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Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study
Hayden KM, Zandi PP, Lyketsos CG, Khachaturian AS, Bastian LA, Charoonruk G, Tschanz JT, Norton MC et al.. Alzheimer disease and associated disorders, 2006-04-01
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
Vascular risk factors for Alzheimer disease (AD) and vascular dementia (VaD) have been evaluated; however, few studies have compared risks by dementia subtypes and sex. We evaluated relationships between cardiovascular risk factors (hypertension, high cholesterol, diabetes mellitus, and obesity), events (stroke, coronary artery bypass graft surgery, and myocardial infarction), and subsequent risk of AD and VaD by sex in a community-based cohort of 3264 Cache County residents aged 65 or older. Cardiovascular history was ascertained by self-report or proxy-report in detailed interviews. AD and VaD were diagnosed using standard criteria. Estimates from discrete-time survival models showed no association between self-reported history of hypertension and high cholesterol and AD after adjustments. Hypertension increased the risk of VaD [adjusted hazard ratio (aHR) 2.42, 95% confidence interval (CI) 0.95-7.44]. Obesity increased the risk of AD in females (aHR 2.23, 95% CI 1.09-4.30) but not males. Diabetes increased the risk of VaD in females after adjustments (aHR 3.33, 95% CI 1.03-9.78) but not males. The risk of VaD after stroke was increased in females (aHR 16.90, 95% CI 5.58-49.03) and males (aHR 10.95, 95% CI 2.48-44.78). The results indicate that vascular factors increase risks for AD and VaD differentially by sex. Future studies should focus on specific causal pathways for each of these factors with regard to sex to determine if sex differences in the prevalence of vascular factors have an influence on sex differences in dementia risk.
What this study adds
Evidence grade: Moderate
In 3,264 Cache County residents aged 65 or older, a past stroke was linked to a much higher risk of vascular dementia in both women (aHR 16.90) and men (aHR 10.95). Reported effect size: aHR 2.23; aHR 3.33; aHR 16.90.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
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APA 7th
Hayden, K. M., Zandi, P. P., Lyketsos, C. G., Khachaturian, A. S., Bastian, L. A., Charoonruk, G., et al. (2006). Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer disease and associated disorders. https://doi.org/10.1097/01.wad.0000213814.43047.86
Vancouver
Hayden KM, Zandi PP, Lyketsos CG, Khachaturian AS, Bastian LA, Charoonruk G, et al. Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer disease and associated disorders. 2006. doi:10.1097/01.wad.0000213814.43047.86. PMID: 16772744.
BibTeX
@article{hayden2006-16772744,
author = {Hayden, K. M. and Zandi, P. P. and Lyketsos, C. G. and Khachaturian, A. S. and Bastian, L. A. and Charoonruk, G. and Tschanz, J. T. and Norton, M. C. and others},
title = {{Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study}},
journal = {Alzheimer disease and associated disorders},
year = {2006},
doi = {10.1097/01.wad.0000213814.43047.86},
pmid = {16772744},
url = {https://doi.org/10.1097/01.wad.0000213814.43047.86}
}
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Key findings
- The results indicate that vascular factors increase risks for AD and VaD differentially by sex.
Why it matters
In 3,264 Cache County residents aged 65 or older, a past stroke was linked to a much higher risk of vascular dementia in both women (aHR 16.90) and men (aHR 10.95). Obesity was linked to Alzheimer's disease (aHR 2.23) and diabetes to vascular dementia (aHR 3.33) in women only, while self-reported high blood pressure and cholesterol were not linked to Alzheimer's after adjustment. The risk factors were self- or proxy-reported and the study is observational, so it shows associations that differ by sex, not that managing these factors prevents dementia.
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Study details
- Effect sizeaHR 2.23; aHR 3.33; aHR 16.90
- Evidence strengthModerate
How this study scored 51/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer disease and associated disorders) |
| Journal's citation record | 1 / 4 | Alzheimer Disease & Associated Disorders: journal h-index 131 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| 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 | 2006 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 294 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 13.4 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 4 / 6 | Cited 10.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 25 other studies in this library |
| Still being cited | 2 / 4 | Cited 27 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Kathleen Anne Welsh-Bohmer: h-index 80 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16772744) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 51 / 100 | — |
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