Hypertension in Elderly Appears to Cause Mild
Cognitive Impairment that Leads to Alzheimer's
How high blood pressure increases the risk of
cognitive impairment or dementia in senior citizens is not unclear
Dec.
10, 2007 – Researchers just cannot seem to find enough bad to say about
high blood pressure. A new study being released tomorrow finds that
hypertension in senior citizens – people age 65 and older - can lead to
mild cognitive impairment, a condition that involves difficulties with
thinking and learning.
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“Mild cognitive impairment has attracted increasing
interest during the past years, particularly as a means of identifying
the early stages of Alzheimer’s disease as a target for treatment and
prevention,” the authors write as background information in the article.
The report is in the December issue of Archives of Neurology, one of the
JAMA/Archives journals.
About 10 out of every 1,000 elderly American
without dementia will develop mild cognitive impairment each year, the
article reports. And, about 10 to 12 percent of these will progress to
Alzheimer's disease. Of the elderly without mild cognitive impairment,
only about 1 to 2 percent will develop Alzheimer's.
Christiane Reitz, M.D., Ph.D., and colleagues at
the Columbia University Medical Center, New York, followed 918 Medicare
recipients age 65 and older (average age 76.3) without mild cognitive
impairment beginning in 1992 through 1994.
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Senior Citizen Health & Medicine |
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High Blood Pressure Afflicts 75 Percent with
Diseases Leading to Cardiovascular Problems
Diabetes, stroke, coronary heart disease patients
make little progress against hypertension
 Dec. 10, 2007 - Nearly three-fourths of American
adults with conditions such as coronary heart disease, stroke, diabetes
or others that raise their risk for cardiovascular complications also
have hypertension (high blood pressure). And, although about 75 percent
of these patients are being treated for hypertension, only about 30 to
50 percent are reaching blood pressure goals.
Read more...
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All participants underwent an initial interview and
physical examination, along with tests of cognitive function, and then
were examined again approximately every 18 months for an average of 4.7
years.
Individuals with mild cognitive impairment had low
cognitive scores and a memory complaint, but could still perform daily
activities and did not receive a dementia diagnosis.
Over the follow-up period, 334 individuals
developed mild cognitive impairment.
This included 160 cases of amnestic (associated
with amnesia) mild cognitive impairment, which involves low scores on
memory portions of the neuropsychological tests, and 174 cases of non-amnestic
mild cognitive impairment.
Hypertension (high blood pressure) was associated
with an increased risk of all types of mild cognitive impairment that
was mostly driven by an increased risk of non-amnestic mild cognitive
impairment.
Hypertension was not, however, associated with
amnestic mild cognitive impairment, nor with the change over time in
memory and language abilities.
“The mechanisms by which blood pressure affects the
risk of cognitive impairment or dementia remain unclear,” the authors
write.
“Hypertension may cause cognitive impairment
through cerebrovascular disease. Hypertension is a risk factor for
subcortical white matter lesions found commonly in Alzheimer’s disease.
"Hypertension may also contribute to a blood-brain
barrier dysfunction, which has been suggested to be involved in the
cause of Alzheimer’s disease."
Other possible explanations for the association are
shared risk factors, including the formation of cell-damaging compounds
known as free radicals.
“Our findings support the hypothesis that
hypertension increases the risk of incident mild cognitive impairment,
especially non-amnestic mild cognitive impairment,” the authors
conclude.
“Preventing and treating hypertension may have an
important impact in lowering the risk of cognitive impairment.”
Editor's Note: This study was supported by
grants from the National Institutes of Health; the Charles S. Robertson
Memorial Gift for Research in Alzheimer’s Disease; and the Blanchette
Hooker Rockefeller Foundation.
