THE DUTCH VASCULAR FACTORS IN DEMENTIA STUDY - RATIONALE AND DESIGN

Dementia is a rapidly increasing health problem in the industrialized countries. With the ageing of the population the number of demented pe rsons increases bath in relative and absolute terms. Obviously there i s a need for prevention and intervention strategies. We describe the m ethods and baseline findings of a large study aimed at identifying pot entially modifiable vascular, thrombogenic, and metabolic determinants of dementia. The study population consists of subjects 55 years of ag e or older. Since the vascular wall of the cerebral vessels is differe nt from that of the coronary or peripheral vessels, we formed three su bgroups in which vascular risk factors for dementia are studied. Subje cts with stroke were distinguished from subjects with coronary or peri pheral artery disease, and from subjects without stroke or coronary or peripheral artery disease. To obtain a large enough number of subject s with stroke, cases and controls from a stroke registry were combined with cases and controls of a population-based study from the same reg ion. For the diagnosis of dementia the DSM-III-R criteria were used. E xtensive information on cardiovascular risk factors was collected, inc luding indicators of atherosclerosis. Blood and urine were sampled to study platelet function and thrombogenic and metabolic factors. The st udy population consists of 7,466 subjects, of whom 300 were recruited from a hospital-based stroke registry. Coronary or peripheral artery d isease was present in 956 subjects and stroke in 617. Dementia was pre sent in 434 (5.8%) of all subjects. The prevalence of dementia was 3.0 , 24.0, and 4.4% in subjects with a history of coronary or peripheral artery disease, a history of stroke, and subjects without a history of coronary or peripheral artery disease or stroke, respectively. The st udy will allow us to investigate the role of vascular factors in demen tia, irrespective of its cause.