| Popis: |
The principal aim of the present study was to examine the longitudinal change in cognitive test performance in relation to major clinical CVDs and vascular risk factors in a population-based sample of older people. The analysis is based on a cohort of 809 men and 783 women aged 55-74 years which in 1987/8 was randomly selected from the general population of Edinburgh. The findings from the present study further add to those of previous investigations demonstrating a relationship between CVDs, vascular risk factors, and cognitive decline in older people. Specifically, they reveal that, even in the absence of overt stroke, clinical CVDs are associated with a greater cognitive decline in the elderly, independently of potential confounding by a wide range of vascular risk factors. Also, the relationships between several vascular risk factors and cognitive decline proved to be independent of co-existing vascular pathology. Based on these findings, further study is needed to determine the combined effects of CVDs and multiple risk factors on cognitive outcomes in samples of older people. In addition, what the likely pathological mechanisms are underlying cognitive decline associated with atherosclerotic disease and vascular risk factors risk factors needs to be addressed in future studies. From a perspective of preventing or delaying vascular-based cognitive decline and impairment, more research is required to assess the effectiveness of both individual and population-based strategies targeting vascular disease and risk factors in older age groups. Finally, further investigation is needed to address the potential impact of subtle cognitive deficits on indictors of the quality of life and the capability of self-maintenance of elderly vascular patients, on adherence to medical treatment and rehabilitation, and further cognitive decrements and survival. |
