Detection of mild cognitive impairment in people older than 65 years of age and its relationship to cardiovascular risk factors (DECRIVAM)

M Victoria Perea-Bartolome, Ricardo García-García, Valentina Ladera-Fernández, Sara Mora-Simón, María C Patino-Alonso, Tita J Almanza-Guerra, Cristina Agudo-Conde, M Paz Muriel-Diez, Emiliano Rodríguez-Sánchez, M Victoria Perea-Bartolome, Ricardo García-García, Valentina Ladera-Fernández, Sara Mora-Simón, María C Patino-Alonso, Tita J Almanza-Guerra, Cristina Agudo-Conde, M Paz Muriel-Diez, Emiliano Rodríguez-Sánchez

Abstract

Background: Studies centered on the detection of cognitive impairment and its relationship to cardiovascular risk factors in elderly people have gained special relevance in recent years. Knowledge of the cardiovascular risk factors that may be associated to cognitive impairment could be very useful for introducing treatments in early stages - thereby possibly contributing to improve patient quality of life.The present study explores cognitive performance in people over 65 years of age in Salamanca (Spain), with special emphasis on the identification of early symptoms of cognitive impairment, with the purpose of detecting mild cognitive impairment and of studying the relationships between this clinical situation and cardiovascular risk factors.

Methods/design: A longitudinal study is contemplated. The reference population will consist of 420 people over 65 years of age enrolled through randomized sampling stratified by healthcare area, and who previously participated in another study.

Measurement: a) Sociodemographic variables; b) Cardiovascular risk factors; c) Comorbidity; d) Functional level for daily life activities; and e) Study of higher cognitive functions based on a neuropsychological battery especially adapted to the evaluation of elderly people.

Discussion: We hope that this study will afford objective information on the representative prevalence of cognitive impairment in the population over 65 years of age in Salamanca. We also hope to obtain data on the relationship between cognitive impairment and cardiovascular risk factors in this specific population group. Based on the results obtained, we also will be able to establish the usefulness of some of the screening tests applied during the study, such as the Mini-Mental State Examination and the 7 Minute Screen test.

Trial registration: ClinicalTrials.gov: NCT01327196.

