Preventing Dementia in Older Cardiovascular Patients

Current Cardiovascular Risk Reports

Volumn 8, Issue 10, 2014, Pages

  Kuller, Lewis H ^a   Lopez, Oscar L ^b  

^a UNIVERSITY OF PITTSBURGH GRADUATE SCHOOL OF PUBLIC HEALTH   (United States)

^b UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

Author keywords

Aging; Alzheimer s disease; Blood pressure; Brain infarcts; Carotid artery disease; Congestive heart failure; Coronary artery calcium; Dementia; Diabetes; Frailty; Microvascular disease; Myocardial infarction; Physical activity; Statins; Stroke; Vascular stiffness

Indexed keywords

LIPID;

AGED; ALZHEIMER DISEASE; ANTIHYPERTENSIVE THERAPY; ATHEROSCLEROSIS; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CEREBROVASCULAR DISEASE; CLINICAL TRIAL (TOPIC); COGNITIVE DEFECT; COGNITIVE RESERVE; CONGESTIVE HEART FAILURE; CORONARY ARTERY ATHEROSCLEROSIS; DEMENTIA; DIABETES MELLITUS; HEART ATRIUM FIBRILLATION; HEART FAILURE; HEART INFARCTION; HUMAN; HYPOGLYCEMIA; ISCHEMIC HEART DISEASE; KIDNEY DISEASE; META ANALYSIS (TOPIC); NERVE DEGENERATION; NEUROPSYCHOLOGY; NON INSULIN DEPENDENT DIABETES MELLITUS; OUTCOME ASSESSMENT; PHYSICAL ACTIVITY; REVIEW; SMOKING CESSATION; SYSTOLIC HYPERTENSION; VASCULAR DISEASE;

EID: 84908528627     PISSN: 19329520     EISSN: 19329563     Source Type: Journal    
DOI: 10.1007/s12170-014-0401-x     Document Type: Review

References (96)

