Background:Illiteracy, high cerebrovascular risk and copies ofAPOE-ϵ4 are risk factors for Alzheimer's disease dementia (AD). We aimed to investigate the impacts of gender, education, coronary heart disease (CHD) risk and creatinine clearance variations, body mass index (BMI) andAPOEhaplotypes over the rates of cognitive and functional decline of AD in one year. Methods:Consecutive outpatients with late-onset AD were assessed for gender, schooling, BMI andAPOEhaplotypes, variations in one year of creatinine clearance and Framingham projections of the 10-year absolute CHD risk, and prospective scores of the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating Sum-of-Boxes (CDR-SOB), the Index of Independence in Activities of Daily Living (ADL) and Lawton's Scale for Instrumental Activities of Daily Living (IADL). Results:For 191 patients, mean age at AD onset was 73.26 ± 6.4 years-old, earlier forAPOE-ϵ4/ϵ4 carriers (p= 0.0039). For women, higher BMI led to improvements in CDR-SOB (β = −0.091;p= 0.037) and MMSE (β = 0.126;p= 0.017) scores, while increased creatinine clearance was associated with improvements in ADL (β = 0.028;p= 0.012) and MMSE (β = 0.043;p= 0.039) scores and higher schooling led to faster worsening of IADL (β = −0.195;p= 0.022) scores. No variables impacted cognitive or functional decline for men, whereas copies ofAPOE-ϵ4 and the CHD risk had no significant effects whatsoever. Conclusions:Higher BMI and creatinine clearance are protective regarding cognitive and functional decline for women, whereas higher cognitive reserve may lead to faster decline in instrumental functionality.APOEhaplotypes affected the age at AD onset, but not cognitive or functional decline. [ABSTRACT FROM AUTHOR]