Vascular risk factors, cognitve decline, and dementia

Abstract

Dementia is one of the most important neurological disorders in the elderly. Aging is associated with a large increase in the prevalence and incidence of degenerative (Alzheimer's disease) and vascular dementia, leading to a devastating loss of autonomy. In view of the increasing longevity of populations worldwide, prevention of dementia has turned into a major public health challenge. In the past decade, several vascular risk factors have been found to be associated with vascular dementia but also Alzheimer's disease. Some longitudinal studies, have found signifi cant associations between hypertension, diabetus mellitus, and metabolic syndrome, assessed at middle age, and dementia. Studies assessing the link between hypercholesterolemia, atrial fi brillation, smoking, and dementia have given more confl icting results. Furthermore, some studies have highlighted the possible protective effect of antihypertensive therapy on cognition and some trials are evaluating the effects of statins and treatments for insulin resistance. Vascular risk factors and their treatments are a promising avenue of research for prevention of dementia, and further long-term, placebo-controlled, randomized studies, need to be performed.

Physical Functioning Is Associated With Processing Speed and Executive Functions in Community-Dwelling Older Adults

“…Previous studies have demonstrated a relationship between CVR factors and cognitive functioning (Duron & Hanon, 2008;Knopman et al, 2001). The lack of such association in this study can be explained by methodological and conceptual factors.…”

“…By choosing a nonweighted method for the computation of cardiovascular factors, we may have overlooked some important distinctions in the relative influence of each medical condition on cognitive performance. Some conditions, such as diabetes and hypertension, appear to be stronger independent predictors of cognition (Duron & Hanon, 2008;Kuo et al, 2005) than others, such as elevated waist circumference (Chu et al, 2009;Dore, Elias, Robbins, Budge, & Elias, 2008), which was very prevalent in our sample. Yet, they all contributed equally to the total score.…”

“…A large body of research has shown that CVR factors are associated with cognitive decline and a higher risk of vascular dementia, but also Alzheimer's disease (Whitmer, Sidney, Selby, Johnston, & Yaffe, 2005). Hypertension (Papademetriou, 2005;Tzourio, Dufouil, Ducimetiere, & Alperovitch, 1999), diabetes mellitus (Kuo et al, 2005;McCrimmon, Ryan, & Frier, 2012), coronary heart diseases (Singh-Manoux et al, 2008), and obesity (Whitmer, gunderson, Barrett-Connor, Quesenberry, & Yaffe, 2005), among others, have been recognized as leading risk factors for dementia and cognitive impairment without dementia, independently of the risk of stroke or major cardiac event (see Duron & Hanon, 2008, for a review). Some studies have shown that the accumulation of factors has a better predictive value of cognitive performance than each factor taken alone (Carmelli et al, 1998;Song, Mitnitski, & Rockwood, 2005;Villeneuve, Belleville, Massoud, Bocti, & gauthier, 2009).…”

Cognitive Exercise and Its Role in Cognitive Function in Older Adults

“…CT is therefore best viewed as only part of a wider strategy of maximal risk reduction and maintenance of optimal brain health. CT complements and should be combined with other risk reduction strategies, including participation in cognitive, social, and physical leisure activities [45,46], as well as careful control of vascular risk factors [47].…”

Hypertension: Protective Effects of Physical Exercise on Cognition Function, Arterial Function and Brain Health

“…Furthermore, SAH is associated with subtle neurocognitive deficits [22,23] which may be potentiated by one's lifestyle, like obesity [24], smoking [25], sedentary behavior [26], stress [27] and may further increase the risk of dementia [28]. Taken together, this background is associated with an increased chance SAH individuals have for developing vascular dementia, especially those who have been exposed to this condition for years [29].…”