The Association Between Vascular Risk Factor‐Mediating Medications and Cognition and Dementia Diagnosis in a Community‐Based Sample of African‐Americans

Richards, Stephanie S.; Emsley, Christine L.; Roberts, J. M.; Murray, Michael D.; Hall, Kathleen; Gao, Sujuan; Hendrie, Hugh C.

doi:10.1111/j.1532-5415.2000.tb04777.x

Cited by 55 publications

(44 citation statements)

References 49 publications

(43 reference statements)

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“…35,36 In addition, physicians might be hesitant to prescribe some effective drugs, such as anticoagulants, even when otherwise indicated, because of their potential adverse effects, the perception of noncompliance and poor feasibility, and the consideration of futility for any intervention in demented stroke patients. Some studies have demonstrated that often vascular risk factors are not treated in patients with severe dementia.…”

Section: Discussionmentioning

confidence: 99%

Previous and Incident Dementia as Risk Factors for Mortality in Stroke Patients

Barba

Morin

Cemillán

et al. 2002

Stroke

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Background and Purpose-We sought to determine whether previous or incident dementia increases the risk of mortality after stroke. Methods-We assessed clinical, functional, and cognitive status in 324 consecutive stroke patients who were followed up for 24 months. Prestroke dementia was diagnosed at admission (Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria) and poststroke dementia 3 months after stroke (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria). The proportion of patients surviving in the groups with and without dementia and the relative risk of mortality were calculated with Kaplan-Meier and with Cox proportional hazards analyses, respectively, for prestroke, stroke-related, and poststroke dementia. Results-Forty-nine patients (15.1% of the total sample) were found to have prestroke dementia. Three months after stroke, 75 cases had poststroke dementia: 50 incident cases (20% of 251 reexamined cases) with stroke-related dementia and 25 already demented before the stroke. After a mean follow-up of 16.1Ϯ9.9 months, the proportion of survivors was 20.4% in patients with and 72.6% in those without prestroke dementia. After a mean follow-up of 22.1Ϯ6.7 months, the proportion of survivors was 58.3% in patients with and 95.4% in those without stroke-related dementia. Using multivariate analysis and adjusting for age, sex, hypertension, diabetes, previous stroke, heart disease, and severity and recurrence of stroke, we found the relative risk of mortality associated with prestroke dementia to be 2.1 (95% CI, 1.2 to 3.6), with stroke-related dementia 6.3 (95% CI, 2.3 to 17.3), and with poststroke dementia 8.5 (95% CI, 3.4 to 20.9). Conclusions-Both previous dementia and incident dementia adversely influence long-term survival after stroke, even after adjustment for other predictors of stroke mortality. (Stroke.

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Section: Discussionmentioning

confidence: 99%

Previous and Incident Dementia as Risk Factors for Mortality in Stroke Patients

Barba

Morin

Cemillán

et al. 2002

Stroke

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“…We had previously reported lower frequencies of vascular risk factors among the Yoruba as compared with the African Americans (Ogunniyi et al, 2000;Hendrie et al, 2004). In African Americans, on the other hand, two studies have shown the benefit of antihypertensive medications excluding the centrally-acting sympatholytic drugs in the preservation of cognitive functions (Richards et al, 2000;Murray et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for incident Alzheimer's disease in African Americans and Yoruba

et al. 2006

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“…Effective management of hypertension preserves cognitive functions [11, 12, 13, 14, 15, 16, 17, 18, 19]. However, this useful effect could not be observed in hypertensive subjects treated with centrally acting sympatholytic agents [20]. Some studies have shown that a certain blood pressure level, particularly a systolic pressure of at least 130 mm Hg, is important for the maintenance of cognitive functions in the elderly.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Retinopathy and Cognitive Impairment among Hypertensive Subjects

et al. 2004

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Background: The relationship between hypertension and cognitive impairment has been investigated in the literature; several clinical studies suggested a relationship between hypertension and retinopathy. Methods: We examined the relationship between the retinopathy status and cognitive functions by using the Mini-Mental State Examination (MMSE) among hypertensive subjects older than 40 years who were admitted to our Family Medicine, Internal Medicine and Ophthalmology clinics. The subjects were categorized into three groups: group 1 = control subjects (n = 39), group 2 = hypertensive patients without retinopathy (n = 32), and group 3 = hypertensive patients with retinopathy (n = 25). Results: The number of patients with total MMSE scores less than 24 was distributed as follows: group 1: 3 patients (7.7%), group 2: 4 patients (12.5%), and group 3: 14 patients (56%). Hypertension was found to be related with a significant decrease in total MMSE scores in comparison with group 1 subjects (p < 0.001). Furthermore, retinopathy significantly correlated with lower MMSE scores among hypertensive patients (p = 0.001). Compared with group 1, group 3 showed a significant decrease in orientation (p = 0.001), registration (p = 0.001), attention and calculation (p = 0.004), recall (p = 0.009), and total (p < 0.001) MMSE scores. We also found a significant decrease in recall (p = 0.032) and total (p = 0.034) scores in group 3 when compared with group 2. There was a significant decrease in registration (p = 0.002) and total (p = 0.029) MMSE scores in group 2 when compared with group 1. We also observed negative correlations between duration of the disease and orientation (R = –0.597, n = 32, p = 0.001), and between duration of the disease and total (R = –0.495, n = 32, p = 0.006) scores in group 2. Conclusions: Hypertension was found to be related with a decline in MMSE scores. This relation was even more significant in the group of hypertensive patients with retinopathy. Thus, we suggest that cognitive tests be routinely used in the follow-up of hypertensive patients.

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The Association Between Vascular Risk Factor‐Mediating Medications and Cognition and Dementia Diagnosis in a Community‐Based Sample of African‐Americans

Cited by 55 publications

References 49 publications

Previous and Incident Dementia as Risk Factors for Mortality in Stroke Patients

Previous and Incident Dementia as Risk Factors for Mortality in Stroke Patients

Risk factors for incident Alzheimer's disease in African Americans and Yoruba

Relationship between Retinopathy and Cognitive Impairment among Hypertensive Subjects

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