BACKGROUND AND PURPOSE: Cardiovascular risk factors are associated with an 
increased risk of dementia. Treatment of hypertension and hypercholesterolemia 
is associated with a decrease in incident dementia. Whether interventions aimed 
at cardiovascular risk factors in late life also reduce dementia risk is 
unknown. Here, we report the outline of a pragmatic study that will attempt to 
answer this question and we describe the prevalence of cardiovascular risk 
factors in the target population.
METHODS: We designed a large cluster-randomized trial with a 6-year follow-up in 
3700 elderly subjects (70 to 78 y) to assess whether nurse-led intensive 
vascular care in primary care decreases the incidence of dementia and reduces 
disability. Secondary outcome parameters are mortality, incidence of vascular 
events, and cognitive functioning. Intensive vascular care comprises treatment 
of hypertension, hypercholesterolemia, diabetes and reducing overweight, smoking 
cessation, and stimulating physical exercise.
RESULTS: Baseline data of 1004 subjects show that 87% of the subjects have 1 or 
more cardiovascular risk factors and 44% have even 2 or more risk factors 
amenable to treatment. Seventy-nine percent of the subjects receiving 
antihypertensive medication still have a systolic pressure of >140 mm Hg.
CONCLUSIONS: In this older age group, the very high percentage of elderly 
subjects with cardiovascular risk factors illustrates the large window of 
opportunity for therapies directed to lower the cardiovascular risk and 
potentially also the risk for dementia.