Hypertension and Cognitive Decline: Impact on Executive Function

Vicario, Augusto; Martinez, Carlos; Baretto, Dolores; Casale, Alejandro Diaz; Nicolosi, Liliana

doi:10.1111/j.1524-6175.2005.04498.x

Cited by 90 publications

(74 citation statements)

References 52 publications

(35 reference statements)

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“…Some studies have found that hypertension is a risk factor for the development of cognitive decline; on the other hand, others report that hypertension in old age is a concomitant phenomenon of already-existing cognitive impairment, rather than an independent risk factor. [23][24][25] Our findings in this very elderly population are not consistent with studies based on people aged 65 years or older. However, participants in these earlier studies were younger and had better cognitive function and lower prevalence of hypertension than the participants in this study.…”

Section: Discussioncontrasting

confidence: 57%

“…It is generally thought that hypertension and cognitive impairment are significantly and highly correlated in both younger adults and the elderly. [23][24][25] Many earlier studies have inferred causality between hypertension and cognitive impairment in old age. Some studies have found that hypertension is a risk factor for the development of cognitive decline; on the other hand, others report that hypertension in old age is a concomitant phenomenon of already-existing cognitive impairment, rather than an independent risk factor.…”

Section: Discussionmentioning

confidence: 99%

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Cognitive impairment and hypertension among Chinese nonagenarians and centenarians

et al. 2009

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In this study, we explore the association between hypertension and cognitive impairment in the very elderly, using a sample ranging in age from 90 to 108 years. This work was conducted as a cross-sectional study. Our population included 782 unrelated Chinese nonagenarians and centenarians (67.5% women, mean age 93.62 years). The mean cognitive function score for the sample was 14. 95 (s.d.: 5.99, range: 0-28). There were no significant differences between individuals with and without hypertension with regard to cognitive function scores (14.95±6.01 vs. 14.95±5.82, P¼0.997) or cognitive impairment prevalence (59.52 vs. 59.42, P¼0.976). There were also no significant differences in the prevalence of hypertension (56.99 vs. 57.10, P¼0.976) or in the levels of arterial blood pressure (including systolic blood pressure (SBP) and diastolic blood pressure (DBP) Keywords: Chinese; cognitive impairment; hypertensive; nonagenarians and centenarians INTRODUCTION About 10% of people older than 65 years have cognitive impairment, ranging from mild deficits to dementia. 1 Hypertension has been viewed as a common risk factor for cognitive disorders. 2-4 Many prospective and cross-sectional observational studies have shown that hypertension is associated with cognitive decline in older persons. [5][6][7][8][9][10][11][12][13][14] Common to each of these studies, however, has been the relatively young age of the participants. The average age of these populations has been under 85 years; only a few studies have included individuals aged 90 years or above, and no studies have focused only on individuals aged 90 years or older. Cognitive impairment and hypertension are both major components of age-related deterioration. 15,16 As the population of older persons increases, the number of cognitively impaired older individuals is expected to rise. 17,18 To the best of our knowledge, no studies have explored whether cognitive impairment is associated with hypertension among very old people, that is, those aged 90 years and above. In this study, we sought to observe the association of cognitive impairment with hypertension among very old people using a cohort of Chinese men and women aged 90-108 years.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Cognitive impairment and hypertension among Chinese nonagenarians and centenarians

et al. 2009

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“…PLMS has been associated with increased sympathetic activity, elevated blood pressure and incident cardiovascular diseases, 3,20 which all contribute to vascular-related cognitive impairment, as featured by impairment in executive function. [21][22][23] Moreover, dopamine deficit, as a frequently suggested cause of PLMS, 4 also plays a key role in neurodegeneration and affects particularly the prefrontal cortex area, which regulates executive function. 24,25 Previous research suggests that executive function is a better predictor of functional decline and mortality in older women 26 ; thus, the current finding on PLMS and decline in executive function might have important clinical implications.…”

Section: Discussionmentioning

confidence: 99%

Periodic Limb Movements in Sleep are Associated with Greater Cognitive Decline in Older Men without Dementia

