Relationship of vascular risk to the progression of Alzheimer disease

We read with interest the article by Regan et al. in which the authors discuss the role of vascular risk factors on disease progression in Alzheimer disease (AD).1 There was no difference in rate of deterioration between people with and without vascular risk factors except in those who had a cerebrovascular accident. Thus, vascular risk factors may contribute to the expression of AD initially but are not part of the underlying etiologic process.1 These findings correspond with our ongoing study carried out on a consecutive series of patients with AD2 aimed at evaluating the genotype-phenotype effect of well-known vascular risk factors and their possible interactions. Among 230 patients with AD, 90 had been followed periodically through a 1-year follow-up. Each patient underwent a clinical and …