1. Kuller LH, Lopez OL. Dementia and Alzheimer's disease: a new direction. The 2010 Jay L. Foster Memorial Lecture. Alzheimers Dement. 2011;7:540–50.
2. Jack Jr CR, Knopman DS, Weigand SD, et al. An operational approach to National Institute on Aging-Alzheimer's Association criteria for preclinical Alzheimer disease. Ann Neurol. 2012;71:765–75. The National Institute on Aging and the Alzheimer's Association have created new criteria for classification of asymptomatic preclinical AD. Individuals can now be classified as stage 0-stage 3; a new criterion of neurodegeneration without amyloid deposition was also added. Individuals at a higher stage are at substantially greater short-term risk of dementia.
3. Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:2672–713.
4. Kalaria RN. Cerebrovascular disease and mechanisms of cognitive impairment: evidence from clinicopathological studies in humans. Stroke. 2012;43:2526–34.
5. Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol. 2013;12:483–97.
6. Raji CA, Lopez OL, Kuller LH, et al. White matter lesions and brain gray matter volume in cognitively normal elders. Neurobiol Aging. 2012;33(834):e7–16.
7. Yang FM, Grigorenko A, Tommet D, et al. AD pathology and cerebral infarctions are associated with memory and executive functioning one and five years before death. J Clin Exp Neuropsychol. 2013;35:24–34.
8. Tzourio C, Laurent S, Debette S. Is hypertension associated with an accelerated aging of the brain? Hypertension. 2014;63:894–903. This paper is an excellent up-to-date review of the relationship of hypertension to brain vascular disease and risk of dementia. The authors do not support MRI screening to identify brain vascular disease among older “normal” individuals. However, if brain vascular disease is identified on an MRI then such individuals should be considered to be at very high risk of both stroke and dementia.
9. Bos D, van der Rijk MJ, Geeraedts TE, et al. Intracranial carotid artery atherosclerosis: prevalence and risk factors in the general population. Stroke. 2012;43:1878–84.
10. Roher AE, Tyas SL, Maarouf CL, et al. Intracranial atherosclerosis as a contributing factor to Alzheimer's disease dementia. Alzheimers Dement. 2011;7:436–44.
11. Kovacic JC, Fuster V. Atherosclerotic risk factors, vascular cognitive impairment, and Alzheimer disease. Mt Sinai J Med. 2012;79:664–73.
12. Vidal JS, Sigurdsson S, Jonsdottir MK, et al. Coronary artery calcium, brain function and structure: the AGES-Reykjavik Study. Stroke. 2010;41:891–7.
13. Pendlebury ST, Rothwell PM. Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis. Lancet Neurol. 2009;8:1006–18.
14. Rist PM, Chalmers J, Arima H, et al. Baseline cognitive function, recurrent stroke, and risk of dementia in patients with stroke. Stroke. 2013;44:1790–5.
15. Hughes TM, Kuller LH, Barinas-Mitchell EJ, et al. Pulse wave velocity is associated with beta-amyloid deposition in the brains of very elderly adults. Neurology. 2013;81:1711–8. In the follow-up of the Gingko Evaluation of Memory Study, 75 % of the nondemented participants mean age 83 had a positive scan for β-amyloid. Pulse wave velocity predicted both the baseline amyloid positivity and the increased in amyloid over 2 years.
16. Hughes TM, Kuller LH, Barinas-Mitchell EJ, et al. Arterial stiffness and beta-amyloid progression in nondemented elderly adults. JAMA Neurol. 2014. doi:10.1001/jamaneurol.2014.186.
17. Virta JJ, Heikkila K, Perola M, et al. Midlife cardiovascular risk factors and late cognitive impairment. Eur J Epidemiol. 2013;28:405–16.
18. Ninomiya T. Diabetes mellitus and dementia. Curr Diabetes Rep. 2014;14:487.
19. Jayaraman A, Pike CJ. Alzheimer's disease and type 2 diabetes: multiple mechanisms contribute to interactions. Curr Diabetes Rep. 2014;14:476.
20. Chang CC, Zhao Y, Lee CW, et al. Smoking, death, and Alzheimer disease: a case of competing risks. Alzheimer Dis Assoc Disord. 2012;26:300–6.
21. Beason-Held LL, Moghekar A, Zonderman AB, et al. Longitudinal changes in cerebral blood flow in the older hypertensive brain. Stroke. 2007;38:1766–73.
22. Lopez OL, Becker JT, Kuller LH. Patterns of compensation and vulnerability in normal subjects at risk of Alzheimer's disease. J Alzheimers Dis. 2013;33 Suppl 1:S427–38.
23. Wilson AC, Shao Y-H, Pantazopolous JS, The MIDAS Study Group, et al. Changing age distribution of first ever acute myocardial infarction among men and women in New Jersey hospitals. Circulation. 2007;116(16 Suppl II):2–832.
24. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129:e28–292.
25. Fleg JL, Forman DE, Berra K, et al. Secondary prevention of atherosclerotic cardiovascular disease in older adults: a scientific statement from the American Heart Association. Circulation. 2013;128:2422–46.
26. Haring B, Leng X, Robinson J, et al. Cardiovascular disease and cognitive decline in postmenopausal women: results from the Women's Health Initiative Memory Study. J Am Heart Assoc. 2013;2:e000369.
