The Association Between the Revised Framingham Stroke Risk Profile and
Cognitive Outcomes: a Longitudinal Analysis of the NACC Cohort 
   Lead Investigator:    Isabelle Pelcher
   Institution      :    Boston University
   E-Mail           :    ipelcher@bu.edu
   Proposal ID      :    1334



   Proposal Description:
   Cardiovascular disease (CVD) is associated with increased risk for Alzheimer's disease (AD) and related dementias. Indeed, cerebrovascular disease   (CBVD) pathology frequently co-occurs with Alzheimer's disease pathology in       one study it was found that in nondemented respondents with a diagnosis of        probable or definite AD, 71 of them had vascular pathology [1]. In demented       individuals with a diagnosis of probable or definite AD, 58 had vascular          pathology [1]. Another study observed the brains of individuals diagnosed with    Alzheimer's dementia post mortem and saw that 50 of individuals also had          cerebrovascular pathology, and 30 had only AD pathology [2].                           The relationship between CVD and AD has long been investigated, but, until   recently, has focused on individual or small clusters of CVD markers (e.g.,       hypertension or obesity). Focusing on individual CVD markers seldom captures      the full clinical picture, as CVD and associated risk factors rarely occur in     isolation, particularly in older adults. The Framingham Stroke Risk Profile       (FSRP) was developed in 1991 to predict risk of incident stroke using the         Framingham Heart Study (FHS) cohort. The FSRP is a composite based on age,        systolic blood pressure (SBP), use of hypertensives, presence of diabetes         mellitus (DM), cigarette smoking, cardiovascular disease (CVD), atrial            fibrillation (AF), and left ventricular hypertrophy (LVH) [3]. The profile        devised a point system based on sex and the risk factors to calculate the         probability of an individual having a stroke from one to ten years in the         future.                                                                                The FSRP has since been adopted to study the association between CVD and     cognition. The FSRP has been shown to predict incident cognitive impairment, as   well as cognitive decline. Elias et al us