Vascular Risk Factors vs MCI Conversion into Alzheimer's Disease

Just in case you didn't realize, I've been traipsing across the country on behalf of the American Academy of Family Physicians' Chapter Lecture Series on the topic of Alzheimer's disease (AD).  Last fall, I went to the CT, IN & MO chapter meetings within a short 2-3 week span.  These last 2 weeks, I've been to OR, MN & just returned from CO, where someone asked about vascular risk factors (VRF), eg high blood pressure, high cholesterol & high sugar.

One of my slides talks about treating vascular risk factors aggressively to minimize stroke risk.  However, in an online release published in Neurology this last week, the authors observed that those patients with VRF were more likely to progress from mild cognitive impairment (MCI) to AD compared to those without VRF.  But more intriguing, those who aggressively managed all their VRF were less likely to progress from MCI to AD compared to those who only managed a few of their vascular risk factors.

Granted, these findings were observed in 837 patients w/MCI followed for 5 years, so there's been no randomized, double blind, placebo controlled trial as of yet to demonstrate causation.  But when you think about it, is there any reason to accept "good enough" care any longer?  We need to strive for optimal care for all our patients!