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Diabetes and other vascular risk factors for dementia: which factor matters most? A systematic review
Kloppenborg RP, van den Berg E, Kappelle LJ, Biessels GJ.. European journal of pharmacology, 2008-03-04
Topic: Risk, prevention and care in population studies
Vascular risk factors, such as type 2 diabetes, hypertension, obesity and dyslipidaemia often co-occur. Each of these factors has been associated with an increased risk of dementia, but it is uncertain which factor imposes the greatest risk. Moreover, the effect of age at time of exposure may differ across factors. This paper systematically reviews the evidence for the association of each of these risk factors with dementia. Longitudinal population-based studies that assessed the incidence of dementia in relation to diabetes (n=14), hypertension (n=13), dyslipidaemia (n=8) or obesity (n=9) were included. All four risk factors were indeed associated with an increased risk of dementia, but the results of studies on diabetes and obesity were most consistent. The magnitude of the effects was comparable across the risk factors, with odds ratios for 'any dementia' around 1.5. For hypertension, obesity and dyslipidaemia age appeared to modulate the association: the risk of dementia was generally largest in studies that measured the risk factor in midlife (compared to late life) and had a long follow-up time. At midlife, the population attributable risk of dementia was highest for hypertension, up to 30% of cases of late life dementia. Later in life diabetes appears to convey the highest risk of dementia. This review shows that vascular risk factors should be regarded as a major target for preventive measures, but that timing of such measures appears to be critical.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Kloppenborg, R. P., van den Berg, E., Kappelle, L. J., & Biessels, G. J. (2008). Diabetes and other vascular risk factors for dementia: which factor matters most? A systematic review. European journal of pharmacology. https://doi.org/10.1016/j.ejphar.2008.02.049
Vancouver
Kloppenborg RP, van den Berg E, Kappelle LJ, Biessels GJ. Diabetes and other vascular risk factors for dementia: which factor matters most? A systematic review. European journal of pharmacology. 2008. doi:10.1016/j.ejphar.2008.02.049. PMID: 18395201.
BibTeX
@article{kloppenborg2008-18395201,
author = {Kloppenborg, R. P. and van den Berg, E. and Kappelle, L. J. and Biessels, G. J.},
title = {{Diabetes and other vascular risk factors for dementia: which factor matters most? A systematic review}},
journal = {European journal of pharmacology},
year = {2008},
doi = {10.1016/j.ejphar.2008.02.049},
pmid = {18395201},
url = {https://doi.org/10.1016/j.ejphar.2008.02.049}
}
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Key findings
- Each of these factors has been associated with an increased risk of dementia, but it is uncertain which factor imposes the greatest risk.
- All four risk factors were indeed associated with an increased risk of dementia, but the results of studies on diabetes and obesity were most consistent.
- For hypertension, obesity and dyslipidaemia age appeared to modulate the association: the risk of dementia was generally largest in studies that measured the risk factor in midlife (compared to late life) and had a long follow-up time.
Why it matters
This systematic review of longitudinal population studies found that diabetes, high blood pressure, obesity and high cholesterol were each linked to a higher risk of dementia, with odds ratios "around 1.5". The findings for diabetes and obesity were the most consistent. Timing mattered: for blood pressure, obesity and cholesterol the link was generally strongest when measured in midlife, and midlife high blood pressure accounted for "up to 30%" of late-life dementia at the population level, while in later life diabetes "appears to convey the highest risk". These are associations, not proof that treating these factors prevents dementia; the authors conclude that vascular risk factors are a major target for prevention but that "timing of such measures appears to be critical".
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Study details
- Study designlongitudinal study
- Participants14
- Evidence strengthModerate
How this study scored 65/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (European journal of pharmacology) |
| Journal's citation record | 3 / 4 | European Journal of Pharmacology: journal h-index 276 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question (from PubMed type “Systematic Review”) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 14 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 6 / 7 | Cited 370 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 18.5 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 2 / 6 | Cited 2.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 21 other studies in this library |
| Still being cited | 2 / 4 | Cited 35 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Geert Jan Biessels: h-index 105 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Groningen: institution h-index 1,383 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18395201) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 65 / 100 | — |
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