Vascular Risk Factors Aggravate the Progression of Alzheimer's Disease

Qiao, Jin; Lu, Wenhui; Wang, Jin; Guo, Xin-Heng; Qu, Qing

doi:10.1177/1533317514522853

Cited by 13 publications

(10 citation statements)

References 36 publications

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“…Also, patients characterized by AD progression did not differ from those without any change in the MMSI score in regard to systolic and diastolic BP values, prevalence of HT, number of patients being treated, having controlled HT and the number of antihypertensive drugs taken [37][38][39].…”

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confidence: 81%

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Hypertension in patients with Alzheimer's disease—prevalence, characteristics, and impact on clinical outcome. Experience of one neurology center in Poland

Warchoł-Celińska

Styczyńska

Prejbisz

et al. 2015

Journal of the American Society of Hypertension

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mentioning

confidence: 81%

“…Also, it has been documented that vascular risk factors may play an etiologic role in the progression from mild cognitive impairment (MCI) to AD, and the treatment of VRF may be associated with a slower cognitive decline in AD [37][38][39].…”

mentioning

confidence: 99%

Hypertension in patients with Alzheimer's disease—prevalence, characteristics, and impact on clinical outcome. Experience of one neurology center in Poland

Warchoł-Celińska

Styczyńska

Prejbisz

et al. 2015

Journal of the American Society of Hypertension

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“…In the large retrospective cohort study comprising 5831 men and 17918 women, the shorter survival in men was explained by the increased number of co-morbidities in this group (cancer, arrhythmia, obstructive pulmonary disease, and Parkinson's disease [21]. High educational level appeared also as an indicator of worse outcomes [22,[31][32][33]. Vascular risk factors were associated with poorer outcomes in some studies [33][34][35][36] but not in another one [32].…”

Section: Demographic Factorsmentioning

confidence: 98%

“…Language and executive function impairment in early phases [16,32] 3. High CSF t-tau and p-tau levels [69] 4.…”

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confidence: 99%

Determinants of Progression and Mortality in Alzheimers disease: A Systematic Review

Modrego¹,

Lobò²

2018

Neuropsychiatry

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Neuropsychiatric symptoms (NPS) have been regarded as predictors of poor outcomes, and the use of neuroleptics as well, but with contradictory results. The objective of this article is to perform a systematic review of published works dealing with progression and survival in AD. Methods We searched articles aimed at determining the factors predicting faster cognitive decline and mortality in AD, published from January 1987 to April, 2018. We gave priority to prospective and retrospective cohorts analysing the influence of gender, NPS, neuropsychological predictors, co morbidities, and the use of neuroleptics/ antidepressants. The data-sources were 42 prospective cohorts including 24,711 patients; Hazard ratios/relative risks of mortality and faster cognitive decline were obtained for NPS and the use of psychotropic drugs. The risk of mortality for neuroleptics and ChEI was also obtained from 7 retrospective cohorts totalling 242,013 patients followed up. Results High levels of NPS were predictors of both mortality and faster cognitive decline Considered in isolation, agitation/aggression, hallucinations, and depression predicted mortality. However the results for apathy and psychosis/delusions varied across the studies. According to prospective cohort studies there is no clear evidence that neuroleptics increase mortality. The use of neuroleptics is associated with faster cognitive deterioration. Conventional neuroleptics for NPS did not result in lower mortality rates than the atypical ones. Conclusions The presence of NPS is associated with poor outcomes in AD such as mortality and greater cognitive decline. Atypical neuroleptics do not shorten survival but are associated with faster cognitive decline

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“…Whereas cerebrovascular risk factors may contribute to the incidence of AD, one French study of 629 subjects found no differences in cognitive decline after 2 years between patients with cerebrovascular risk factors and those without [27], though a recent Brazilian study of 193 subjects found that combinations of cerebrovascular risk factors may cumulatively lead to cognitive improvement in 1 year in patients with late-onset AD [3]. Contrariwise, a Chinese study of 123 subjects has recently demonstrated faster functional and cognitive decline in 3 years for patients with AD and arterial hypertension [28]. Different sample sizes, ethnic disparities and unidentified genetic differences could account for some of these inconsistencies.…”

Section: Discussionmentioning

confidence: 99%

Associations of Blood Pressure with Functional and Cognitive Changes in Patients with Alzheimer's Disease

Oliveira¹,

Chen

Smith

et al. 2016

Dement Geriatr Cogn Disord

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Background: Midlife hypertension followed by late life hypotension resulting from neurodegeneration increases amyloidogenesis and tauopathy. Methods: Consecutive outpatients with late-onset Alzheimer's disease (AD) at various stages and their respective caregivers were assessed for score variations in 1 year of tests assessing caregiver burden, functionality and cognition according to blood pressure (BP) variations and APOE haplotypes, while also taking into account differential effects of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, calcium channel blockers, diuretics, or no antihypertensive medication on score changes. The diagnosis and treatment of arterial hypertension followed the JNC 7 report. Results: Variations in systolic BP (-11.76 ± 17.1 mm Hg), diastolic BP (-4.92 ± 10.3 mm Hg) and pulse pressure (-6.84 ± 12.6 mm Hg) were significant after 1 year (n = 191; ρ < 0.01). For APOE4+ carriers, rises in systolic or diastolic BP improved Clinical Dementia Rating Scale Sum of Boxes scores (ρ < 0.04), with marginally significant improvements in Mini-Mental State Examination scores resulting from risen systolic (ρ = 0.069) or diastolic BP (ρ = 0.079), and in basic independence only regarding risen diastolic BP (ρ = 0.055). APOE4- carriers resisted any functional or cognitive effects of BP variations. No differences were found regarding any antihypertensive class for variations in BP or any test scores, regardless of APOE haplotypes. Conclusions: Targeting mild BP elevations brings better functional and cognitive results for APOE4+ carriers with AD.

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Vascular Risk Factors Aggravate the Progression of Alzheimer's Disease

Abstract: Vascular risk factors are common comorbidities in patients with AD in China, with younger, better educated ones showing faster cognitive decline. Hypertension and hyperhomocysteinemia may also aggravate the progression, and it is important to prevent and treat patients with AD.

Cited by 13 publications

References 36 publications

Hypertension in patients with Alzheimer's disease—prevalence, characteristics, and impact on clinical outcome. Experience of one neurology center in Poland

Hypertension in patients with Alzheimer's disease—prevalence, characteristics, and impact on clinical outcome. Experience of one neurology center in Poland

Determinants of Progression and Mortality in Alzheimers disease: A Systematic Review

Associations of Blood Pressure with Functional and Cognitive Changes in Patients with Alzheimer's Disease

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