Influence of cardiovascular risk factors on pre-mild cognitive decline at middle and old age
https://doi.org/10.14412/2074-2711-2021-1-13-17
Abstract
Much attention is currently paid to non-dementia cognitive impairment, such as mild cognitive impairment and pre-mild cognitive decline (PMCD), since their timely detection and optimal correction increase the possibility of preventing dementia.
Objective: to analyze the neuropsychological characteristics of patients with PMCD depending on the presence or absence of cardiovascular risk factors (CVRFs): hypertension, cardiac disorders (ischemic heart disease, intracardiac conduction disturbance), and prior stroke and myocardial infarction, as well as diabetes mellitus.
Patients and methods. Examinations were made in 182 patients (132 women, 50 men; mean age, 59.32±5.41 years) with PMCD and CVFRs, 101 patients (77 women, 24 men; mean age, 59.45±7.04 years) with PMCD without CVRFs, and 77 control persons (55 women, 22 men; mean age, 60.55±5.65 years). All underwent general clinical, neurological, and clinical psychological studies using rating scales and tests.
Results and discussion. The patients with PMCD and CVRFs had lower scores on all neuropsychological tests than the control group and on most tests than the patients with PMCD without CVRFs. In addition to some deterioration in memory indicators, the patients with CVRFs performed worse executive function tests. Cluster analysis showed that in the patients with PMCD, the severity of cognitive decline was considerably affected by hypertension, cardiac disorders, and diabetes mellitus; among them, hypertension was of the most significance.
Conclusion. The association of cognitive decline with the burden of CVRFs indicates their important role in the deterioration of cognitive functions in PMCD.
About the Authors
N. N. Koberskaya
Design Information Technologies Center Russian Academy of Sciences; Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Nadezhda Nikolaevna Koberskaya
7A, Marshal Biryuzov St., Odintsovo, Moscow Region 143003
11, Rossolimo St., Build. 1, Moscow 119021
N. N. Yakhno
Design Information Technologies Center Russian Academy of Sciences; Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
7A, Marshal Biryuzov St., Odintsovo, Moscow Region 143003
11, Rossolimo St., Build. 1, Moscow 119021
Russian Federation
7A, Marshal Biryuzov St., Odintsovo, Moscow Region 143003
11, Rossolimo St., Build. 1, Moscow 119021
V. N. Gridin
Design Information Technologies Center Russian Academy of Sciences
Russian Federation
7A, Marshal Biryuzov St., Odintsovo, Moscow Region 143003
Russian Federation
7A, Marshal Biryuzov St., Odintsovo, Moscow Region 143003
D. S. Smirnov
Design Information Technologies Center Russian Academy of Sciences
Russian Federation
7A, Marshal Biryuzov St., Odintsovo, Moscow Region 143003
Russian Federation
7A, Marshal Biryuzov St., Odintsovo, Moscow Region 143003
References
1. Parfenov VA. Combination and mutual effect of Alzheimer's disease and cerebrovascular disease. Meditsinskiy Sovet = Medical Council. 2019;(9):8-13. doi: 10.21518/2079-701X-20199-8-13 (In Russ.).
2. Levin OS, Trusova NA. Vascular risk factors for Alzheimer's disease. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Spetsvypuski = S.S. Korsakov Journal of Neurology and Psychiatry (Special Issues). 2013;113(7-2):3-12 (In Russ.).
3. Cermakova P, Eriksdotter M, Lund LH, et al. Heart failure and Alzheimer's disease. J Intern Med. 2015 Apr;277(4):406-25. doi: 10.1111/joim.12287. Epub 2014 Aug 1.
4. Broce IJ, Tan CH, Fan CC, et al. Dissecting the genetic relationship between cardiovascular risk factors and Alzheimer's disease. Acta Neuropathol. 2019 Feb;137(2):209-26. doi: 10.1007/s00401-018-1928-6. Epub 2018 Nov 9.
5. Bergmann C, Sano M. Cardiac risk factors and potential treatments in Alzheimer's disease. Neurol Res. 2006 Sep;28(6):595-604. doi: 10.1179/016164106X130498
6. Waldstein SR, Giggey PP, Thayer JF, Zonderman AB. Nonlinear relations of blood pressure to cognitive function: the Baltimore longitudinal study of aging. Hypertension. 2005 Mar;45(3):374-9. doi: 10.1161/01.HYP.0000156744.44218.74. Epub 2005 Feb 7.
7. Paradise MB, Glozier NS, Naismith SL, et al. Subjective memory complaints, vascular risk factors and psychological distress in the middle-aged: a cross-sectional study. BMC Psychiatry. 2011 Jul 1;11:108. doi: 10.1186/1471-244X-11-108
8. Taylor CA, Bouldin ED, Greenlund KJ, McGuire LC. Comorbid Chronic Conditions Among Older Adults with Subjective Cognitive Decline, United States, 2015–2017. Innov Aging. 2020;4(1):igz045. doi: 10.1093/geroni/igz045. Epub2020 Jan 1.
