IMPACT OF CARDIOVASCULAR RISK FACTORS ON THE PREVENTION AND PROGRESSION OF VASCULAR DEMENTIA

• DOI: https://doi.org/10.22533/at.ed.1594952423104

• Palavras-chave: Dementia, Vascular Dementia, Cardiovascular Risk Factors, Cerebrovascular Diseases.

• Keywords: Dementia, Vascular Dementia, Cardiovascular Risk Factors, Cerebrovascular Diseases.

• Abstract:

  INTRODUCTION: Dementia refers to the progressive loss of cognitive functions, which affects the ability to carry out daily activities. It results from pathological conditions, such as Vascular Dementia, which accounts for 10% to 20% of cases in the elderly. Its prevalence increases with age, especially in individuals with cardiovascular comorbidities. Vascular Dementia results from damage to the blood vessels in the brain, leading to cell death due to hypoxia. The main risk factors include hypertension, diabetes, smoking and physical inactivity. This condition compromises quality of life, generating dependency, psychological suffering and high social costs. OBJECTIVES: This study aims to analyze the impact of cardiovascular risk factors on the prevention and progression of vascular dementia, identifying the most influential ones and exploring biological mechanisms such as atherosclerosis and stroke. It also analyzes the impact of lifestyle and compares interventions, seeking to provide guidance for health professionals and the public on the prevention and treatment of vascular dementia. METHODS: This integrative review investigated the impact of cardiovascular risk factors on vascular dementia, using articles published between 2019 and 2024 in the VHL, PUBMED and MEDLINE databases, with specific keywords. The selection process involved three stages: identification of 257 articles, exclusion of 169 for irrelevant topics, resulting in 88 reviewed, of which 34 were included in the final analysis to compare approaches to prevention and management of vascular dementia. RESULTS AND DISCUSSION: Cerebrovascular diseases are important causes of cognitive impairment in the elderly, including atherosclerosis, arteriolosclerosis, cerebral amyloid angiopathy (CAA) and microvascular disease. These affect the brain in different ways, causing infarcts, hemorrhages and brain atrophy. The overlap of cerebrovascular pathologies and Alzheimer's in the elderly makes diagnosis difficult, since factors such as hypertension, diabetes, dyslipidemia and smoking influence vascular and cerebral health. Hypertension is a risk factor for vascular dementia, damaging vessels and promoting inflammation and ischemic lesions such as leukoaraiosis. The interaction between genetic and environmental factors, such as diet and stress, influences the progression and development of dementia. Type 2 diabetes mellitus is associated with vascular dementia due to hyperglycemia and insulin resistance, which damage the endothelium and compromise cerebral vascular function. Genetic and epigenetic factors, such as diet and chronic inflammation, influence the progression of the disease. Dyslipidemia increases the risk of vascular dementia through atherosclerosis and chronic inflammation, impairing endothelial function and increasing susceptibility to brain damage. Genes related to lipid metabolism and inflammation also contribute to this risk. Adopting lifestyle changes and pharmacological treatments is crucial to controlling dyslipidemia and reducing vascular dementia. Finally, smoking has a negative impact on blood vessel health, contributing to the development and worsening of vascular dementia. CONCLUSION: Cerebrovascular diseases play a crucial role in the development of cognitive impairment and dementia, especially in the elderly, due to the overlap of vascular pathologies. Cardiovascular risk factors such as hypertension, diabetes and dyslipidemia, smoking and physical inactivity contribute significantly to vascular dementia. Understanding genetic and epigenetic interactions is essential for developing effective preventive strategies. Controlling risk factors and promoting healthy habits are key to reducing morbidity and improving the quality of life of the elderly.