The relationship of hypertension in the elderly to AD, vascular dementia, and cognitive function

Hypertension at the age of 45 to 50 years may predispose to AD later in life. It is not known whether hypertension after age 65 years also contributes to AD risk, and its effect on cognitive function is also not fully understood. Data were analyzed from 1,259 Medicare recipients free of dementia in...

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Veröffentlicht in:Neurology 2002-04, Vol.58 (8), p.1175-1181
Hauptverfasser: POSNER, H. B, TANG, M.-X, LUCHSINGER, J, LANTIGUA, R, STERN, Y, MAYEUX, R
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container_issue 8
container_start_page 1175
container_title Neurology
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creator POSNER, H. B
TANG, M.-X
LUCHSINGER, J
LANTIGUA, R
STERN, Y
MAYEUX, R
description Hypertension at the age of 45 to 50 years may predispose to AD later in life. It is not known whether hypertension after age 65 years also contributes to AD risk, and its effect on cognitive function is also not fully understood. Data were analyzed from 1,259 Medicare recipients free of dementia in a longitudinal study covering a 7-year period (1991 to 1998). The effect of hypertension was first examined in relationship to the risk for incident AD and then to incident vascular dementia (VaD) using Cox proportional hazards models. Changes in performance over time on tasks of memory, language, and visuospatial/cognitive function were compared in those with and without hypertension using generalized estimating equations. Of the 1,259 subjects, 731 (58.1%) had a history of hypertension associated with diabetes, stroke, and heart disease. A history of hypertension was not associated with an increased risk for AD (rate ratio [RR] 0.9, 95% CI 0.7 to 1.3) but was associated with an increased risk for VaD (1.8 [1.0 to 3.2]). Hypertension was not associated with changes in memory, language, and general cognitive function in normal individuals over time. Compared with individuals with neither hypertension nor heart disease, those with hypertension or heart disease alone had no increase in risk for VaD. However, when both were present, there was a threefold increase in risk for VaD. A sixfold increase in risk was observed when both hypertension and diabetes were present. Hypertension after age 65 years is not associated with AD and does not adversely affect memory, language, or general cognitive function. A history of hypertension may be an antecedent to VaD, particularly in the presence of heart disease or diabetes.
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Prion diseases</topic><topic>Dementia, Vascular - epidemiology</topic><topic>Dementia, Vascular - pathology</topic><topic>Dementia, Vascular - physiopathology</topic><topic>Diabetes Mellitus - pathology</topic><topic>Ethnic Groups</topic><topic>Female</topic><topic>Genotype</topic><topic>Humans</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - physiopathology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neurology</topic><topic>Neuropsychological Tests</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Stroke - pathology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>POSNER, H. 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The effect of hypertension was first examined in relationship to the risk for incident AD and then to incident vascular dementia (VaD) using Cox proportional hazards models. Changes in performance over time on tasks of memory, language, and visuospatial/cognitive function were compared in those with and without hypertension using generalized estimating equations. Of the 1,259 subjects, 731 (58.1%) had a history of hypertension associated with diabetes, stroke, and heart disease. A history of hypertension was not associated with an increased risk for AD (rate ratio [RR] 0.9, 95% CI 0.7 to 1.3) but was associated with an increased risk for VaD (1.8 [1.0 to 3.2]). Hypertension was not associated with changes in memory, language, and general cognitive function in normal individuals over time. Compared with individuals with neither hypertension nor heart disease, those with hypertension or heart disease alone had no increase in risk for VaD. 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subjects Aged
Alzheimer Disease - epidemiology
Alzheimer Disease - pathology
Alzheimer Disease - physiopathology
Apolipoproteins E - genetics
Biological and medical sciences
Cognition - physiology
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dementia, Vascular - epidemiology
Dementia, Vascular - pathology
Dementia, Vascular - physiopathology
Diabetes Mellitus - pathology
Ethnic Groups
Female
Genotype
Humans
Hypertension - epidemiology
Hypertension - physiopathology
Magnetic Resonance Imaging
Male
Medical sciences
Neurology
Neuropsychological Tests
Proportional Hazards Models
Risk Factors
Stroke - pathology
Vascular diseases and vascular malformations of the nervous system
title The relationship of hypertension in the elderly to AD, vascular dementia, and cognitive function
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