Vascular risk factors and dementia revisited. J Neurol Neurosurg Psychiatry

Although dementia is for the most part a disease of older people, epidemiological data suggest that the pathological pro-cesses leading to the disease start operat-ing many years before the clinical onset.1 2 Hence, there is reason to believe that some risk factors begin to exert their impact as early as midlife. In this issue (see page 1194), Alonso et al present evidence suggesting that exposure to vascular risk factors in midlife is asso-ciated with an increased risk of dementia.3 In 11 151 community participants from the Atherosclerosis Risk in the Communities study, vascular risk factor