The relationship of hypertension in the elderly to AD, vascular dementia, and cognitive function
| Autor: | Rafael Lantigua, Richard Mayeux, José A. Luchsinger, Yaakov Stern, Ming-Xin Tang, Holly Posner |
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| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.medical_specialty Genotype Heart disease Neuropsychological Tests Vascular dementia Apolipoproteins E Cognition Alzheimer Disease Risk Factors Internal medicine Diabetes mellitus Diabetes Mellitus Ethnicity medicine Humans Dementia Risk factor Stroke Aged Proportional Hazards Models Hypertension in old age Proportional hazards model business.industry Dementia Vascular Alzheimer's disease medicine.disease Magnetic Resonance Imaging Surgery Neurology Hypertension Cardiology Female Neurology (clinical) Cognition--Age factors business |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.58.8.1175 |
| Popis: | Background: Hypertension at the age of 45 to 50 years may predispose to AD later in life. It is not known whether hypertension after age 65 years also contributes to AD risk, and its effect on cognitive function is also not fully understood.Methods: Data were analyzed from 1,259 Medicare recipients free of dementia in a longitudinal study covering a 7-year period (1991 to 1998). The effect of hypertension was first examined in relationship to the risk for incident AD and then to incident vascular dementia (VaD) using Cox proportional hazards models. Changes in performance over time on tasks of memory, language, and visuospatial/cognitive function were compared in those with and without hypertension using generalized estimating equations.Results: Of the 1,259 subjects, 731 (58.1%) had a history of hypertension associated with diabetes, stroke, and heart disease. A history of hypertension was not associated with an increased risk for AD (rate ratio [RR] 0.9, 95% CI 0.7 to 1.3) but was associated with an increased risk for VaD (1.8 [1.0 to 3.2]). Hypertension was not associated with changes in memory, language, and general cognitive function in normal individuals over time. Compared with individuals with neither hypertension nor heart disease, those with hypertension or heart disease alone had no increase in risk for VaD. However, when both were present, there was a threefold increase in risk for VaD. A sixfold increase in risk was observed when both hypertension and diabetes were present.Conclusions: Hypertension after age 65 years is not associated with AD and does not adversely affect memory, language, or general cognitive function. A history of hypertension may be an antecedent to VaD, particularly in the presence of heart disease or diabetes. |
| Databáze: | OpenAIRE |
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