Abstract
Background: Cardiovascular diseases are leading causes of death and patients
with dementia are often affected by them.
Objective: Investigate associations of cardiovascular diseases with
different dementia disorders and determine their impact on mortality.
Methods: This study included 29,630 patients from the Swedish Dementia
Registry (mean age 79 years, 59% women) diagnosed with Alzheimer’s disease (AD), mixed
dementia, vascular dementia, dementia with Lewy bodies (DLB), Parkinson’s disease dementia
(PDD), frontotemporal dementia (FTD), or unspecified dementia. Records of cardiovascular
diseases come from the Swedish National Patient Register. Multinomial logistic regression
and cox proportional hazard models were applied.
Results: Compared to AD, we found a higher burden of all cardiovascular
diseases in mixed and vascular dementia. Cerebrovascular diseases were more associated
with DLB than with AD. Diabetes mellitus was less associated with PDD and DLB than with
AD. Ischemic heart disease was less associated with PDD and FTD than AD. All
cardiovascular diseases predicted death in patients with AD, mixed, and vascular dementia.
Only ischemic heart disease significantly predicted death in DLB patients (HR = 1.72; 95%
CI = 1.16–2.55). In PDD patients, heart failure and diabetes mellitus were associated with
a higher risk of death (HR = 3.06; 95% CI = 1.74–5.41 and HR = 3.44; 95% CI = 1.31–9.03).
In FTD patients, ischemic heart disease and atrial fibrillation or flutter significantly
predicted death (HR = 2.11; 95% CI = 1.08–4.14 and HR = 3.15; 95% CI = 1.60–6.22,
respectively).
Conclusion: Our study highlights differences in the occurrence and
prognostic significance of cardiovascular diseases in several dementia disorders. This has
implications for the care and treatment of the different dementia disorders.
