Can Framingham Risk Score predict cognitive decline progression in Alzheimer’s Disease ?

Background and Aims: The role of vascular factors in influencing cognitive decline has been extensively investigated, and some difficulties in defining their weight in dementia pathogenesis emerged. Aim of the study was to investigate, in a population of Alzheimers Disease (AD) patients, the relevance of the Framingham cardiovascular risk profile (FCRP) in influencing cognitive deterioration. Patients and Methods: 284 consecutive AD patients were enrolled. For each patient, FCRP score was calculated. APOE alleles were evaluated in order to assess genetic predisposition do develop a more aggressive cognitive deterioration. We performed a one-year-follow-up in order to quantify the cognitive decline by the Clinical Dementia Rating score changes. Results: FCPR score predicted cognitive deterioration with an AUC of 0.63 (95%CI: 0.57-0.69; p<0.0001). In the sub-population of patients with a genetic increased predisposition to develop cognitive deterioration, and with an advanced vascular impairment, FRCP predictive value significantly increased with an AUC of 0.77 (95%CI: 0.52-0.93; p<0.05). Our findings show that FCRP, a cluster of vascular risk factors, can predict the progression of deterioration in AD patients. This was particularly evident in patients with major genetic and atherosclerotic risk factors.