Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review

Ligthart, Suzanne A.; Charante, Eric P. Moll van; Gool, Willem A. van; Richard, Edo

doi:10.2147/vhrm.s7343

Cited by 84 publications

(68 citation statements)

References 58 publications

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“…Additionally, ACE activity in the CSF was positively correlated with both plasma and CSF levels of 27-OH (45). Accumulating data support an association between hypertension with cognitive function and dementia (46), although insufficient evidence showed that antihypertensive drugs can really prevent cognitive decline or dementia (47). Animal studies have shown that ACE inhibitors enhance cognitive performance (48), and improve learning and retention of memory (49).…”

Section: Discussionmentioning

confidence: 99%

Side Chain-oxidized Oxysterols Regulate the Brain Renin-Angiotensin System through a Liver X Receptor-dependent Mechanism

Mateos

Ismail

Gil-Bea

et al. 2011

Journal of Biological Chemistry

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Disturbances in cholesterol metabolism have been associated with hypertension and neurodegenerative disorders. Because cholesterol metabolism in the brain is efficiently separated from plasma cholesterol by the blood-brain barrier (BBB), it is an unsolved paradox how high blood cholesterol can cause an effect in the brain. Here, we discuss the possibility that cholesterol metabolites permeable to the BBB might account for these effects. We show that 27-hydroxycholesterol (27-OH) and 24S-hydroxycholesterol (24S-OH) up-regulate the renin-angiotensin system (RAS) in the brain. Brains of mice on a cholesterol-enriched diet showed up-regulated angiotensin converting enzyme (ACE), angiotensinogen (AGT), and increased JAK/STAT activity. These effects were confirmed in in vitro studies with primary neurons and astrocytes exposed to 27-OH or 24S-OH, and were partially mediated by liver X receptors. In contrast, brain RAS activity was decreased in Cyp27a1-deficient mice, a model exhibiting reduced 27-OH production from cholesterol. Moreover, in humans, normocholesterolemic patients with elevated 27-OH levels, due to a CYP7B1 mutation, had markers of activated RAS in their cerebrospinal fluid. Our results demonstrate that side chain-oxidized oxysterols are modulators of brain RAS. Considering that levels of cholesterol and 27-OH correlate in the circulation and 27-OH can pass the BBB into the brain, we suggest that this cholesterol metabolite could be a link between high plasma cholesterol levels, hypertension, and neurodegeneration.

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Section: Discussionmentioning

confidence: 99%

Side Chain-oxidized Oxysterols Regulate the Brain Renin-Angiotensin System through a Liver X Receptor-dependent Mechanism

Mateos

Ismail

Gil-Bea

et al. 2011

Journal of Biological Chemistry

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“…31 As yet, there is no conclusive evidence that antiplatelet or cholesterol-lowering drugs have a positive effect on dementia disorders or their progression. 32 But cognitive impairment was not defined as the primary endpoint of these studies. Older people benefit from medical secondary prevention even without an existing CHD.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Impact of coronary heart disease on cognitive decline in Alzheimer’s disease: a prospective longitudinal cohort study in primary care

et al. 2016

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BackgroundArteriosclerotic disorders increase the risk of dementia. As they have common causes and risk factors, coronary heart disease (CHD) could influence the course of dementia.AimTo determine whether CHD increases the speed of cognitive decline in Alzheimer’s disease, and to discuss the potential for secondary cardiovascular prevention to modify this decline.Design and settingProspective multicentre cohort study in general practices in six cities in Germany.MethodParticipants were patients with probable mild-to-moderate Alzheimer’s dementia or mixed dementia (n = 118; mean age 85.6 [±3.4] years, range 80–96 years). The authors assessed the presence of CHD according to the family physicians’ diagnosis. Cognitive performance was measured during home visits for up to 3 years in intervals of 6 months, using Mini Mental State Examination (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SoB). The authors also recorded whether patients died in the observation period.ResultsAt baseline, 65 patients (55%) had CHD and/or a heart condition following a myocardial infarction. The presence of CHD accelerated cognitive decline (MMSE, P<0.05) by about 66%, and reduced cognitive-functional ability (CDR-SoB, P<0.05) by about 83%, but had no impact on survival.ConclusionThe study shows that CHD has a significant influence on cognitive decline in older patients with late-onset dementia. The dementia process might therefore be positively influenced by cardiovascular prevention, and this possible effect should be further investigated.

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“…Total plasma homocysteine (Hcy) and cardiovascular risk factors have been suggested as potential risk factors for small vessel disease in vascular dementia and AD [10,11,12,13,14,15,16]. Studies so far have given equivocal results [17,18,19,20].…”

Section: Introductionmentioning

confidence: 99%

Mild Cognitive Impairment, Risk Factors and Magnetic Resonance Volumetry: Role of Probable Alzheimer's Disease in the Family

Rogne

Vangberg

Eldevik

et al. 2013

Dement Geriatr Cogn Disord

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Background/Aims: Late-onset Alzheimer's disease (LOAD) comprises sporadic LOAD and familial LOAD. We wanted to determine whether total plasma homocysteine (Hcy), cardiovascular risk factors and volumetric analyses of cerebral magnetic resonance imaging (MRI) were differently associated with mild cognitive impairment (MCI) in subjects from families with aggregation of LOAD (probable familial LOAD) and MCI in subjects from families without LOAD (probable sporadic LOAD). Methods: A total of 103 subjects with MCI without known stroke or other apparent causative diseases were included as cases together with 58 controls. The cases were stratified into 3 groups according to the number of biological relatives with probable LOAD on one side of the family. Cerebral MRI was obtained from all. The case groups were compared to the control group in sex-specific analyses of covariance. Results: Hcy was significantly elevated in all cases compared to controls, except for women with probable familial LOAD. These women also had significantly smaller hippocampal volume and significantly larger lateral ventricles, unlike the women in the other case groups. Conclusions: Our findings suggest that research on Hcy, cardiovascular risk factors and other potential risk factors for LOAD might benefit from distinguishing between sporadic and familial LOAD.

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Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review

Cited by 84 publications

References 58 publications

Side Chain-oxidized Oxysterols Regulate the Brain Renin-Angiotensin System through a Liver X Receptor-dependent Mechanism

Side Chain-oxidized Oxysterols Regulate the Brain Renin-Angiotensin System through a Liver X Receptor-dependent Mechanism

Impact of coronary heart disease on cognitive decline in Alzheimer’s disease: a prospective longitudinal cohort study in primary care

Mild Cognitive Impairment, Risk Factors and Magnetic Resonance Volumetry: Role of Probable Alzheimer's Disease in the Family

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