Cardiovascular Disease Risk Factors and Cognition in the Elderly

Although it is relatively widely known that cardiovascular disease (CVD) can result in cognitive decline, it is becoming increasingly clearer that actual risk factors for CVD, such as high blood pressure, diabetes, and obesity, are also associated with alterations to brain structure and cognition. The prevalence of CVD risk factors increases exponentially with age and these risk factors are often overlooked as a source of cognitive changes that are otherwise thought to be part of the “normal” aging process. Associated cognitive changes are observed even at levels of risk that would be considered subclinical by current diagnostic convention, and they are often significant enough to interfere with daily functional abilities. More importantly, if not controlled, CVD risk can lead to further decline, including cerebrovascular disease and dementia. Thus, it is critically important to consider these factors in the elderly, and we recommend more routine cognitive screenings, particularly when CVD risk factors are involved.

[1]  R. Petersen,et al.  Mild cognitive impairment , 2006, The Lancet.

[2]  K. Yaffe,et al.  The metabolic syndrome and development of cognitive impairment among older women. , 2009, Archives of neurology.

[3]  L. Lind,et al.  Cognitive function and risk of stroke in elderly men , 2010, Neurology.

[4]  G. Pearlson,et al.  Cranial volume, mild cognitive deficits, and functional limitations associated with diabetes in a community sample. , 2010, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[5]  Victoria J. Williams,et al.  Variation in blood pressure is associated with white matter microstructure but not cognition in African Americans. , 2010, Neuropsychology.

[6]  J. Williamson,et al.  Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies , 2005, Diabetologia.

[7]  A. Zonderman,et al.  Carotid Intimal Medial Thickness Predicts Cognitive Decline Among Adults Without Clinical Vascular Disease , 2009, Stroke.

[8]  L. Kuller,et al.  Secondhand smoke, vascular disease, and dementia incidence: findings from the cardiovascular health cognition study. , 2010, American journal of epidemiology.

[9]  Cheryl L. Dahle,et al.  Aging, vascular risk, and cognition: blood glucose, pulse pressure, and cognitive performance in healthy adults. , 2009, Psychology and aging.

[10]  W. Milberg,et al.  Detecting cognitive impairment in individuals at risk for cardiovascular disease: the “Clock‐in‐the‐Box” screening test , 2011, International journal of geriatric psychiatry.

[11]  V. Hachinski,et al.  Hypertension, executive dysfunction, and progression to dementia: the canadian study of health and aging. , 2010, Archives of neurology.

[12]  S. Rathore,et al.  The obesity paradox: body mass index and outcomes in patients with heart failure. , 2005, Archives of internal medicine.

[13]  L. Talbot,et al.  Effect of Blood Pressure and Diabetes Mellitus on Cognitive and Physical Functions in Older Adults: A Longitudinal Analysis of the Advanced Cognitive Training for Independent and Vital Elderly Cohort , 2005, Journal of The American Geriatrics Society.

[14]  L. Flicker Cardiovascular risk factors, cerebrovascular disease burden, and healthy brain aging. , 2010, Clinics in geriatric medicine.

[15]  A. Folsom,et al.  Cardiovascular risk factors and cognitive decline in middle-aged adults , 2001, Neurology.

[16]  Lee Ryan,et al.  Structural brain differences and cognitive functioning related to body mass index in older females , 2009, Human brain mapping.

[17]  Bruce Fischl,et al.  Thickness of the human cerebral cortex is associated with metrics of cerebrovascular health in a normative sample of community dwelling older adults , 2011, NeuroImage.

[18]  A. Alexandrov,et al.  Association of higher diastolic blood pressure levels with cognitive impairment , 2009, Neurology.

[19]  Arto Mannermaa,et al.  Apolipoprotein E 4 Allele, Elevated Midlife Total Cholesterol Level, and High Midlife Systolic Blood Pressure Are Independent Risk Factors for Late-Life Alzheimer Disease , 2002, Annals of Internal Medicine.

[20]  Kathleen Insel,et al.  Executive function, working memory, and medication adherence among older adults. , 2006, The journals of gerontology. Series B, Psychological sciences and social sciences.

[21]  M. Folstein,et al.  The Mini-Mental State Examination. , 1983, Archives of general psychiatry.

[22]  Naftali Raz,et al.  Pattern of normal age-related regional differences in white matter microstructure is modified by vascular risk , 2009, Brain Research.

[23]  A. Reiss,et al.  Insulin resistance and hippocampal volume in women at risk for Alzheimer's disease , 2011, Neurobiology of Aging.

[24]  Lewis H Kuller,et al.  Midlife and late-life obesity and the risk of dementia: cardiovascular health study. , 2009, Archives of neurology.

[25]  B. Frier,et al.  The relationship between type 2 diabetes and cognitive dysfunction: longitudinal studies and their methodological limitations. , 2004, European journal of pharmacology.

[26]  J. Jolles,et al.  Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age. , 2002, American journal of epidemiology.

[27]  H. Chui,et al.  The Modified Mini-Mental State (3MS) examination. , 1987, The Journal of clinical psychiatry.

[28]  D. Madden,et al.  Effects of Adult Age and Blood Pressure on Executive Function and Speed of Processing , 2010, Experimental aging research.

[29]  D. Royall,et al.  Correlates of disability among elderly retirees with "subclinical" cognitive impairment. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[30]  N. Raz,et al.  Differential Aging of the Brain: Patterns, Cognitive Correlates and Modifiers , 2022 .

[31]  A. Newman,et al.  Hypertension, White Matter Hyperintensities, and Concurrent Impairments in Mobility, Cognition, and Mood: The Cardiovascular Health Study , 2011, Circulation.

[32]  P. Wolf,et al.  Interactive effects of apolipoprotein E type 4 genotype and cerebrovascular risk on neuropsychological performance and structural brain changes. , 2010, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[33]  Griselda J. Garrido,et al.  Smoking is associated with reduced cortical regional gray matter density in brain regions associated with incipient Alzheimer disease. , 2008, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.