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Senior News on Alzheimer's, Dementia
Dementia Not Prevented in Older People by Lowering
Blood Pressure
Vascular dementias
was often linked to high blood pressure
By Lise Millay Stevens, Contributing Writer
Health Behavior News Service
May 25, 2006 - Lowering blood pressure does not appear to prevent
cognitive or dementia-related disorders, a desired effect in light of
the large number of elderly adults who suffer from both cognitive
impairment and hypertension.
(Editor's Note: See sidebar stories
on earlier studies suggesting lowering blood pressure does offer
dementia protection.)
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Related Stories |
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Dementia Risk Lowered in Elderly by Sustained Blood Pressure
Treatment
Study finds
protection against Alzheimer’s and vascular dementia
April 30, 2006 – Hypertension treatment for senior
citizens age 80 and older has proven successful in providing
protection from cardiovascular problems. but a new study says sustained
treatment may also
reduce the risk of dementia in old age.
Read more...
Blood Pressure Lowering Drugs Linked To Reduced Risk
of Alzheimer's
Diuretics most effective in lowering incidence of
Alzheimer's in senior citizens
March 17, 2006 - Taking medications to lower blood
pressure, particularly those known as diuretics, may be associated with
a lower incidence of Alzheimer's disease, according to a study of senior
citizens. Beta blockers and anti-hypertensives also were linked to a
slightly protective effect against AD, but ACE inhibitors did not.
Read more...
Blood Flow in Brain Takes a Twist, Affecting Views
of Alzheimer's
Are astrocytes gone wild starving neurons from oxygen
Jan. 6, 2006 - New findings that long-overlooked
brain cells play an important role in regulating blood flow in the brain
call into question one of the basic assumptions underlying today's most
sophisticated brain imaging techniques and could open a new frontier
when it comes to understanding Alzheimer's disease.
Read more...
Low Blood Flow to Brain May Be A Cause of Dementia
“Diminished cerebral blood flow indeed causes brain
damage.”
Aug. 30, 2005 - The amount of blood flowing into
the brain may play a larger role in the development of dementia than
previously believed, which emphasizes the importance of monitoring both
high and low blood pressure in senior citizens, according to a study in
the September issue of the journal Radiology.
Read more...
Read more
on
Alzheimer's & Dementia |
|
Authors of a new systematic review analyzed three
studies comprising 12,091 patients with hypertension who were treated
with either medication or lifestyle strategies for at least six months
while undergoing testing to assess their cognitive function. All were
followed for five years.
“There is no convincing evidence that lowering
blood pressure prevents the development of dementia or cognitive
impairment in hypertensive patients without apparent prior
cerebrovascular disease,” write co-authors including A. Peter Passmore,
M.D., of the department of Public Health Medicine and Primary Care at
Queen’s University in Belfast, Ireland.
One blood-pressure medication, Nitrendipine, did
appear to reduce dementia in one of the studies reviewed, but when
combined with all data, this effect was not significant.
The review appears in the current issue of The
Cochrane Library, a publication of The Cochrane Collaboration, an
international organization that evaluates medical research. Systematic
reviews draw evidence-based conclusions about medical practice after
considering both the content and quality of existing medical trials on a
topic.
Patients included in the study were between 60 and
89 years old with a minimum blood pressure of 160/90 and no previous
cerebrovascular disease. Interventions to lower blood pressure included
a variety of medications and/or lifestyle changes such as cutting salt
and alcohol intake, quitting smoking and losing weight.
Vascular dementias have been linked to
cardiovascular disorders, especially high blood pressure, and are often
preceded by a series of small strokes. People can also suffer from a
combination of vascular and Alzheimer’s dementia. Hardening and
narrowing of the blood vessels leading to the brain can result in
gradual death of brain cells and impairments in memory, reasoning,
planning and behavior.
Despite the review results, “lowering blood
pressure may have beneficial effects on both atherosclerotic and
blood-related mechanisms in the brain.” Passmore said. “It is not clear
whether it is the absolute lowering of blood pressure or the individual
medications used that may affect cognition,” he added.
David S. Knopman, M.D., a neurological-vascular
specialist at the Mayo Clinic, says of the review, “The overall negative
result of the Cochrane review can be accounted for by a number of
possibilities. The studies may not have been long enough; the effects of
treating hypertension probably require decades to accrue benefit. The
subjects were too old and the effects of hypertension may have been
sufficiently established, and damage initiated, in midlife, so that late
life treatment was ‘too little, too late.”
He added, “Perhaps longer studies would be better,
but when you deal with the elderly, there is excessive attrition from
studies, which degrades the studies and makes interpretation more
difficult. The problem is that the people who drop out are the sicker
people, who might have been more likely to benefit from treatment.”
“It is difficult to say if longer follow-up would
have yielded different results,” Passmore said. “The evidence from some
studies suggests midlife hypertension but not late life hypertension is
related to cognitive decline. It would be useful to follow younger
patients for longer.”
According to the National Alliance for Caregiving,
the number of elderly Americans is set to double by 2050, and the number
with dementia caused by Alzheimer’s disease is expected to triple from
current estimates of 4 million to 12 million by then.
The Cochrane Collaboration is an international
nonprofit, independent organization that produces and disseminates
systematic reviews of health care interventions and promotes the search
for evidence in the form of clinical trials and other studies of
interventions. Visit
http://www.cochrane.org for more information.
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