Effects of different antihypertensive medication groups on cognitive function in older patients: A systematic review

Štuhec, Matej; Keuschler, Jan; Serra-Mestres, Jordi; Isetta, Marco

doi:10.1016/j.eurpsy.2017.07.015

Cited by 39 publications

(31 citation statements)

References 23 publications

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“…The positive effects on cognition of lowering blood pressure in the elderly are well documented [ 40 ] with recent reviews indicating that antihypertensive medication, particularly Angiotensin II receptor blockers, benefit episodic memory in elderly individuals [ 41 , 42 ]. Though it should be noted that our statistical plan was quite conservative in that it required the a-priori removal of outliers to 2 SD from the mean, our findings are consistent with this previous research in that the WBE111 both reduced systolic blood pressure and showed improved episodic memory at 3 months.…”

Section: Discussionmentioning

confidence: 99%

A Randomized, Double-Blinded, Placebo-Controlled Study to Compare the Safety and Efficacy of Low Dose Enhanced Wild Blueberry Powder and Wild Blueberry Extract (ThinkBlue™) in Maintenance of Episodic and Working Memory in Older Adults

et al. 2018

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Previous research has shown beneficial effects of polyphenol-rich diets in ameliorating cognitive decline in aging adults. Here, using a randomized, double blinded, placebo-controlled chronic intervention, we investigated the effect of two proprietary blueberry formulations on cognitive performance in older adults; a whole wild blueberry powder at 500 mg (WBP500) and 1000 mg (WBP1000) and a purified extract at 100 mg (WBE111). One hundred and twenty-two older adults (65–80 years) were randomly allocated to a 6-month, daily regimen of either placebo or one of the three interventions. Participants were tested at baseline, 3, and 6 months on a battery of cognitive tasks targeting episodic memory, working memory and executive function, alongside mood and cardiovascular health parameters. Linear mixed model analysis found intervention to be a significant predictor of delayed word recognition on the Reys Auditory Verbal Learning Task (RAVLT), with simple contrast analysis revealing significantly better performance following WBE111 at 3 months. Similarly, performance on the Corsi Block task was predicted by treatment, with simple contrast analysis revealing a trend for better performance at 3 months following WBE111. Treatment also significantly predicted systolic blood pressure (SBP) with simple contrast analysis revealing lower SBP following intervention with WBE111 in comparison to placebo. These results indicate 3 months intervention with WBE111 can facilitate better episodic memory performance in an elderly population and reduce cardiovascular risk factors over 6 months.

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Section: Discussionmentioning

confidence: 99%

A Randomized, Double-Blinded, Placebo-Controlled Study to Compare the Safety and Efficacy of Low Dose Enhanced Wild Blueberry Powder and Wild Blueberry Extract (ThinkBlue™) in Maintenance of Episodic and Working Memory in Older Adults

et al. 2018

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“…By contrast, while hypertension is associated with reduced cerebral blood flow and metabolism, as well as endothelial injury (Waldstein, 2003), some observational studies in older persons suggest that successful blood pressure control mitigates the effects of hypertension on cognition (Obisesan et al, 2008), and that individuals with treated hypertension may still experience less decline in cognition even when blood pressure is not fully controlled (Rouch et al, 2015). More recent studies suggest specific anti-hypertensives may even have benefits on cognition, independent of their effects on hypertension (Stuhec et al, 2017).…”

