The association between vascular factors and subjective memory impairment in older people: The HUNT Study, Norway

Abstract

Objectives: Subjective memory impairment (SMI) is often considered an early sign of dementia. This study investigates the relationship between SMI and dementia-related vascular factors in older people. Method: This study was based on data from 12,255 individuals, 65 years and older, participating in the Nord-Trøndelag health study, third survey 2006-08 (HUNT3). SMI, vascular diseases, exercise, smoking, and alcohol consumption were self-reported. Blood pressure, cholesterol and body mass index (BMI) were clinically measured. SMI were predicted using linear regression analysis. Results: Stroke and heart disease were associated with SMI. High exercise intensity was associated with less SMI. Respondents with high systolic blood pressure (SBP) reported less SMI than those with moderate SBP. In men, low SBP was associated with significantly more SMI compared to those with moderate SBP. In women, moderate alcohol consumption compared to low alcohol consumption was associated with significantly more SMI. Conclusion: SMI was positively associated with stroke and heart disease in this study. For the other investigated vascular factors, we did not find strong relationships with SMI. However, for preventive and treatment purposes, it is noteworthy that high exercise intensity and high systolic blood pressure was associated with less SMI in both genders.

Gender differences in subjective memory impairment in a general population: the HUNT study, Norway

“…However, including cardiovascular related variables into the linear regression model in the present data set did not change the gender association with the SMI sum score substantially. In a previous paper from the same HUNT population it was demonstrated a clear associations between stroke and heart disease and higher levels of SMI, otherwise strong positive relationships between cardiovascular risk factors and SMI were not found (Langballe et al 2012). As a conclusion, there is no evidence in our data that the different cardiovascular risk can explain the gender differences in SMI.…”

Sub‐clinical orthostatic hypotension is associated with greater subjective memory impairment in older adults

“…In line with our results, Scuteri et al previously reported that hypotensive episodes (defined as at least one reading <100 mmHg) during 24‐h ambulatory monitoring—which could plausibly have resulted from daytime orthostatic fluctuations—were more common in those with SMI (Scuteri et al ., ). The HUNT study, which sampled a population of 12 225 participants, aged 65 and over, found that relative to moderate sitting SBP levels, higher seated SBP was associated with better subjective memory—in line with our results suggesting that lower supine BP drives lower SBP following orthostatic stress (Langballe et al ., ). Lower OBP, even at sub‐clinical levels, may not be effectively compensated by auto‐regulatory processes, and this may result in inadequate hemodynamic responses to cognitive demands (Tzeng and Ainslie, ).…”

“…Although sex differences in cognitive deficits remain poorly understood (Mielke et al ., ), a recent study has suggested that SMI may reflect objective cognition in men but affective state in women (Tomita et al ., ); women reported poorer subjective memory despite having better objective cognition; men, however, were more accurate in self‐appraisal of cognitive abilities. The HUNT study also described sex differences in their findings—in men, but not in women, lower seated systolic BP was related to greater SMI relative to moderate seated systolic BP (Langballe et al ., ). Interestingly, older men have previously been shown to have higher rates of OH‐related hospitalisations and demonstrate poorer cerebral auto‐regulation during standing than women (Deegan et al ., ).…”

Selective impact of disease on short-term and long-term components of self-reported memory: a population-based HUNT study

“…Another problem with assessing SMI is that the relationship between self-reported memory impairment and performance-based measures of memory is far from clear, as both positive 4 5 7–10 and negative associations have been obtained. 11 However, there are many indications that SMI is related to depression 9 12 ; personality traits such as neuroticism 13 14 ; vascular factors such as heart disease and stroke 15 16 ; brain changes such as white matter hyperintensities, 17 brain metabolic dysfunction 18 and structural changes 19–21 ; and psychosocial stress. 16 Research on the relationship between SMI and development of Alzheimer’s disease (AD) and dementia has demonstrated mixed results, both positive 22–24 and negative associations.…”