Undetected Peripheral Arterial Disease Among Older Adults With Alzheimer’s Disease and Other Dementias

Taşçı, İlker; Safer, Umut; Naharci, Mehmet İlkin; Gezer, Mustafa; Demir, Orhan; Bozoğlu, Ergün; Doruk, Hüseyin

doi:10.1177/1533317517724000

Cited by 17 publications

(8 citation statements)

References 52 publications

(51 reference statements)

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“…Stroke diagnosis was based on self-reported history of a thrombotic event, cerebral hemorrhage, or small stroke/transient ischemic attack documented by hospital admission records. Peripheral arterial disease (PAD) was diagnosed by the ankle-brachial index measurement [ 18 ]. Cardiovascular disease (CVD) referred to the composite of CHD, stroke, and PAD.…”

Section: Methodsmentioning

confidence: 99%

Multiple Antihyperglycemic Drug Use is Associated with Undernutrition Among Older Adults with Type 2 Diabetes Mellitus: A Cross-Sectional Study

2019

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Introduction Undernutrition is prevalent in older age. Current management of type 2 diabetes mellitus (T2DM) requires modified diet patterns; however, older adults with diabetes may also be at the risk of undernutrition due to age, disease, and medication-related factors. Our objectives in this study were to examine the proportion and associations of undernutrition among community-dwelling older adults with T2DM. Methods This prospective, cross-sectional study involved older outpatient adults (≥ 65 years) with and without T2DM. We assessed the nutritional status using the Mini Nutritional Assessment-Short Form. Undernutrition referred to being either at risk of malnutrition or malnourished. Variables independently associated with undernutrition were evaluated by logistic regression analysis. Results Five hundred forty-six older adults [ n = 215 with T2DM and n = 331 control; mean (SD) age, 74.9 (6.3) years; 388 (71.1%) female] were included in the study. The frequency of undernutrition was 31.1%, which was higher in patients with T2DM than in those without (36.7% vs. 27.5%, p < 0.05). However, the difference was no longer significant after adjustment for covariates (gender, lower education, lower body mass index, cardiovascular disease, multimorbidity, cognitive performance, functional performance, depressive symptoms, and polypharmacy). In the T2DM group, the ratio of multiple antihyperglycemic drug use (≥ 2) was higher in those with undernutrition compared with normal nutritional status (78.5% vs. 59.6%, p = 0.005). On multivariable analysis, decreased functional performance, depressive symptoms, and use of multiple antihyperglycemic drugs were associated with undernutrition in patients with T2DM. Conclusions Undernutrition was more common among older adults with T2DM compared with the control group. Undernutrition was further dependent on chronic conditions and diabetes management.

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Section: Methodsmentioning

confidence: 99%

Multiple Antihyperglycemic Drug Use is Associated with Undernutrition Among Older Adults with Type 2 Diabetes Mellitus: A Cross-Sectional Study

2019

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“…Patients in the case group were given cilostazol to treat PAOD, which could have improved local cerebral perfusion 13,14 and enhanced the effects of AchEIs through different mechanisms, increasing the degradation and inhibiting the aggregation of beta-amyloid, which are the main pathogenesis of AD. 13,14 PAOD is common among older adults. An ABI score <0.9 is used as an indicator of PAOD.…”

Section: Discussionmentioning

confidence: 99%

“…There is a double prevalence of PAOD in patients with AD. 14 Although most patients are asymptomatic, early detection and treatment may prevent AD. Cilostazol is a phosphodiesterase 3 inhibitor.…”

Section: Discussionmentioning

confidence: 99%

“…An ABI score <0.9 is used as an indicator of PAOD. There is a double prevalence of PAOD in patients with AD 14 . Although most patients are asymptomatic, early detection and treatment may prevent AD.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the CASI domain category fluency showed a lower decline in the case group than in the control group. Patients in the case group were given cilostazol to treat PAOD, which could have improved local cerebral perfusion 13,14 and enhanced the effects of AchEIs through different mechanisms, increasing the degradation and inhibiting the aggregation of beta-amyloid, which are the main pathogenesis of AD. 13,14 PAOD is common among older adults.…”

Section: Discussionmentioning

confidence: 99%

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Cognitive effects of cilostazol in Alzheimer's dementia patients with peripheral arterial occlusive disease: A case–control study

Chien

Huang

et al. 2023

Geriatrics Gerontology Int

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Aim Alzheimer's dementia (AD) is a slowly progressing neurodegenerative disease, characterized by beta‐amyloid deposition and neurofibrillary tangles. Peripheral atherosclerosis may deteriorate these processes via endothelial cell dysfunction and microvascular impairment. Cilostazol – a phosphodiesterase 3 inhibitor – is a standard treatment for peripheral arterial occlusive disease and a potential treatment for preserving cognitive function in AD patients. We aimed to determine whether cilostazol is beneficial in AD patients with peripheral arterial occlusive disease by evaluating Cognitive Abilities Screening Instrument (CASI) domains. Methods We conducted a retrospective case–control study of 62 AD patients in Taiwan. Thirty‐one patients had peripheral arterial occlusive disease and were receiving cilostazol plus acetylcholinesterase inhibitors (AchEIs) or N‐methyl d‐aspartate antagonists, whereas 31 others were receiving AchEIs. Therapeutic responses were measured using neuropsychological assessments. The CASI was administered at baseline and 12 months later; different domains were analyzed between the groups using univariate and multivariate analyses. Results Age, sex, education duration, ApoE ε4 gene status, and initial Mini‐Mental State Examination scores were not different between the two groups. Except for fluency, no CASI domains showed a statistical difference between the groups. A significant difference was observed in category fluency (P = 0.010). In the logistic regression analysis, after adjusting for covariate effects, category fluency still showed a significant difference between the groups (P = 0.013). Conclusions In AD patients with peripheral arterial occlusive disease who have received Food and Drug Administration‐approved pharmacotherapy, cilostazol, as an antiplatelet, may help to preserve general cognitive function, with significant preservation in category fluency. Geriatr Gerontol Int 2023; 23: 194–199.

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Cognitive decrement in older adults with symptomatic peripheral artery disease

et al. 2021

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Undetected Peripheral Arterial Disease Among Older Adults With Alzheimer’s Disease and Other Dementias

Abstract: The prevalence of PAD was more than double in patients with dementia, with no difference among AD, VaD, and AD-VaD types.

Cited by 17 publications

References 52 publications

Multiple Antihyperglycemic Drug Use is Associated with Undernutrition Among Older Adults with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Multiple Antihyperglycemic Drug Use is Associated with Undernutrition Among Older Adults with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Cognitive effects of cilostazol in Alzheimer's dementia patients with peripheral arterial occlusive disease: A case–control study

Cognitive decrement in older adults with symptomatic peripheral artery disease

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