Ausência de relação entre hipertensão arterial sistêmica e desempenho cognitivo em idosos de uma comunidade

Abstract

ResumoContexto: Pesquisas documentam que a hipertensão arterial pode estar envolvida no declínio cognitivo em pacientes idosos. Estima-se que até 60% dos idosos apresentem hipertensão arterial, tornando-os mais suscetíveis ao declínio cognitivo. Objetivo: Investigar a relação entre hipertensão arterial e desempenho cognitivo em idosos não portadores de demências ou depressão. Método: A amostra foi constituída por idosos participantes de pesquisa populacional em andamento sobre envelhecimento no município de Amparo (SP). Seguindo critérios de inclusão e exclusão, foram selecionados 80 homens e mulheres (40 hipertensos e 40 normotensos) com idade igual ou superior a 60 anos, equivalentes quanto às variáveis sociodemográficas e de saúde. Para avaliar sintomas depressivos, foi utilizada a Geriatric Depression Scale (GDS). Os testes cognitivos utilizados foram a bateria neuropsicológica Consortium to Establish a Registry for Alzheimer's Disease (CERAD) e o Teste do Desenho do Relógio e Dígitos ordem direta e inversa. A análise estatística foi realizada por meio de análise de regressão logística com modelo univariado e multivariado e análise de conglomerados (cluster analysis). Resultados: Não foram encontradas diferenças estatisticamente significativas para as variáveis cognitivas entre os dois grupos. A diferença para fluência verbal aproximou-se da significância estatística (p = 0,075). Conclusões: Os resultados encontrados podem ser explicados pela adesão desta população pertencente à estratégia de saúde da família ao tratamento medicamentoso. Estudos longitudinais serão necessários para investigar a relação entre a hipertensão arterial e o declínio cognitivo na pessoa idosa. Di Nucci FRCF, et al. / Rev Psiq Clín. 2010;37(2):52-6Palavras-chave: Idosos, declínio cognitivo, hipertensão arterial. AbstractBackground: Studies suggest that hypertension might be involved in cognitive decline among older adults. It is estimated that up to 60% of older adults have hypertension, what makes them more vulnerable to cognitive decline. Objective: The objective of this study was to investigate the relationship between hypertension and cognitive performance in non-demented non-depressed older adults. Method: The sample was constituted by community dwelling older adults from an on-going epidemiological study which includes all senior citizens residing in Amparo (SP). Following inclusion and exclusion criteria, 80 seniors (40 diagnosed as having hypertension), including men and women over 60, were recruited. Both groups were equivalent as to socio-demographic and other health variables. In order to evaluate depressive symptoms the Geriatric Depression Scale (GDS) was used. The cognitive tests included the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery, the Clock Drawing Test, and Digit Span Forward and Backward. Logistic regression analyses with univariate and multivariate models and cluster analyses were carried out. Results: No significant differences were found between the two group...

Associação entre declínio cognitivo e qualidade de vida de idosos hipertensos

“…Studies that investigated the impact of antihypertensive treatment on the correlation between hypertension and cognition have produced controversial results. 10,16,17 It is assumed that untreated hypertension is a predictor for cognitive decline and the use of antihypertensive drugs is a protector of cognitive function. Di Nucci et al 10 reported no significant abnormalities in the cognition of hypertensive elderly individuals who used antihypertensive medication on a regular basis.…”

“…Education levels have been reported as one of the most significant determinants of cognitive decline in several studies of the factors associated with this phenomenon. [6][7][8]10,11 Other factors have also been highlighted, such as gender, marital status, smoking and alcohol consumption. 12 Therefore, cognitive dysfunction is determined by a complex association of factors, including individual and social conditions, and can directly affect the quality of life of the elderly individual.…”

“…18 Contrastingly, according to certain investigations, the control of arterial hypertension through antihypertensive drugs also influences the appearance/evolution of cognitive decline, due to the deleterious effect on cerebral white matter and the cerebrovascular function. 10,20 There are currently very few studies that address the correlation between cognitive decline and the quality of life of hypertensive elderly individuals. In a randomized study conducted by Innocenti et al 21 of 2,791 hypertensive elderly individuals, the results confirmed that a greater level of cognitive function was correlated with higher levels of well-being, self-control and current health status, all of which are reflected in the quality of life of the individual.…”

Queixa subjetiva de memória e a relação com a fluência verbal em idosos ativos

“…Thus, studies are needed to investigate risk factors associated with this decline. Such aspect is due to knowing that the decline will affect the performance of daily life activities, generating great impact on social and occupational activities of individuals (9) . Thus, early identification of cognitive decline may help to create strategies to promote cognitive activities, in order to slow the impact on the individuals' daily life (10) .…”

Cognitive impairment and associated factors among institutionalized elderly persons in Natal, Rio Grande do Norte, Brazil

“…However, studies have reached contrasting conclusions regarding the effects of antihypertensive treatment on hypertension and cognitive decline [20][21][22] . The results of Holanda et al 23 found that hypertensive elderly individuals are at greater risk of cognitive function decline than normotensive elderly persons.…”