- Email: [email protected]
P3-140
Poster P3:: Tuesday Posters paper reports the baseline prevalence of depression in the Medical Research Council Cognitive Functioning and Ageing Study - a communitybased, prospective cohort study comprising 13,004 participants aged 65 and over. Participants were randomly selected through General Practice Registers in 5 geographical areas across England and Wales. After initial baseline screening of 13,004 participants, a sub-sample (N⫽2640) completed an in-depth assessment, including the Geriatric Mental State Examination. Responses were used to generate a diagnosis of both depression and dementia using the AGECAT algorithm. Results: 25.1% (95% C.I. 19.2-31.0) of participants with dementia also had a diagnosis of clinical depression. This amounted to 3.5% (95% C.I. 2.8-4.2) of the total sample. In the sub-sample of people with dementia, there was an association between depression and younger age group (p trend ⫽0.02), high functional disability (p trend ⫽0.02), and comorbid medical illnesses (p trend ⫽0.02). Depression was not related to sex, social class, education or living in a deprived area. Conclusion: Depression is common in people with dementia, particularly in younger participants however, this finding may be due in part to the inability of older patients with more severe dementia to articulate their feelings. Those with other chronic medical conditions are also at particular risk. P3-140
THE EFFECT OF ANTIHYPERTENSIVE MEDICATION USE ON AGE-RELATED COGNITIVE DECLINE
Sevil Yasar, Jing Zhou, Qian-Li Xue, Linda P. Fried, Michelle Carlson, Johns Hopkins University, Baltimore, MD, USA. Contact e-mail: [email protected] Background: There is epidemiological evidence that hypertension is associated both with normal age-related cognitive decline and with vascular dementia and Alzheimer’s disease. Recently, interest has been growing in how antihypertensive medications used to alter vascular risk factors might affect development of vascular dementia and Alzheimer’s disease. There are conflicting reports of protective effects and lack of protective effects of antihypertensive medications on cognition with vascular dementia and Alzheimer’s disease, likely accounted for by differing degrees of blood pressure control achieved or by mechanisms other than, or in addition to, blood-pressure lowering. Little data is available in the literature about effects of antihypertensive medications on cognitive decline in the absence of clinical dementia. Objective: To evaluate effects of antihypertensive medications on cognitive decline in the absence of clinical dementia in an older community-dwelling population of the Women’s Health and Aging Study II (WHAS II) over a 6-year interval. Methods: Subjects were 436 participants in the WHAS II older than 70 years of age. Data on medication use was collected prospectively for up to 9 years. Random Effect Model (REM) was used to evaluate effects of antihypertensive medication use on trajectories of global and domain-specific cognitive decline from baseline. In addition, the effect of blood pressure control on this association was evaluated. Analyses were adjusted for education, race, age, history of high blood pressure and vascular diseases. Results: 52% of the population reported use of antihypertensive medications. There was no association between antihypertensive medication use and global or domain-specific cognitive decline in subjects using antihypertensive medications. However, subjects with uncontrolled blood pressure that used antihypertensive medications showed slower declines in TMT-B test performance than non-users, indicating a direct effect of medication use. Conclusions: In this community dwelling population, use of antihypertensive medications did not alter trajectories of global or domain-specific cognitive decline when blood pressure was well controlled, but when blood pressure was uncontrolled antihypertensive medication use slowed decline in executive function. Further studies are needed to separately evaluate effects of different antihypertensive medications.
