Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study

Abstract

OBJECTIVE:To determine the independent effects of obesity and hypertension on cognitive functioning. METHODS: Using a prospective design, male (n ¼ 551) and female (n ¼ 872) participants of the Framingham Heart Study were classified by presence or absence of obesity and hypertension based on data collected over an 18-y surveillance period. All subjects were free from dementia, stroke, and clinically diagnosed cardiovascular disease up to the time of cognitive testing. Statistical models were adjusted for age, education, occupation, cigarette smoking, alcohol consumption, total cholesterol, and a diagnosis of type II diabetes. Body mass index status (nonobese or obese) and blood pressure status (normotensive or hypertensive) were then related to cognitive performance (learning, memory, executive functioning, and abstract reasoning) on tests administered 4-6 y later. RESULTS: Adverse effects of obesity and hypertension on cognitive performance were observed for men only. Obese and hypertensive men performed more poorly than men classified as either obese or hypertensive, and the best performance was observed in nonobese, normotensive men. CONCLUSIONS: The adverse effects of obesity and hypertension in men are independent and cumulative with respect to cognitive deficit.

Interleukin-6 Covaries Inversely with Hippocampal Grey Matter Volume in Middle-Aged Adults

“…Adipose tissue is a potent source of peripheral IL-6 thought to account for approximately 30% of circulating levels (33). Further, greater BMI in middle and later life is associated with poorer cognitive function independently of age (52) and predicts temporal lobe and global brain atrophy, cognitive decline, and the incidence of dementia (35,(52)(53)(54)(55)(56). Animal studies also show that obesity is associated with impaired hippocampal LTP (57) and deficits in hippocampal-dependent learning and memory (58).…”

Fatores de risco cardiovascular, declínio cognitivo e alterações cerebrais detectadas através de técnicas de neuroimagem

“…Em anos recentes, tem começado a ficar clara também a associação entre fatores de risco cardiovascular e distúrbios do desempenho cognitivo (Farmer et al, 1990;Elias et al, 2003).…”

“…A partir da classificação da gravidade de ICC de acordo com os critérios da New York Heart Association (NYHA), o comprometimento da memória, em especial de fixação e aprendizado (Harrington et al, 2000), nos pacientes com ICC nas classes funcionais (CF) I, II e III da NYHA vem sendo apontado consistentemente na literatura (Deary et al, 1991;Grubb et al, 2000;Glynn et al, 2002;Elias et al, 2003;Bennett e Sauve, 2003;Antonelli Incalzi et al, 2003). No caso de pacientes com ICC-grave (CF IV -NYHA), o prejuízo da cognição é mais intenso e global, incluindo déficits atencionais (Almeida e Flicker, 2001;Almeida e Tamai, 2001).…”

“…Indivíduos hipertensos apresentam pior performance em testes neuropsicológicos que avaliam funções tais como o Mini Exame do Estado Mental (MEEM) (Bertolucci et al, 1994), Modulo Cognitivo do Cambridge Examination for the Elderly (CAMCOG), Digit Span e Digit Symbol (Hertzog et al, 1978;Guo et al, 1997;Heckbert et al, 1997;Guo et al, 1999;Havlik et al, 2002). No Framingham Heart Study, que envolve o seguimento mais longo até hoje, com avaliações bienais de amostra de 1.993 indivíduos baseada em uma mesma comunidade, foi reportada uma relação inversa entre níveis de pressão arterial e performance cognitiva (Farmer et al, 1990;Elias et al, 2003).…”

The link between cardiovascular risk, Alzheimer's disease, and mild cognitive impairment: support from recent functional neuroimaging studies

“…35 A large body of epidemiological and clinical evidence in recent years has indicated that, rather than separate entities with distinct causes, VaD and AD share similar CVRFs. 36 Thus, several studies have suggested that, even in the absence of stroke, the incidence of AD is significantly influenced by the presence and severity of elevated blood pressure, [37][38][39] diabetes, 30,40 smoking, 41 and physical inactivity. 42 High cholesterol levels have been associated with increased risk of AD in a number of studies, but there are also negative reports, and these conflicting results are thought to be caused by different mediating effects of age, gender, and APOE genotype.…”