Section: Comorbidity Valuementioning

confidence: 99%

Diabetes and anxiety adversely affect cognition in multiple sclerosis

Marrie

Patel

Figley

et al. 2019

Multiple Sclerosis and Related Disorders

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A B S T R A C TObjective: To determine whether comorbid diabetes and hypertension are associated with cognition in multiple sclerosis (MS) after accounting for psychiatric comorbidities. Methods: Participants completed a structured psychiatric interview, the Hospital Anxiety and Depression Scale (HADS), a comorbidity questionnaire, and cognitive testing including the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test (CVLT-II), Brief Visuospatial Memory Test-Revised (BVMT-R), and verbal fluency. Test scores were converted to age-, sex-and education-adjusted z-scores. We evaluated associations between diabetes and hypertension and the four cognitive z-scores using a multivariate linear model, adjusting for comorbid depression and anxiety disorders, psychotropic medications, disease-modifying therapies, smoking status and body mass index. Results: Of 111 participants, most were women (82.9%) with relapsing remitting MS (83.5%), of mean (SD) age 49.6 (12.7) years. Comorbidity was common; 22.7% participants had hypertension, 10.8% had diabetes, 9.9% had current major depression, and 9.9% had current anxiety disorders. Mean (SD) z-scores were: SDMT −0.66 (1.15), CVLT-II −0.43 (1.32), BVMT-R −0.49 (1.07) and fluency −0.59 (0.86). Diabetes (p = 0.02) and anxiety disorder (p = 0.02) were associated with cognitive function overall. Diabetes was associated with lower BVMT-R (β = −1.18, p = 0.0015) and fluency (β = −0.63, p = 0.037) z-scores. Anxiety was associated with lower SDMT (β = -1.07, p = 0.0074) z-scores. Elevated anxiety symptoms (HADS-A ≥ 11) were associated with lower z-scores on the SDMT and CVLT-II. Conclusion: Comorbidities, including diabetes and anxiety, are associated with cognitive dysfunction in MS. Their presence may contribute to the heterogeneous pattern of impairments seen across individuals and they may represent targets for improved management of cognitive symptoms.

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“…Even subtle deterioration in cognitive performance predicts future development of dementia, which leads affected individuals to a level of cognitive impairment severe enough to interfere with daily functioning and dependency on caregivers [2]. Declining cognitive functions of older adults are, therefore, one of the primary concerns for European countries [1, 3, 4]. Cognitive impairment has multifactorial aetiology and is likely caused by a combination of genetic susceptibility, environmental factors as well as gene-environment interactions [1].…”

Section: Introductionmentioning

confidence: 99%

Differences in cognitive performance and cognitive decline across European regions: a population-based prospective cohort study

Formánek¹,

Kågström²,

Winkler

et al. 2019

Eur. psychiatr.

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Background:A large variation in cognitive performance exists between European regions. However, it is unclear how older Europeans differ in the rate of cognitive decline.Methods:We analysed data from 22 181 individuals (54% women; median age 71) who participated in the Survey on Health, Ageing and Retirement in Europe. Cognition was measured using tests on verbal fluency, immediate and delayed recall. We used linear regression and linear mixed effects regression to examine regional differences in the level of cognitive performance and the rate of cognitive decline.Results:Scandinavians had the highest baseline cognitive scores (mean standardized overall cognitive score 0.3), followed by Western Europeans (mean 0.2), Central and Eastern Europeans (mean 0.1) and individuals from Mediterranean countries (mean -0.4). These differences persisted even after adjustment for sociodemographic and clinical characteristics. The annual cognitive decline in Scandinavia (0.59%) was approximately two times greater than in Western Europe (0.28%), Central and Eastern Europe (0.25%) and Mediterranean countries (0.23%).Discussion:There are substantial differences in cognitive performance as well as rates of cognitive decline among the elderly throughout European regions. This might be explained by differing levels of cognitive reserve.

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Effects of different antihypertensive medication groups on cognitive function in older patients: A systematic review

Abstract: This review suggests that ARBs can improve cognitive functions in the elderly, especially episodic memory. ACE-Is, diuretics, BBs and CCBs did not seem to improve cognitive function in the elderly but were similarly effective in blood pressure lowering as ARBs.

Cited by 39 publications

References 23 publications

A Randomized, Double-Blinded, Placebo-Controlled Study to Compare the Safety and Efficacy of Low Dose Enhanced Wild Blueberry Powder and Wild Blueberry Extract (ThinkBlue™) in Maintenance of Episodic and Working Memory in Older Adults

A Randomized, Double-Blinded, Placebo-Controlled Study to Compare the Safety and Efficacy of Low Dose Enhanced Wild Blueberry Powder and Wild Blueberry Extract (ThinkBlue™) in Maintenance of Episodic and Working Memory in Older Adults

Diabetes and anxiety adversely affect cognition in multiple sclerosis

Differences in cognitive performance and cognitive decline across European regions: a population-based prospective cohort study

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