• A Pajak, E Kawalec, and A Szczudlik.
• Pracowni Epidemiologii Klinicznej i Badań Populacyjnych, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
• Prz. Lek. 1998 Jan 1; 55 (12): 676-82.

AbstractDementia is found in a small percent of general population but remains a significant problem in the elderly population. Little is known whether prevention of dementia in the elderly is possible. Some evidence exists that both vascular dementia and Alzheimer's type dementia are related to cardiovascular disease risk factors. The main goal of the CASCADE Kraków Project is to study the relation between the exposure to cardiovascular disease risk factors in the middle age and cognitive impairment and cerebral white matter lesions in old age. Project CASCADE Kraków is an independent part of the international project CASCADE, which is carried out in 11 research centres from 9 countries. Polish part of the study includes a longitudinal observation of the sample screened earlier in POL-MONICA Kraków Project, which was selected from population of residents of rural province (Tarnobrzeg Voivodship). Studied sample are 1318 persons, for whom cardiovascular disease risk factors were measured in 1983-84 and who completed at least 64 years in 1997. Two-stage examination was designed. In the first stage collection of the following data was designed: socio-economic factors, history of cardiovascular disease, perceived health, blood pressure and cognitive function assessment using Mini-Mental State Examination (MMSE) procedure. In the second stage (sub-sample of 300 persons included) the following procedures were designed: detailed neuro-psychological testing, neurolo-gical examination, MRI, determination of total- and HDL-cholesterol and determination of apoE isoforms. There were 625 (47%) men and 693 (53%) women selected for the first stage. Out of them 128 (43%) men and 172 (57%) women were selected for the second stage. There were no important differences in age, education, health status and exposure to cardiovascular disease risk factors between the studied groups in the baseline assessment. However, there were important differences between men and women. Compared to men, women had lower education (higher than elementary education in 17% and 9% respectively), more frequent obesity (respectively 12% and 36%), hypertension (respectively 57% and 71%) and hyperlipoproteinemia (respectively 17% and 30%) but lower smoking rate (respectively 53% and 4%). Integration of neuropsychological testing and neuroimaging with the epidemiological approach to risk factors could contribute to better understanding of the mechanisms on which the disease affects the brain morphology and functions. The results of CASCADE and CASCADE Kraków projects will contribute also to the development of the strategies of medical care and management of the cognitive impairment in the elderly.

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