References

    1. Aguado-Ortego R, Gómez-Carracedo A. In: El anciano con demencia. López-Arrieta J, García FG, editor. Madrid: Sociedad Española de Medicina Geriátrica; 2007. Trastornos psicopatológicos y conductuales en la demencia; pp. 157–196.
    1. Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, Hall K, Hasegawa K, Hendrie H, Huang Y, Jorm A, Mathers C, Menezes PR, Rimmer E, Scazufca M. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366(9503):2112–2117.
    1. Impacto socio sanitario de las enfermedades neurológicas en España.
    1. Antipsychotics for people with dementia. BMJ. 2008;337:a602. doi: 10.1136/bmj.a602.
    1. Salzman C, Jeste DV, Meyer RE, Cohen-Mansfield J, Cummings J, Grossberg GT, Jarvik L, Kraemer HC, Lebowitz BD, Maslow K, Pollock BG, Raskind M, Schultz SK, Wang P, Zito JM, Zubenko GS. Elderly patients with dementia-related symptoms of severe agitation and aggression: consensus statement on treatment options, clinical trials methodology, and policy. J Clin Psychiatry. 2008;69(6):889–898. doi: 10.4088/JCP.v69n0602.
    1. Utilización de antipsicóticos en pacientes ancianos con demencia. Boletín Terapéutico Andaluz. Volume 25. 2009.
    1. Schmidt R, Schmidt H, Fazekas F. Vascular risk factors in dementia. J Neurol. 2000;247(2):81–87. doi: 10.1007/s004150050021.
    1. Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, Copeland JR, Dartigues JF, Jagger C, Martinez-Lage J, Soininen H, Hofman A. Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology. 2000;54(11 Suppl 5):S4–9.
    1. Staekenborg SS, Su T, van Straaten EC, Lane R, Scheltens P, Barkhof F, van der Flier WM. Behavioural and psychological symptoms in vascular dementia; differences between small- and large-vessel disease. J Neurol Neurosurg Psychiatry. 2010;81(5):547–551. doi: 10.1136/jnnp.2009.187500.
    1. Thompson C, Brodaty H, Trollor J, Sachdev P. Behavioral and psychological symptoms associated with dementia subtype and severity. Int Psychogeriatr. 2010;22(2):300–305. doi: 10.1017/S1041610209991220.
    1. Luque-Santiago A, de-Hoyos-Alonso MC, Gorroñogoitia-Iturbe A, Martín-Lesende I, López-Torres-Hidalgo JD, Baena-Díez JM. PAPPS Actualización 2009 Programa de actividades preventivas y de promoción de la salud. Barcelona: semFYC; 2009. Actividades preventivas en los mayores; pp. 25–38.
    1. Losada-Baltar A, Izal-Fernández de Trocóniz M, Montorio-Cerrato I, Márquez-González M, Pérez-Rojo G. Eficacia diferencial de dos intervenciones psicoeducativas para cuidadores de familiares con demencia. Revista de Neurología. 2004;38(8):701–708.
    1. Livingston G, Johnston K, Katona C, Paton J, Lyketsos CG. Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry. 2005;162(11):1996–2021. doi: 10.1176/appi.ajp.162.11.1996.
    1. semFYC GdTdAFySdl. Prescripción de ejercicio en el tratamiento de enfermedades crónicas. Barcelona: semFYC; 2006.
    1. Launer LJ, Andersen K, Dewey ME, Letenneur L, Ott A, Amaducci LA, Brayne C, Copeland JR, Dartigues JF, Kragh-Sorensen P, Lobo A, Martinez-Lage JM, Stijnen T, Hofman A. Rates and risk factors for dementia and Alzheimer's disease: results from EURODEM pooled analyses. EURODEM Incidence Research Group and Work Groups. European Studies of Dementia. Neurology. 1999;52(1):78–84.
    1. Berr C, Wancata J, Ritchie K. Prevalence of dementia in the elderly in Europe. Eur Neuropsychopharmacol. 2005;15(4):463–471. doi: 10.1016/j.euroneuro.2005.04.003.
    1. Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol. 2005;4(8):487–499. doi: 10.1016/S1474-4422(05)70141-1.
    1. Duron E, Hanon O. Hypertension, cognitive decline and dementia. Arch Cardiovasc Dis. 2008;101(3):181–189. doi: 10.1016/S1875-2136(08)71801-1.
    1. Seux ML, Thijs L, Forette F, Staessen JA, Birkenhager WH, Bulpitt CJ, Girerd X, Jaaskivi M, Vanhanen H, Kivinen P, Yodfat Y, Vanska O, Antikainen R, Laks T, Webster JR, Hakamaki T, Lehtomaki E, Lilov E, Grigorov M, Janculova K, Halonen K, Kohonen-Jalonen P, Kermowa R, Nachev C, Tuomilehto J. Correlates of cognitive status of old patients with isolated systolic hypertension: the Syst-Eur Vascular Dementia Project. J Hypertens. 1998;16(7):963–969. doi: 10.1097/00004872-199816070-00009.
    1. Starr JM, Whalley LJ, Inch S, Shering PA. Blood pressure and cognitive function in healthy old people. J Am Geriatr Soc. 1993;41(7):753–756.
    1. Scherr PA, Hebert LE, Smith LA, Evans DA. Relation of blood pressure to cognitive function in the elderly. Am J Epidemiol. 1991;134(11):1303–1315.
