PB0041 - Prevalence of vascular risk factors and I/D angiotensin-converting enzyme gene (ACE) polymorphism in Costa Rican elderly patients with cognitive impariment.

Background: Associations between atherosclerosis and cognitive impairment (CI) , as well risk of Alzheimer Disease (AD) are reports in different populations. Some information suggests that vascular determinants, both environmental and genetic, may predispose to dementia. One player of vascular homeostasis, the renin angiotensin system (RAS) proteins constitute a source of candidate genes. Among these, the angiotensin I-converting enzyme gene (ACE), a central enzyme of the RAS, presents in its sequence a deletion (D)/insertion (I) polymorphism associated with plasma ACE levels. Several studies suggest that this polymorphism may constitute a genetic susceptibility factor for dementia.

Aims: Our aim was to determine the prevalence and association of the I/D ACE polymorphisms and the VRF in Costa Rican elderly patients with CI.

Methods: This was a cross-sectional observational study of the Medicine School of the University of Costa Rica. Elderly patients were recruited of the Geriatric Residence, in Moravia, San José, Costa Rica. Exclusion criteria were any significant brain pathology. The local ethics committee approved the study protocol. The clinical data and diagnosis was collected for each patient and the I/D ACE was determined.

Results: The main age of the elderly patients was 83.8 years old. The gender as a variable were more females (70.8%) than males (29.2%). The main VRF were HTA (83.3%), DM (20.8%) and smoking (16.6%). The I/D ACE genotypes were I/I 20.8 %, I/D 58.3% and D/D: 20.8%. It was not found statistical diference between gender or other VRF and the prevalence of the I/D ACE in CI patients.

Conclusion(s): This study suggests that: HTA was more prevalent VRF in the IC patient following of DM and smoking. The ACE I/D did not emerge as additional risk factor. These preliminary exploratory results should be confirmed in larger studies, in order to define the ACE I/D polimorphism in the risk for CI and dementia.