Managing Risk Factors in Patients with Mixed and Vascular Dementia
Abstract
Introduction:
Vascular dementia is the second most common subtype of dementia, yet perhaps the most preventable as the underlying pathology is cerebrovascular damage. Therefore, managing vascular risk factors is vital to reduce disease progression. The aim of this study was to assess the management of various risk factors contributing to vascular and mixed dementia patients of the Cardiff and Vale memory clinic.
Methods:
A retrospective cross-sectional study was conducted, collecting data from 100 patients diagnosed with mixed or vascular dementia between 2022-2024 using WCP and PARIS. Factors assessed included patient demographics, cholesterol levels, HbA1c, diabetes, atrial fibrillation and antiplatelet and anticoagulant medications. Results were visualised to highlight areas for improvement.
Results:
74% of patients with atrial fibrillation are medicated according to recommendations. 13% are not being treated. This may be due to contraindications such as fall risk, so individual cases should be investigated. A further 13% of patients are on antiplatelet medications no longer recommended for treatment.
Most patients were non-diabetic with their blood glucose below the threshold. 51.6% of patients with diagnosed type 2 diabetes are over threshold, reaching as high as 115mmol/L. 22.6% of patients are overly controlled, going below the recommended threshold of 30mmol/L.
20.3% of hypertensive patients had a blood pressure exceeding 150/90 (recommended for this age group). 12.5% of these patients had a blood pressure below target threshold creating falls risks.
Managing cholesterol levels requires the greatest improvement. 56% of patients do not meet the NICE target cholesterol threshold. 45% of patients with acknowledged/treated hyperlipidaemia are over the threshold.
Conclusions:
It is vital that the importance of managing risk factors in patients with mixed and vascular dementia is highlighted, so clinicians can monitor and optimise appropriately. A review of these factors should be undertaken in memory clinic to include in letters to GPs, recommending areas for improvement and stressing the importance of management in disease progression.