possibility of rapid progression.
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KEYWORD
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Alzheimer’s Disease, Cognition, Progression, Risk Factors
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