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The number of people living with dementia, such as Alzheimer's disease, is increasing worldwide. Persons with dementia often have a high risk of atherosclerotic cardiovascular disease and they are therefore theoretically eligible for treatment of hypertension and hyperlipidemia. However, in this population, beneficial and harmful effects of cardiovascular risk management (CVRM) may be different compared to older persons without cognitive impairment. Current CVRM guidelines are based on trials from which persons with dementia were excluded. In this narrative review, we will discuss how current guidelines can be translated to persons with dementia and which aspects should be taken into account when treating hypertension and hyperlipidemia to prevent major adverse cardiovascular events (MACE). Survival time is significantly shorter in persons with dementia. We therefore suggest that since the main goal of CVRM is prevention of MACE, first of all, the patient's life expectancy and treatment wishes should be evaluated. Risk assessment tools are to be used with care, as they tend to overestimate the 5- and 10-year risk of MACE and benefit from CVRM in the prevention of MACE in persons with dementia. When the clinician and patient have decided that treatment is initiated or intensified, patients should be closely monitored since they are at high risk for adverse drugs events and overtreatment due to the natural course of blood pressure in persons with dementia. In the event of intolerance or side effects, medication should be switched or withdrawn. For persons with dementia and limited life expectancy, deprescribing should be part of usual care.

Introduction: The prevalence of atherosclerotic cardiovascular diseases and its associated mortality are increasing worldwide. In persons with cognitive impairment, the potential benefits from treatment of hypertension and dyslipidaemia may be overestimated due to competing mortality risks related to cognitive impairment. We therefore aim to explore the association between cardiovascular risk and all-cause mortality in a memory clinic population, and whether this relation is modified by cognitive and physical performance. Methods: All patients from the Amsterdam Ageing Cohort who visited the memory clinic were included. Cardiovascular risk was assessed with the SCORE2-OP, a validated instrument to estimate 5- and 10-year risk for non-fatal myocardial infarction, non-fatal stroke and cardiovascular mortality in persons aged ≥70 years. A 10-year risk of