Age of onset of hypertension and risk of dementia in the oldest‐old: The 90+ Study

Corrada, María M.; Hayden, Kathleen M.; Paganini‐Hill, Annlia; Bullain, Szófia S.; DeMoss, Jaime; Aguirre, Colette; Brookmeyer, Ron; Kawas, Claudia H.

doi:10.1016/j.jalz.2016.09.007

Cited by 140 publications

(119 citation statements)

References 40 publications

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“…Similar to data on the link between obesity and cognitive decline/dementia, studies demonstrate that later-life hypertension may be protective against cognitive decline [50,51].…”

Section: Mid-life Hypertensionsupporting

confidence: 61%

Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population‐based perspective

Baumgart

Snyder

Carrillo

et al. 2015

Alzheimer's & Dementia

1,273

1,005

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An estimated 47 million people worldwide are living with dementia in 2015, and this number is projected to triple by 2050. In the absence of a disease-modifying treatment or cure, reducing the risk of developing dementia takes on added importance. In 2014, the World Dementia Council (WDC) requested the Alzheimer's Association evaluate and report on the state of the evidence on modifiable risk factors for cognitive decline and dementia. This report is a summary of the Association's evaluation, which was presented at the October 2014 WDC meeting. The Association believes there is sufficient evidence to support the link between several modifiable risk factors and a reduced risk for cognitive decline, and sufficient evidence to suggest that some modifiable risk factors may be associated with reduced risk of dementia. Specifically, the Association believes there is sufficiently strong evidence, from a population-based perspective, to conclude that regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) reduce the risk of cognitive decline and may reduce the risk of dementia. The Association also believes there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline.

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“…Similar to data on the link between obesity and cognitive decline/dementia, studies demonstrate that later-life hypertension may be protective against cognitive decline [50,51].…”

Section: Mid-life Hypertensionsupporting

confidence: 61%

Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population‐based perspective

Baumgart

Snyder

Carrillo

et al. 2015

Alzheimer's & Dementia

1,273

1,005

View full text Add to dashboard Cite

show abstract

“…Whereas most studies have found cardiovascular disease to be a risk factor for dementia [31, 32], our finding may be the result of survival bias, in that individuals with cardiovascular disease have increased mortality or they may develop dementia at earlier ages, which would have excluded them from the current sample. Furthermore, Corrada et al[33] found that late-life onset of hypertension was associated with reduced risk of dementia in The 90+ Study, highlighting that findings of dementia risk in the young-old may not be directly applicable to the oldest-old.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study’s Old-Old

Wong

Thomas

Edmonds

et al. 2018

Dement Geriatr Cogn Disord

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Background/Aims: Mild cognitive impairment (MCI) lacks a “gold standard” operational definition. The Jak/Bondi actuarial neuropsychological criteria for MCI are associated with improved diagnostic stability and prediction of progression to dementia compared to conventional MCI diagnostic approaches, although its utility in diagnosing MCI in old-old individuals (age 75+) is unknown. Therefore, we investigated the applicability of neuropsychological MCI criteria among old-old from the Framingham Heart Study. Methods: A total of 347 adults (ages 79–102) were classified as cognitively normal or MCI via Jak/Bondi and conventional Petersen/Winblad criteria, which differ on cutoffs for cognitive impairment and number of impaired scores required for a diagnosis. Cox models examined MCI status in predicting risk of progression to dementia. Results: MCI diagnosed by both the Jak/Bondi and Petersen/Winblad criteria was associated with incident dementia; however, when both criteria were included in the regression model together, only the Jak/Bondi criteria remained statistically significant. At follow-up, the Jak/Bondi criteria had a lower MCI-to-normal reversion rate than the Petersen/Winblad criteria. Conclusions: Our findings are consistent with previous research on the Jak/Bondi criteria and support the use of a comprehensive neuropsychological diagnostic approach for MCI among old-old individuals.

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“…This dovetails well with evidence that midlife risk factors lead to a late-life phenotypes. Midlife-onset hypertension is a risk factor for AD in late life; late life-onset hypertension appears to be protective of cognition 4 . What sorts of interventions might these be?…”

Section: Can We Pinpoint How Early Is “Early Enough”?mentioning

confidence: 99%

Midlife interventions are critical in prevention, delay, or improvement of Alzheimer’s disease and vascular cognitive impairment and dementia

Gandy

Bartfai

Lees³

et al. 2017

F1000Res

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The basic strategy for focusing exclusively on genetically identified targets for intervening in late life dementias was formulated 30 years ago. Three decades and billions of dollars later, all efforts at disease-modifying interventions have failed. Over that same period, evidence has accrued pointing to dementias as late-life clinical phenotypes that begin as midlife pathologies. Effective prevention therefore may need to begin in midlife, in order to succeed. No current interventions are sufficiently safe to justify their use in midlife dementia prevention trials. Observational studies could be informative in testing the proposal that amyloid imaging and APOEε 4 genotype can predict those who are highly likely to develop Alzheimer’s disease and in whom higher risk interventions might be justifiable. A naturally occurring, diet-responsive cognitive decline syndrome occurs in canines that closely resembles human Alzheimer’s. Canine cognitive dysfunction could be useful in estimating how early intervention must begin in order to succeed. This model may also help identify and assess novel targets and strategies. New approaches to dementia prevention are urgently required, since none of the world’s economies can sustain the costs of caring for this epidemic of brain failure that is devastating half of the over 85-year-olds globally.

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Age of onset of hypertension and risk of dementia in the oldest‐old: The 90+ Study

Cited by 140 publications

References 40 publications

Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population‐based perspective

Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population‐based perspective

Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study’s Old-Old

Midlife interventions are critical in prevention, delay, or improvement of Alzheimer’s disease and vascular cognitive impairment and dementia

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