Occurrence and Progression of Dementia in a Community Population Aged 75 Years and Older

Guo, Zhenchao; Fratiglioni, Laura; Zhu, Li; Fastbom, Johan; Winblad, Bengt; Viitanen, Matti

doi:10.1001/archneur.56.8.991

Cited by 202 publications

(133 citation statements)

References 42 publications

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“…159 Moreover the results of the non-randomised, observational, Kungsholmen Project showed that antihypertensive treatment and particularly, but not only, diuretics may protect against dementia in the elderly. 160 Furthermore, the HOPE study also showed that long-term blood pressure control by diuretics or ACE inhibitors may reverse cognitive impairment associated with pre-existing hypertension. 161 A deleterious effect of calcium channel blockers on cognitive function has been suspected in a cross-sectional study 162 and in a 5-year prospective study.…”

Section: Journal Of Human Hypertensionmentioning

confidence: 99%

Cerebral complications of hypertension

Rigaud

Staessen

et al. 2000

J Hum Hypertens

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Ischaemic and degenerative brain diseases are a major health problem leading to a devastating loss of autonomy. Hypertension has been shown to carry an increased risk not only for cerebrovascular morbidity and mortality but also for cognitive impairment and dementia. Although diastolic blood pressure is considered an important risk factor, it is now clear that isolated systolic hypertension and elevated pulse pressure also play an important role in the development of brain complications. Therefore the treatment of these conditions must urgently become a widespread tool of prevention. All the randomised placebo-controlled trials completed for the last 30 years have shown a reduction in fatal and/or non-fatal strokes. In the most recent trials in isolated systolic hypertension in older patients, the benefit was even greater because of the higher risk in these populations. The new classes of drugs, in particular, calcium-channels blockers and angiotensin-

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Section: Journal Of Human Hypertensionmentioning

confidence: 99%

Cerebral complications of hypertension

Rigaud

Staessen

et al. 2000

J Hum Hypertens

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“…Active lowering of BP should prevent or reduce cognitive impairment, although not all antihypertensive agents seem to be equally effective in this regard. [4][5][6][7][8] Growing evidence has suggested that the reninangiotensin system (RAS) in the central nervous system participates in the processing of sensory information, learning and memory. 9,10 Brain angiotensin II (Ang II) and its fragments Ang IV and Ang III have been shown to influence performance in learning and memory paradigms directly or by modulating the activity of other neurotransmitters, like acetylcholine, catecholamines, serotonin and other peptides.…”

Section: Introductionmentioning

confidence: 99%

Effect of telmisartan/hydrochlorothiazide vs lisinopril/hydrochlorothiazide combination on ambulatory blood pressure and cognitive function in elderly hypertensive patients

et al. 2005

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The aim of this study was to compare the effects of telmisartan/hydrochlorothiazide (HCTZ) vs lisinopril/ HCTZ combination on ambulatory blood pressure and cognitive function in elderly hypertensive patients. A total of 160 patients, 76 men and 84 women, aged 61-75 years, with sitting diastolic blood pressure (DBP) 490 mmHg and o110 mmHg and systolic blood pressure (SBP) 4140 mmHg were randomized to receive temisartan 80 mg/HCTZ 12.5 mg o.d. or lisinopril 20 mg/HCTZ 12.5 mg o.d. for 24 weeks, according to a prospective, open-label, blinded end point, parallelgroup design. At the end of a 2-week wash-out period and after 12 and 24 weeks of active treatment, 24-h noninvasive ambulatory BP monitoring (ABPM) was performed and cognitive function was evaluated through six different tests (verbal fluency, Boston naming test, word-list memory, word-list recall, wordlist recognition and Trails B). Both treatments significantly reduced ambulatory BP. However, the telmisartan/HCTZ combination produced a greater reduction in 24-h, day-time and night time ABPM values. Lisinopril/ HCTZ did not induce significant changes in any of the cognitive function test scores at any time of the study, whereas at both 12 and 24 weeks telmisartan/HCTZ significantly improved the word-list memory score ( þ 17.1 and þ 15.7%, respectively, Po0.05 vs baseline), the word-list recall score ( þ 13.5 and þ 16.9%, Po0.05) and the Trails B score (À33 and À30.5%, Po0.05). These results suggest that in elderly hypertensive patients treatment with telmisartan/HCTZ produces a slightly greater reduction in ambulatory BP than lisinopril/HCTZ combination and, unlike this latter, improves some of the components of cognitive function, particularly episodic memory and visuospatial abilities.

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“…Na mesma direção, um estudo prospectivo, participante do Longitudinal Population Study of 70-year-olds in Goteborg, Sweden, avaliou 382 indivíduos de 70 a 85 anos, verificou a associação dos níveis pressóricos sistólicos e diastólicos com o aparecimento de quadro demencial (Skoog et al, 1996). Diversos estudos clínicos têm demonstrado que indivíduos com HAS apresentam pior performance em testes neuropsicológicos que avaliam funções como memória, atenção, orientação e funções executivas (Guo et al, 1999). 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).…”

Section: Introductionunclassified

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

Alves¹,

Wajngarten²,

Filho³

2005

Rev. psiquiatr. clín.

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ResumoDiversos estudos têm demonstrado associação entre fatores de risco cardiovascular e desenvolvimento de declínio cognitivo. Também há evidências do aumento das taxas de morbimortalidade em pacientes com doenças cardiovasculares e déficit cognitivo. Dentre os fatores de risco cardiovascular, hipertensão arterial e insuficiência cardíaca apresentaram forte associação com a presença de déficit cognitivo, entretanto os mecanismos cerebrais subjacentes não foram totalmente esclarecidos. Nos pacientes cardiopatas, o prejuízo cognitivo se dá principalmente nos aspectos de memória (fixação e aprendizado) e processamento das informações. Nesse artigo, revisa-se os achados de neuroimagem observados em amostras de pacientes com fatores de risco cardiovascular com declínio cognitivo, incluindo achados regionais de anormalidades volumétricas, hiperintensidade de substância branca, acidentes vasculares silenciosos, infartos lacunares e déficits funcionais na perfusão cerebral global (associada à redução do débito cardíaco) e perfusão cerebral regional. Discute-se, também, as implicações destes achados para a fisiopatologia do declínio cognitivo e suas aplicações clínicas. Finalmente, aborda-se o potencial de utilização de novas técnicas de imagem em estudos futuros na avaliação das alterações estruturais e funcionais associadas a fatores de riscos vasculares em amostras de base populacional.

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Occurrence and Progression of Dementia in a Community Population Aged 75 Years and Older

Abstract: The use of diuretics may protect against dementia in elderly persons.

Cited by 202 publications

References 42 publications

Cerebral complications of hypertension

Cerebral complications of hypertension

Effect of telmisartan/hydrochlorothiazide vs lisinopril/hydrochlorothiazide combination on ambulatory blood pressure and cognitive function in elderly hypertensive patients

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

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