INFLUENCE OF VASCULAR FACTORS ON THE PROGRESSION AND SURVIVAL OF PRODROMAL ALZHEIMER’S DISEASE PATIENTS

Clinical progression and survival have been widely studied in Alzheimer's disease (AD) but few studies have been performed in it prodromal state. Our aim was to analyze the influence of demographic, clinical and analitical factors on the progression and survival in prodromal AD patients. Between 2008 and 2011, 170 patients with mild cognitive impairment (MCI) following Petersen criteria 2006 were included. A physical and neurological examination, neuropsychological testing, Yesavage depression scale, blood tests, brain MRI and lumbar puncture (LP) were performed. CSF levels of Aβ1–42, T-tau, P-tau181 were analyzed. The patients were followed in the outpatient clinic with at most an annual examination. During these examinations, the progression to AD was assessed according to the NIA-AA criteria (2011) and evaluated using the GDS scale of Reisberg (GDS). After a 5.5 ± 1.2 years clinical follow-up, 44 patients remained stable, 15 other forms of dementia, 7 died, 10 received other diagnoses and 94 developed AD. At may 2016, 11 remain in GDS of 4, 62 developed a GDS 5 or superior and 21 died during the follow-up. Hypertension patients developed faster GDS 5 or superior than non hipertensión patients (p< 0.02) and diabetes mellitus patients died in a bigger proportion than non-diabetics (p< 0.03). Hypertension was associated with a greater rate of neurological decline and diabetes mellitus with a worse survival prognosis, in our prodromal AD patients.