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| |  Hypertension May Predict Dementia in Older Adults With Certain Cognitive Deficits CHICAGO -- High blood pressure appears to predict the progression to dementia in older adults with impaired executive functions but not in those with memory dysfunction, according to a study published in the February issue of Archives of Neurology. “Although midlife hypertension has been confirmed as a risk factor for the development of dementia in late life, there have been conflicting findings about the role of late-life hypertension,” the authors wrote as background information in the article. Individuals with mild cognitive impairment may experience deficits in different domains. For instance, some have impairments only in memory function and are more likely to develop Alzheimer’s disease, whereas those whose impairment follows a stroke or other vascular event often experience executive dysfunction. “Because hypertension is a major risk factor for vascular brain diseases and vascular cognitive impairment, we postulated that the cognitive domain of dysfunction may be the crucial factor that determines the association between hypertension and cognitive deterioration,” the authors wrote. To test this hypothesis, Shahram Oveisgharan, MD, University of Western Ontario, London, Ontario, and colleagues studied 990 older adults (mean age, 83 years) with cognitive impairment but no dementia. Over a 5-year follow-up period, dementia developed at approximately the same rate among participants with and without hypertension (59.5% of individuals with hypertension vs 64.2% of those without). A similar pattern was observed among those with memory dysfunction alone and with both memory and executive dysfunction. However, among patients with executive dysfunction only, presence of hypertension was associated with an increased risk of developing dementia (57.7% of those with hypertension progressed to dementia vs 28% of those without). “This study may have profound implications for community dwellers with cognitive impairment, no dementia,” the authors wrote. “Worldwide, neurologic disorders are the most frequent cause of disability-adjusted life years; among these, cerebrovascular disease is the most common risk factor, and dementia is the second most common. There is no preventive or therapeutic intervention to mitigate this public health burden.” “We show herein that the presence of hypertension predicts progression to dementia in a subgroup of about one-third of subjects with cognitive impairment, no dementia,” they concluded. “Control of hypertension in this population could decrease by one-half the projected 50-percent five-year rate of progression to dementia.”
SOURCE: Archives of Neurology
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