27. Newman AB, Fitzpatrick AL, Lopez O, et al. Dementia and Alzheimer's disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort. J Am Geriatr Soc. 2005;53:1101–7.
28. Russ TC, Hamer M, Stamatakis E, et al. Does the Framingham cardiovascular disease risk score also have predictive utility for dementia death? An individual participant meta-analysis of 11,887 men and women. Atherosclerosis. 2013;228:256–8.
29. Roberts RO, Knopman DS, Geda YE, et al. Coronary heart disease is associated with non-amnestic mild cognitive impairment. Neurobiol Aging. 2010;31:1894–902.
30. Kuller LH, Lopez O, Mackey, et al. Coronary artery calcium and risk of death, dementia and disability in older 80+ year old individuals. Circulation. 2012;126(21 Suppl), A16511.
31. van Oijen M, de Jong FJ, Witteman JC, et al. Atherosclerosis. and risk for dementia. Ann Neurol. 2007;61:403–10.
32. Reis JP, Launer LJ, Terry JG, et al. Subclinical atherosclerotic calcification and cognitive functioning in middle-aged adults: the CARDIA study. Atherosclerosis. 2013;231:72–7.
33. Rosano C, Naydeck B, Kuller LH, et al. Coronary artery calcium: associations with brain magnetic resonance imaging abnormalities and cognitive status. J Am Geriatr Soc. 2005;53:609–15.
34. Bos D, Vernooij MW, Elias-Smale SE, et al. Atherosclerotic calcification relates to cognitive function and to brain changes on magnetic resonance imaging. Alzheimers Dement. 2012;8(5 Suppl):S104–11.
35. Schneider AL, Rawlings AM, Sharrett AR, et al. High-sensitivity cardiac troponin T and cognitive function and dementia risk: the atherosclerosis risk in communities study. Eur Heart J. 2014. doi:10.1093/eurheartj/ehu124. New technologies to measure high-sensitivity cardiac troponin T (hs-cTnT) have demonstrated that a large number of older individuals have evidence of silent myocardial necrosis. Elevated hs-cTnT is a powerful predictor of clinical CHD, CHF, and sudden death among older individuals. In the ARIC study, higher hs-cTnT levels were directly related to the risk of hospitalization for dementia.
36. Stefansdottir H, Arnar DO, Aspelund T, et al. Atrial fibrillation is associated with reduced brain volume and cognitive function independent of cerebral infarcts. Stroke. 2013;44:1020–5. Patients with AF have an increased risk of dementia. In a cross-sectional study of 4251 nondemented patients mean age 76, AF (n = 330) was associated with lower brain volumes and such individuals scored lower on tests of memory. Prevention and better treatment of AF may reduce the burden of dementia among older individuals.
37. Kalantarian S, Stern TA, Mansour M, et al. Cognitive impairment associated with atrial fibrillation: a meta-analysis. Ann Intern Med. 2013;158(5 Pt 1):338–46.
38. Santangeli P, Di Biase L, Bai R, et al. Atrial fibrillation and the risk of incident dementia: a meta-analysis. Heart Rhythm. 2012;9:1761–8.
39. Gaita F, Corsinovi L, Anselmino M, et al. Prevalence of silent cerebral ischemia in paroxysmal and persistent atrial fibrillation and correlation with cognitive function. J Am Coll Cardiol. 2013;62:1990–7. The prevalence of silent cerebral ischemia was higher in AF patients, both persistent and paroxysmal AF. Cognitive performance was also worse among patients with AF.
40. Bunch TJ, Crandall BG, Weiss JP, et al. Patients treated with catheter ablation for atrial fibrillation have long-term rates of death, stroke, and dementia similar to patients without atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22:839–45.
41. Higgins P, MacFarlane PW, Dawson J, et al. Noninvasive cardiac event monitoring to detect atrial fibrillation after ischemic stroke: a randomized, controlled trial. Stroke. 2013;44:2525–31.
42. Ambrosy AP, Fonarow GC, Butler J, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol. 2014;63:1123–33.
43. Vogels RL, Scheltens P, Schroeder-Tanka JM, et al. Cognitive impairment in heart failure: a systematic review of the literature. Eur J Heart Fail. 2007;9:440–9.
44. Vogels RL, van der Flier WM, van Harten B, et al. Brain magnetic resonance imaging abnormalities in patients with heart failure. Eur J Heart Fail. 2007;9:1003–9.
45. Jefferson AL. Cardiac output as a potential risk factor for abnormal brain aging. J Alzheimers Dis. 2010;20:813–21.
46. Kitzman DW, Upadhya B. Heart failure with preserved ejection fraction: a heterogeneous disorder with multifactorial pathophysiology. J Am Coll Cardiol. 2014;63:457–9.
47. Steinberg BA, Zhao X, Heidenreich PA, et al. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation. 2012;126:65–75.
48. Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and the National High Blood Pressure Education Program Coordinating Committee. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med. 1997;157:2413–46.
49. Kostis JB, Davis BR, Cutler J, et al. Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group. JAMA. 1997;278:212–6.