9. Duschek S, Matthias E, Schandry R. Essential hypotension is accompanied by deficits in attention and working memory. Behav Med. Winter 2005;30(4):149-58. doi: 10.3200/BMED.30.4.149-160
10. Qiu C, von Strauss E, Fastbom J, et al. Low blood pressure and risk of dementia in the Kungsholmen project: a 6-year follow-up study. Arch Neurol. 2003 Feb;60(2):223-8. doi: 10.1001/archneur.60.2.223
11. Hebert LE, Scherr PA, Bennett DA, et al. Blood pressure and late-life cognitive function change: a biracial longitudinal population study. Neurology. 2004;62(11):2021-4. doi: 10.1212/01.WNL.0000129258.93137.4B
12. Duschek S, Schandry R. Reduced brain perfusion and cognitive performance due to constitutional hypotension. Clin Autonom Res. 2007 Apr;17(2):69-76. doi: 10.1007/s10286-006-0379-7. Epub 2006 Nov 14.
13. Qiu C, Winblad B, Fratiglioni L. The agedependent relation of blood pressure to cognitive function and dementia. Lancet Neurol. 2005 Aug;4(8):487-99. doi: 10.1016/S1474-4422(05)70141-1
14. Feldstein CA. Association between chronic blood pressure changes and development of Alzheimer's disease. J Alzheimer's Dis. 2012;32(3):753-63. doi: 10.3233/JAD-2012120613
15. Villeneuve S, Belleville S, Massoud F, et al. Impact of vascular risk factors and diseases on cognition in persons with mild cognitive impairment. Dement Geriatr Cogn Disord. 2009;27(4):375-81. doi: 10.1159/000209965. Epub 2009 Mar 26.
16. Solomon A, Kivipelto M, Wolozin B, et al. Midlife serum cholesterol and increased risk of Alzheimer's and vascular dementia three decades later. Dement Geriatr Cogn Disord. 2009;28(1):75-80. doi: 10.1159/000231980. Epub 2009 Aug 4.
17. Luchsinger JA, Reitz C, Honig LS, et al. Aggregation of vascular risk factors and risk of incident Alzheimer disease. Neurology. 2005 Aug 23;65(4):545-51. doi: 10.1212/01.wnl.0000172914.08967.dc
18. Adams ML, Grandpre J, Katz DL, Shenson D. Cognitive Impairment and Cardiovascular Disease: A Comparison of Risk Factors, Disability, Quality of Life, and Access to Health Care. Public Health Rep. 2020 Jan;135(1):132-40. doi: 10.1177/0033354919893030
19. Chen ST, Siddarth P, Ercoli LM, et al. Modifiable risk factors for Alzheimer disease and subjective memory impairment across age groups. PLoS One. 2014 Jun 4;9(6):e98630. doi: 10.1371/journal.pone.0098630. eCollection 2014.
20. Yakhno NN, Koberskaya NN, Zakharov VV, et al. The Influence of Age, Gender, Comorbide Cardiovascular And Emotional Factors On Subjective Cognitive Decline. Nevrologicheskiy zhurnal = Neurological Journal. 2018;23(4):184-89. doi: 10.18821/1560-9545-2018-23-3-184189 (In Russ.).
21. Yakhno NN, Koberskaya NN, Zakharov VV, et al. The influence of age, comorbide cardiovascular and emotional factors on subtle cognitive decline in average, elderly and old age. Nevrologicheskiy zhurnal = Neurological Journal. 2018;23(6):309-15. doi: 10.18821/1560-95452018-23-6-309-315 (In Russ.).
22. Yakhno NN, Zakharov VV, Koberskaya NN, et al. «Pre-moderate» (subjective and light) cognitive disorders. Nevrologicheskiy zhurnal = Neurological Journal. 2017;22(4):198-204 (In Russ.).
23. Yakhno NN, Koberskaya NN, Zakharov VV, et al. Influence of the age factor on pre-mild cognitive impairment. Rossiyskiy nevrologicheskiy zhurnal = Russian Neurological Journal. 2019;24(5):32-7. doi: 10.30629/2658-79472019-24-5-32-37 (In Russ.).
24. Parfenov VA, Ostroumova TM, Perepelova EM, et al. Brain Perfusion, Cognitive Functions, and Vascular Age in Middle Aged Patients With Essential Arterial Hypertension. Kardiologiia. 2018;58(5):23-31 (In Russ.).
25. Borda MG, Santacruz JM, Aarsland D, et al. Association of depressive symptoms and subjective memory complaints with the incidence of cognitive impairment in older adults with high blood pressure. Eur Geriatr Med. 2019 Jun;10(3):413-20. doi: 10.1007/s41999-01900185-1. Epub 2019 Apr 3.
26. Gregg EW, Venkat Narayan KM. Type 2 diabetes and cognitive function: are cognitive impairment and dementia complications of type 2 diabetes? Clin Geriatr. 2000;8:1070-389.
27. Whitmer RA. Type 2 diabetes and risk of cognitive impairment and dementia. Curr Neurol Neurosci Rep. 2007 Sep;7(5):373-80. doi: 10.1007/s11910-007-0058-7
Review
Supporting agencies: The investigation has been supported by the Russian Foundation for Basic Research under Scientific Project No. 19-29-01112мк.
For citations:
Koberskaya N.N., Yakhno N.N., Gridin V.N., Smirnov D.S. Influence of cardiovascular risk factors on pre-mild cognitive decline at middle and old age. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1):13-17. (In Russ.) https://doi.org/10.14412/2074-2711-2021-1-13-17
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