P3-141
S415 COGNITIVE FUNCTIONING AND CARDIOVASCULAR RISK: THE BOGALUSA HEART STUDY
Benjamin Seltzer1,2, Jeanette Gustat3, Janet Rice3, Jennifer J. Vasterling4,2, Gerald S. Berenson3, 1Tulane University Health Sciences Center, New Orleans, LA, USA; 2VA Medical Center, New Orleans, LA, USA; 3Tulane University School of Public Health, New Orleans, LA, USA; 4Tulane Unviersity Health Sciences Center, New Orleans, LA, USA. Contact e-mail: [email protected] Background: There is growing evidence that mid-life cardiovascular (CV) risk factors such as untreated hypertension, diabetes mellitus, hyperlipidemia and physical inactivity predispose people to various forms of late-life cognitive impairment, including Alzheimer’s disease. How early in life these factors begin to operate remains unknown. The Bogalusa Heart Study (BHS), an ongoing, long-term community study of childhood and young adulthood CV risk factors in a biracial (black-white) population, offers an ideal opportunity to examine the early antecedents of later life cognitive decline. Objective(s): Our objective is to examine the relationship between cognitive function and cardiovascular risk factors in young to middle aged, biracial adults. Methods: We examined 72 participants in the BHS, ages 24 to 44 years, who were individually administered a battery of standard neuropsychological tests of verbal fluency, reading, digit span and similarities (Wechsler Adult Intelligence Scale), and the logical memory, verbal paired associates and visual reproduction tests from the Wechsler Memory Scale (third edition). Preliminary Pearson Correlations of test scores with various current CV risk factors, e.g. systolic and diastolic blood pressure, age, and insulin level were performed. Results: Mean (⫾ SD) scores on some of the tests are as follows: logical memory second recall (LM2): 24.7 (7.2); logical memory percent total retention (LMPTR): 85.6 (10.9); visual reproduction first recall (VR1): 84.6 (14.3); word recognition (WRAT): 44.5 (7.8). Significant correlations were found between LM2 and age (R:-0.25; p⬍0.03); LMPTR and insulin level (R:-0.31; p⬍0.01); and WRAT and insulin level (R:-0.26; p⬍0.03). Borderline correlations were found between VR1 and diastolic blood pressure (R: 0.21; p⬍0.08) and age (R:-0.23; p⬍0.06). Conclusions: Even within a relatively young population, performance on tests of cognitive function is related to age and CV risk factors. The findings emphasize the importance of maintaining CV health throughout the life span. Further work will explore whether cognitive functioning in middle life is predicted by CV risk factors present in childhood. P3-142
PREVALENCE OF COGNITIVE AND FUNCTIONAL IMPAIRMENT IN MEXICAN POPULATION
Silvia Mejia1, Douglas Ewbank2, Beth Soldo2, Alejandro Miguel1, Luis Miguel Gutierrez1, 1Instituto Nacional de Ciencias Medicas y Nutricion, Mexico DF, Mexico; 2Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA. Contact e-mail: [email protected] Background: The heavy impact of dementia on the healthcare system strictly related to the aging of the world population is becoming increasingly important in developing countries like Mexico. Objective: To determine the prevalence of cognitive impairment together with functional impairment in Mexican population. Methods: Six thousand individuals aged 65 and older from the 2001 baseline of the Mexican Health and Aging Study (MHAS) were analyzed. Cognitive impairment was defined based on the scores in the Cross Cultural Cognitive Examination and functional impairment was derived from the IQCODE. Subjects who had both conditions were classified as possibly demented. Variations by age, sex and education were considered. Results: Prevalence was 47%, rates increased at least two times with each age decade until age 90 where prevalence increased at a lower rate. Sex showed a less clear pattern. Women between 60 and 70 years had prevalence rates almost 3 times higher than men; however, on the next two decades prevalence rates were relatively similar
THE EFFECT OF ANTIHYPERTENSIVE MEDICATION USE ON AGE-RELATED COGNITIVE DECLINE
Sevil Yasar, Jing Zhou, Qian-Li Xue, Linda P. Fried, Michelle Carlson, Johns Hopkins University, Baltimore, MD, USA. Contact e-mail: [email protected] Background: There is epidemiological evidence that hypertension is associated both with normal age-related cognitive decline and with vascular dementia and Alzheimer’s disease. Recently, interest has been growing in how antihypertensive medications used to alter vascular risk factors might affect development of vascular dementia and Alzheimer’s disease. There are conflicting reports of protective effects and lack of protective effects of antihypertensive medications on cognition with vascular dementia and Alzheimer’s disease, likely accounted for by differing degrees of blood pressure control achieved or by mechanisms other than, or in addition to, blood-pressure lowering. Little data is available in the literature about effects of antihypertensive medications on cognitive decline in the absence of clinical dementia. Objective: To evaluate effects of antihypertensive medications on cognitive decline in the absence of clinical dementia in an older community-dwelling population of the Women’s Health and Aging Study II (WHAS II) over a 6-year interval. Methods: Subjects were 436 participants in the WHAS II older than 70 years of age. Data on medication use was collected prospectively for up to 9 years. Random Effect Model (REM) was used to evaluate effects of antihypertensive medication use on trajectories of global and domain-specific cognitive decline from baseline. In addition, the effect of blood pressure control on this association was evaluated. Analyses were adjusted for education, race, age, history of high blood pressure and vascular diseases. Results: 52% of the population reported use of antihypertensive medications. There was no association between antihypertensive medication use and global or domain-specific cognitive decline in subjects using antihypertensive medications. However, subjects with uncontrolled blood pressure that used antihypertensive medications showed slower declines in TMT-B test performance than non-users, indicating a direct effect of medication use. Conclusions: In this community dwelling population, use of antihypertensive medications did not alter trajectories of global or domain-specific cognitive decline when blood pressure was well controlled, but when blood pressure was uncontrolled antihypertensive medication use slowed decline in executive function. Further studies are needed to separately evaluate effects of different antihypertensive medications.