50. Afilalo J, Alexander KP, Mack MJ, et al. Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol. 2014;63:747–62.
51. Studenski S, Perera S, Patel K, et al. Gait speed and survival in older adults. JAMA. 2011;305:50–8.
52. Murad K, Kitzman DW. Frailty and multiple comorbidities in the elderly patient with heart failure: implications for management. Heart Fail Rev. 2012;17:581–8.
53. Buchman AS, Schneider JA, Leurgans S, et al. Physical frailty in older persons is associated with Alzheimer disease pathology. Neurology. 2008;71:499–504.
54. Buchman AS, Boyle PA, Wilson RS, et al. Frailty is associated with incident Alzheimer's disease and cognitive decline in the elderly. Psychosom Med. 2007;69:483–9.
55. Strandberg TE, Pitkala KH, Tilvis RS, et al. Geriatric syndromes–vascular disorders? Ann Med. 2013;45:265–73. Geriatric syndromes are characterized as clinical conditions, which do not normally have specific diagnostic criteria. Such syndromes include frailty, dementia, delirium, incontinence, falls, and dizziness. Geriatric syndromes are common in about 50 % of individuals over the age of 65. The authors believe that vascular disease is the underlying basis, at least in part, for these geriatric syndromes and that vascular disease accounts for the correlation within the same person of these syndromes, ie, many individuals have multiple syndromes. Prevention of vascular disease may reduce the prevalence of these geriatric syndromes, including dementia.
56. Colcombe S, Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003;14:125–30.
57. Erickson KI, Prakash RS, Voss MW, et al. Aerobic fitness is associated with hippocampal volume in elderly humans. Hippocampus. 2009;19:1030–9.
58. Schou L, Ostergaard B, Rasmussen LS, et al. Cognitive dysfunction in patients with chronic obstructive pulmonary disease—a systematic review. Respir Med. 2012;106:1071–81.
59. Singh B, Mielke MM, Parsaik AK, et al. A prospective study of chronic obstructive pulmonary disease and the risk for mild cognitive impairment. JAMA Neurol. 2014. doi:10.1001/jamaneurol.2014.94.
60. Tierney MC, Naglie G, Upshur R, et al. Factors associated with primary care physicians’ recognition of cognitive impairment in their older patients. Alzheimer Dis Assoc Disord. 2014; [Epub ahead of print].
61. Fowler NR, Barnato AE, Degenholtz HB, et al. Effect of dementia on the use of drugs for secondary prevention of ischemic heart disease. J Aging Res. 2014;2014:897671.
62. Tehrani DM, Darki L, Erande A, et al. In-hospital mortality and coronary procedure use for individuals with dementia with acute myocardial infarction in the United States. J Am Geriatr Soc. 2013;61:1932–6. Using data from the Nationwide Inpatient Sample, the authors found that dementia diagnosis in the clinical record was associated with a higher age-adjusted case fatality following MI. The case fatality was diminished among those who received invasive cardiovascular procedures during their hospitalization. Unfortunately, there is no further information on the criteria for the definition of dementia nor other comorbidities that may have attributed to the higher case fatality.
63. Yoon CW, Shin JS, Kim HJ, et al. Cognitive deficits of pure subcortical vascular dementia vs Alzheimer disease: PiB-PET-based study. Neurology. 2013;80:569–73.
64. Roberts RO, Geda YE, Knopman DS, et al. Cardiac disease associated with increased risk of nonamnestic cognitive impairment: stronger effect on women. JAMA Neurol. 2013;70:374–82. A follow-up study of the Mayo Clinic cohort showed that history of CVD was associated with an increased risk of nonamnestic but not amnestic MCI. These results would be consistent with the probably greater effect of vascular disease on frontal lobe function, such as executive function and speed of processing of information.
65. Gelber RP, Ross GW, Petrovitch H, et al. Antihypertensive medication use and risk of cognitive impairment: the Honolulu-Asia Aging Study. Neurology. 2013;81:888–95.
66. Haag MD, Hofman A, Koudstaal PJ, et al. Duration of antihypertensive drug use and risk of dementia: a prospective cohort study. Neurology. 2009;72:1727–34.
67. Yasar S, Xia J, Yao W, et al. Antihypertensive drugs decrease risk of Alzheimer disease: Ginkgo Evaluation of Memory Study. Neurology. 2013;81:896–903.
68. Li NC, Lee A, Whitmer RA, et al. Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis. BMJ. 2010;340:b5465.
69. Tryambake D, He J, Firbank MJ, et al. Intensive blood pressure lowering increases cerebral blood flow in older subjects with hypertension. Hypertension. 2013;61:1309–15.
70. Seshadri S. Delaying dementia: can antihypertensives prevent Alzheimer dementia? Neurology. 2013;81:860–2.
71. Mackey RH, Kuller LH. Blood pressure and cognitive outcomes. Curr Cardiovasc Risk Rep. 2010;4:369–75.
