Factors associated with vascular dementia in an elderly community population

Objective. Examination of associated factors for vascular dementia in comparison with Alzheimer's disease and a non-demented control population. Setting. A semi-rural geographically defined population, in Melton Mowbray and the surrounding area, consisting of elderly patients aged 75 and over from a 13-doctor general practice. Method. 438 subjects, sampled according to results of initial screening with the Mini-Mental State Examination (MMSE), were examined using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX), which was also used to classify the subtypes of dementia. Results. 34 subjects had vascular dementia, 222 had Alzheimer's disease and 140 were non-demented according to the clinician's diagnosis based on the CAMDEX criteria. Significant factors associated with vascular dementia, when compared to the Alzheimer's disease and non-demented groups, were family history of stroke and diabetes. Stroke was also significant, but this factor is one of those defining the criteria for diagnostic grouping. There were no significant differences between groups for falls, heart attack, hypertension, head injury, substance abuse or lipid levels. Conclusion. The results are broadly consistent with the published literature and emphasize the importance of diabetes as a key risk factor for vascular dementia. (C) 1999 John Wiley & Sons, Ltd.