There is a systematic review of the effects of interventions for cardiovascular risk factors on prevention of dementia by Ligtart and colleagues which is freely available here. The authors select a number of vascular risk factors for investigation – hypertension, hyperhomocysteinuria, dyslipidaemia, NIDDM and obesity. They select randomised controlled trials of interventions for these risk factors by searching several databases including Medline. They list the search criteria and after identifying a large number of papers are able to exclude many of these leaving 43 for futher analysis. There are no firm conclusions from the analysis as there are a number of difficulties the authors encounter. Many of the papers use dementia as a secondary outcome measure and so perhaps what this means is that the selection criteria are too narrow at this point in time to reach meaningful conclusions. The authors note that there are a number of studies underway which are focusing on interventions for these risk factors. Thus a repeat of this analysis in a few years time may be warranted. There are some positive findings amongst the results and the association between vascular risk factors and prevalence of dementia is supported by an abundant evidence base although the possibility of confounders should be borne in mind. I thought that the tables of results for selected studies as well as the guide for interpreting studies were particularly useful products of this review.
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