72. Gorelick PB, Nyenhuis D, On behalf of the American Society of Hypertension Writing Group. Blood pressure and treatment of persons with hypertension as it relates to cognitive outcomes including executive function. J Am Soc Hypertens. 2012;6:309–15.
73. NHLBI. Press Release: NIH launches multicenter clinical trial to test blood pressure strategy. 2009. Accessed May 12, 2014. Available at: http://www.nih.gov/news/health/oct2009/nhlbi-29.htm.
74. Kavousi M, Leening MJ, Nanchen D, et al. Comparison of application of the ACC/AHA guidelines, Adult Treatment Panel III guidelines, and European Society of Cardiology guidelines for cardiovascular disease prevention in a European cohort. JAMA. 2014;311:1416–23.
75. Navar-Boggan AM, Pencina MJ, Williams K, et al. Proportion of US adults potentially affected by the 2014 hypertension guideline. JAMA. 2014;311:1424–9.
76. Evans MA, Kawas CH, Corrada MM. History of high cholesterol and incidence of dementia: The 90+ study. Circulation. 2014;129 Suppl 1:AP052.
77. Euser SM, van Bemmel T, Schram MT, et al. The effect of age on the association between blood pressure and cognitive function later in life. J Am Geriatr Soc. 2009;57:1232–7.
78. Poortvliet RK, de Ruijter W, de Craen AJ, et al. Blood pressure trends and mortality: the Leiden 85-plus Study. J Hypertens. 2013;31:63–70.
79. Tinetti ME, Han L, Lee DS, et al. Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Intern Med. 2014;174:588–95.
80. Berry SD, Kiel DP. Treating hypertension in the elderly: should the risk of falls be part of the equation? JAMA Intern Med. 2014;174:596–7.
81. Richardson K, Hunter S, Dening T, et al. Neuropathological correlates of falling in the CC75C population-based sample of the older old. Curr Alzheimer Res. 2012;9:697–708.
82. Muller M, Smulders YM, de Leeuw PW, et al. Treatment of hypertension in the oldest old: a critical role for frailty? Hypertension. 2014;63:433–41. There is controversy about the treatment of hypertension in the oldest old (age 80–85+). There is both a very high burden of brain vascular disease that contributes to increased risk of stroke, dementia, and disability and potential adverse effects of drug therapy to lower BP. The authors believe that biological age rather than chronological age may discriminate older individuals who are candidates for more intensive drug therapy and lowering of BP. This paper provides an excellent review of the issues of treating elevated BP among the oldest old.
83. Tonelli M, Riella M. Chronic kidney disease and the ageing population. Lancet. 2014;383:1278–9.
84. Mitchell GF, van Buchem MA, Sigurdsson S, et al. Arterial stiffness, pressure and flow pulsatility and brain structure and function: the Age, Gene/Environment Susceptibility—Reykjavik study. Brain. 2011;134(Pt 11):3398–407.
85. Pencina MJ, Navar-Boggan AM, D'Agostino Sr RB, et al. Application of new cholesterol guidelines to a population-based sample. N Engl J Med. 2014;370:1422–31.
86. Afilalo J, Duque G, Steele R, et al. Statins for secondary prevention in elderly patients: a hierarchical bayesian meta-analysis. J Am Coll Cardiol. 2008;51:37–45.
87. Glynn RJ, Koenig W, Nordestgaard BG, et al. Rosuvastatin for primary prevention in older persons with elevated C-reactive protein and low to average low-density lipoprotein cholesterol levels: exploratory analysis of a randomized trial. Ann Intern Med. 2010;152:488–96. W174.
88. Shepardson NE, Shankar GM, Selkoe DJ. Cholesterol level and statin use in Alzheimer disease: II. review of human trials and recommendations. Arch Neurol. 2011;68:1385–92.
89. Kuller LH. Statins and dementia. Curr Atheroscler Rep. 2007;9:154–61.
90. Finegold JA, Manisty CH, Goldacre B, et al. What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice. Eur J Prev Cardiol. 2014;21:464–74.
91. Rengo JL, Savage PD, Toth MJ, et al. Statin therapy does not attenuate exercise training response in cardiac rehabilitation. J Am Coll Cardiol. 2014. doi:10.1016/j.jacc.2014.02.554.
92. Munro CL, Marroquin OC, Diamond DM, et al. Examination of the Food and Drug Administration black box warning for statins and cognitive dysfunction. Circulation. 2013;128(22 Suppl), A10589.
93. Exalto LG, Whitmer RA, Kappele LJ, et al. An update on type 2 diabetes, vascular dementia and Alzheimer's disease. Exp Gerontol. 2012;47:858–64.
94. Geller AI, Shehab N, Lovegrove MC, et al. National estimates of insulin-related hypoglycemia and errors leading to emergency department visits and hospitalizations. JAMA Intern Med. 2014;174:678–86.
95. Launer LJ, Miller ME, Williamson JD, et al. Effects of intensive glucose lowering on brain structure and function in people with type 2 diabetes (ACCORD MIND): a randomised open-label substudy. Lancet Neurol. 2011;10:969–77.
96. Williamson JD, Espeland M, Kritchevsky SB, et al. Changes in cognitive function in a randomized trial of physical activity: results of the lifestyle interventions and independence for elders pilot study. J Gerontol A Biol Sci Med Sci. 2009;64:688–94.