P3-141
S415 COGNITIVE FUNCTIONING AND CARDIOVASCULAR RISK: THE BOGALUSA HEART STUDY
Benjamin Seltzer1,2, Jeanette Gustat3, Janet Rice3, Jennifer J. Vasterling4,2, Gerald S. Berenson3, 1Tulane University Health Sciences Center, New Orleans, LA, USA; 2VA Medical Center, New Orleans, LA, USA; 3Tulane University School of Public Health, New Orleans, LA, USA; 4Tulane Unviersity Health Sciences Center, New Orleans, LA, USA. Contact e-mail: [email protected] Background: There is growing evidence that mid-life cardiovascular (CV) risk factors such as untreated hypertension, diabetes mellitus, hyperlipidemia and physical inactivity predispose people to various forms of late-life cognitive impairment, including Alzheimer’s disease. How early in life these factors begin to operate remains unknown. The Bogalusa Heart Study (BHS), an ongoing, long-term community study of childhood and young adulthood CV risk factors in a biracial (black-white) population, offers an ideal opportunity to examine the early antecedents of later life cognitive decline. Objective(s): Our objective is to examine the relationship between cognitive function and cardiovascular risk factors in young to middle aged, biracial adults. Methods: We examined 72 participants in the BHS, ages 24 to 44 years, who were individually administered a battery of standard neuropsychological tests of verbal fluency, reading, digit span and similarities (Wechsler Adult Intelligence Scale), and the logical memory, verbal paired associates and visual reproduction tests from the Wechsler Memory Scale (third edition). Preliminary Pearson Correlations of test scores with various current CV risk factors, e.g. systolic and diastolic blood pressure, age, and insulin level were performed. Results: Mean (⫾ SD) scores on some of the tests are as follows: logical memory second recall (LM2): 24.7 (7.2); logical memory percent total retention (LMPTR): 85.6 (10.9); visual reproduction first recall (VR1): 84.6 (14.3); word recognition (WRAT): 44.5 (7.8). Significant correlations were found between LM2 and age (R:-0.25; p⬍0.03); LMPTR and insulin level (R:-0.31; p⬍0.01); and WRAT and insulin level (R:-0.26; p⬍0.03). Borderline correlations were found between VR1 and diastolic blood pressure (R: 0.21; p⬍0.08) and age (R:-0.23; p⬍0.06). Conclusions: Even within a relatively young population, performance on tests of cognitive function is related to age and CV risk factors. The findings emphasize the importance of maintaining CV health throughout the life span. Further work will explore whether cognitive functioning in middle life is predicted by CV risk factors present in childhood. P3-142
PREVALENCE OF COGNITIVE AND FUNCTIONAL IMPAIRMENT IN MEXICAN POPULATION
Silvia Mejia1, Douglas Ewbank2, Beth Soldo2, Alejandro Miguel1, Luis Miguel Gutierrez1, 1Instituto Nacional de Ciencias Medicas y Nutricion, Mexico DF, Mexico; 2Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA. Contact e-mail: [email protected] Background: The heavy impact of dementia on the healthcare system strictly related to the aging of the world population is becoming increasingly important in developing countries like Mexico. Objective: To determine the prevalence of cognitive impairment together with functional impairment in Mexican population. Methods: Six thousand individuals aged 65 and older from the 2001 baseline of the Mexican Health and Aging Study (MHAS) were analyzed. Cognitive impairment was defined based on the scores in the Cross Cultural Cognitive Examination and functional impairment was derived from the IQCODE. Subjects who had both conditions were classified as possibly demented. Variations by age, sex and education were considered. Results: Prevalence was 47%, rates increased at least two times with each age decade until age 90 where prevalence increased at a lower rate. Sex showed a less clear pattern. Women between 60 and 70 years had prevalence rates almost 3 times higher than men; however, on the next two decades prevalence rates were relatively similar