Modifiable risk factors and symptom progression in dementia over up to 8 years—Results of the DelpHi-MV trial

Abstract

INTRODUCTION: This study investigated the association between modifiable factors and symptom progression in dementia over up to 8 years. METHODS: Multilevel growth curve models assessed the role of modifiable risk factors (low education, hearing impairment and its treatment, depression, physical inactivity, diabetes and its treatment, smoking, hypertension and its treatment, obesity, alcohol consumption, social isolation, and visual impairment) on cognitive and functional trajectories in 353 people with dementia. RESULTS: Higher education was associated with higher initial cognitive status but faster decline. Antidiabetic medication was associated with slower cognitive decline, whereas depression and visual impairment were linked to low baseline functioning and faster cognitive decline. DISCUSSION: Several modifiable risk factors influenced symptom progression. Education initially had a protective effect, whereas depressive symptoms were linked to worse symptom progression. Treatment of comorbidities (diabetes, visual impairment) could have a positive impact on dementia symptoms. Modifiable risk factors are promising targets for tertiary prevention. Highlights: Modifiable risk factors were associated with symptom progression in dementia over up to 8 years. More education was associated with higher initial cognitive status but faster decline. Depressive symptoms were linked to less favorable symptom progression. Treatment of comorbidities (diabetes, visual impairment) may positively impact the course of symptoms. Modifiable risk factors are promising targets for tertiary prevention.