Leng

Blackwell

Stone

et al. 2016

Sleep

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Study Objectives: To examine the association between periodic limb movements in sleep (PLMS) and change in selected aspects of cognition in community-dwelling older men. Methods: We studied 2,636 older men without dementia who underwent in-home polysomnography with measurement of the periodic limb movement index (PLMI) and periodic limb movement arousal index (PLMAI) using piezoelectric sensors. Random-effects models and logistic regression were used to examine the association between PLMI, PLMAI, and 3-to 4-y change in cognition. Results: After multivariable adjustment, men with a high PLMI had greater decline on the Trail Making Test -Part B (P trend = 0.02); those with a PLMI ≥ 30 were 48% more likely (odds ratio = 1.48, 95% confidence interval = 1.05-2.07) to experience the development of significant cognitive impairment (≥ 1 SD above mean change). Further adjustment for sleep efficiency, nocturnal hypoxemia, or dopaminergic medication use and analysis among men without Parkinson disease (n = 2,607) showed similar findings. No significant association was found for PLMAI or for Modified Mini-Mental State Examination scores. Conclusions: Among older men without dementia, higher PLMS frequency was associated with greater decline in cognition, particularly in executive function.

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“…48 Accordingly, Knecht et al 27 found that systolic BP explained up to 11% of the variance in cognitive performance in nondemented groups of individuals in midlife age, suggesting that in this population hypertension may account for onetenth of cognitive impairment and thus for an increased risk for dementia. Another study performed by Vicario et al 19 demonstrated that cognitive impairment of hypertensive patients is present in areas such as attention, memory, and executive function. 19 While evaluating middle-aged, never-treated hypertensive patients, Sierra et al 49 first described that the presence of silent cerebral white matter lesions is associated with a mild decline in basic attention.…”

Section: Discussionmentioning

confidence: 99%

“…17 The applied tests, previously used by several authors, [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] can reveal such minor alterations of the cognitive function, which are not necessarily evident during everyday activity. All tests were carried out and scored by a trained psychologist.…”

Section: Neuropsychological Examinationmentioning

confidence: 99%

Elevated LDL-C combined with hypertension worsens subclinical vascular impairment and cognitive function

Kovács

Bajkó²,

Szekeres³

et al. 2014

Journal of the American Society of Hypertension

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Hypertension and dyslipidemia belong to the most prevalent modifiable risk factors for cerebrovascular and cardiovascular diseases. Hereby, we aimed to examine the combined effects of newly diagnosed hypertension and hyperlipidemia on the characteristics of the arterial wall and on cognitive function. We examined 72 hypertensive and 85 apparently healthy individuals. Based on serum lipid levels, four subgroups were created ranging from normotensive-normolipidemic to hypertensivehyperlipidemic subjects. Carotid intima-media thickness (IMT), arterial stiffness, and cognitive function were assessed. IMT of controls was the lowest, whereas that of patients with both risk factors the highest. Stiffness parameters increased when both risk factors were present, whereas subjects with only one risk factor exhibited intermediate values. Hypertensive patients performed worse when memory, attention, reaction time, and trait anxiety were assessed. Significant worsening of IMT, arterial stiffness, and sum of neuropsychological scores was observed along with increasing mean arterial pressure. Generally, hyperlipidemia combining with hypertension resulted in further worsening of all examined parameters. Subclinical changes of the vascular wall and cognitive performance are already present in recently diagnosed hypertensive patients. Combination of hyperlipidemia and hypertension results in more severe impairments, therefore, early and intensive treatment may be crucial to prevent further deterioration. J Am Soc Hypertens 2014;-(-):1-11.

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Hypertension and Cognitive Decline: Impact on Executive Function

Abstract: (J Clin Hypertens. 2005;7:598-604)

Cited by 90 publications

References 52 publications

Cognitive impairment and hypertension among Chinese nonagenarians and centenarians

Cognitive impairment and hypertension among Chinese nonagenarians and centenarians

Periodic Limb Movements in Sleep are Associated with Greater Cognitive Decline in Older Men without Dementia

Elevated LDL-C combined with hypertension worsens subclinical vascular impairment and cognitive function

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