Vascular risk factors and white matter hyperintensities as predictors of progression to dementia in patients with mild cognitive impairment.

Background: Evidence of the effect of vascular risk factors and white matter lesions on the progression of mild cognitive impairment (MCI) to dementia is not conclusive. Objective: The study aimed to analyze the impact of these factors on MCI progression to dementia from a global perspective. Methods: Our study included a population of 105 patients with MCI. Results: After a mean follow-up period of 3.09 years (range, 2-3.79), 47 patients (44.76%) progressed to dementia: 32 (30.8%) to mixed dementia, 13 (12.5%) to probable AD, and 2 (1.9%) to vascular dementia. Total cholesterol levels (OR: 1.015 [1.003-1.028]) and LDL cholesterol levels (OR: 1.018 [1.004-1.032]) increased the risk of progression to dementia. Cystatin C was a protective factor against progression to dementia (OR: 0.119 [0.015-0.944], p = 0.044). During the second year of follow-up, the presence of subcortical white matter hyperintensities increased the risk of progression to dementia (OR: 5.854 [1.008-33.846]). Subcortical and periventricular white matter hypermintensities were also associated with an increased risk of progression to dementia during the second year of follow-up (OR: 3.130 [1.098-8.922] and OR: 3.561 [1.227-10.334], respectively). The same was true for silent infarcts (OR: 4.308 [1.48012.500]). Conclusion: A high percentage of patients progressed to dementia. Total cholesterol, LDL cholesterol, and white matter hypermtensities were found to be associated with MCI progression to dementia. In contrast, cystatm C was shown to be a protective factor against progression to dementia.