11 feb 2010-- In elderly adults, executive dysfunction -- but not memory dysfunction -- accompanied by hypertension may help predict progression to dementia and provide an opportunity to intervene, according to a study in the February issue of the Archives of Neurology.
Shahram Oveisgharan, M.D., of the University of Western Ontario in London, Canada, and a colleague studied 990 subjects (mean age, 83.06 years) with baseline cognitive impairment but no dementia (CIND) who were enrolled in the Canadian Study of Health and Aging. After a follow-up of five years, the researchers found that the rate of progression to dementia was not affected by the presence of hypertension and memory dysfunction alone or the presence of hypertension, memory dysfunction, and executive dysfunction. However, they found that the rate of progression to dementia was significantly affected by the presence of hypertension and executive dysfunction alone. Among subjects with executive dysfunction alone, 57.7 percent of those with hypertension progressed to dementia compared to 28 percent of those with normal blood pressure. "It is assumed that cognitive decline progresses to CIND before the development of dementia," the authors conclude. "We show herein that the presence of hypertension predicts progression to dementia in a subgroup of about one-third of subjects with CIND. Control of hypertension in this population could decrease by one-half the projected 50 percent five-year rate of progression to dementia."
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