    1. Farmer ME, White LR, Abbott RD, Kittner SJ, Kaplan E, Wolz MM, Brody JA, Wolf PA. Blood pressure and cognitive performance. The Framingham Study. Am J Epidemiol. 1987;126(6):1103–1114.
    1. Swan GE, Carmelli D, Larue A. Systolic blood pressure tracking over 25 to 30 years and cognitive performance in older adults. Stroke. 1998;29(11):2334–2340. doi: 10.1161/01.STR.29.11.2334.
    1. Kilander L, Nyman H, Boberg M, Lithell H. The association between low diastolic blood pressure in middle age and cognitive function in old age. A population-based study. Age Ageing. 2000;29(3):243–248. doi: 10.1093/ageing/29.3.243.
    1. Whitmer RA, Sidney S, Selby J, Johnston SC, Yaffe K. Midlife cardiovascular risk factors and risk of dementia in late life. Neurology. 2005;64(2):277–281. doi: 10.1212/01.WNL.0000149519.47454.F2.
    1. Kuller LH, Lopez OL, Newman A, Beauchamp NJ, Burke G, Dulberg C, Fitzpatrick A, Fried L, Haan MN. Risk factors for dementia in the cardiovascular health cognition study. Neuroepidemiology. 2003;22(1):13–22. doi: 10.1159/000067109.
    1. Qiu C, von Strauss E, Fastbom J, Winblad B, Fratiglioni L. Low blood pressure and risk of dementia in the Kungsholmen project: a 6-year follow-up study. Arch Neurol. 2003;60(2):223–228. doi: 10.1001/archneur.60.2.223.
    1. Skoog I, Lernfelt B, Landahl S, Palmertz B, Andreasson LA, Nilsson L, Persson G, Oden A, Svanborg A. 15-year longitudinal study of blood pressure and dementia. Lancet. 1996;347(9009):1141–1145. doi: 10.1016/S0140-6736(96)90608-X.
    1. Hanon O, Haulon S, Lenoir H, Seux ML, Rigaud AS, Safar M, Girerd X, Forette F. Relationship between arterial stiffness and cognitive function in elderly subjects with complaints of memory loss. Stroke. 2005;36(10):2193–2197. doi: 10.1161/01.STR.0000181771.82518.1c.
    1. Verghese J, Lipton RB, Hall CB, Kuslansky G, Katz MJ. Low blood pressure and the risk of dementia in very old individuals. Neurology. 2003;61(12):1667–1672.
    1. Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Cochrane Database Syst Rev. 2009. p. CD004034.
    1. Kivipelto M, Helkala EL, Laakso MP, Hanninen T, Hallikainen M, Alhainen K, Soininen H, Tuomilehto J, Nissinen A. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study. BMJ. 2001;322(7300):1447–1451. doi: 10.1136/bmj.322.7300.1447.
    1. Romas SN, Tang MX, Berglund L, Mayeux R. APOE genotype, plasma lipids, lipoproteins, and AD in community elderly. Neurology. 1999;53(3):517–521.
    1. Kuusisto J, Koivisto K, Mykkanen L, Helkala EL, Vanhanen M, Hanninen T, Kervinen K, Kesaniemi YA, Riekkinen PJ, Laakso M. Association between features of the insulin resistance syndrome and Alzheimer's disease independently of apolipoprotein E4 phenotype: cross sectional population based study. BMJ. 1997;315(7115):1045–1049.
    1. Duron E, Hanon O. Vascular risk factors, cognitive decline, and dementia. Vasc Health Risk Manag. 2008;4(2):363–381.
    1. Biessels GJ, Staekenborg S, Brunner E, Brayne C, Scheltens P. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol. 2006;5(1):64–74. doi: 10.1016/S1474-4422(05)70284-2.
    1. Xu W, Qiu C, Winblad B, Fratiglioni L. The effect of borderline diabetes on the risk of dementia and Alzheimer's disease. Diabetes. 2007;56(1):211–216. doi: 10.2337/db06-0879.
    1. Yaffe K. Metabolic syndrome and cognitive disorders: is the sum greater than its parts? Alzheimer Dis Assoc Disord. 2007;21(2):167–171. doi: 10.1097/WAD.0b013e318065bfd6.
    1. Vanhanen M, Koivisto K, Moilanen L, Helkala EL, Hanninen T, Soininen H, Kervinen K, Kesaniemi YA, Laakso M, Kuusisto J. Association of metabolic syndrome with Alzheimer disease: a population-based study. Neurology. 2006;67(5):843–847. doi: 10.1212/01.wnl.0000234037.91185.99.
    1. Dik MG, Jonker C, Comijs HC, Deeg DJ, Kok A, Yaffe K, Penninx BW. Contribution of metabolic syndrome components to cognition in older individuals. Diabetes Care. 2007;30(10):2655–2660. doi: 10.2337/dc06-1190.
    1. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–383. doi: 10.1016/0021-9681(87)90171-8.
    1. Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245–1251. doi: 10.1016/0895-4356(94)90129-5.
    1. Solomon PR, Murphy CA. Should we screen for Alzheimer's disease? A review of the evidence for and against screening Alzheimer's disease in primary care practice. Geriatrics. 2005;60(11):26–31.
    1. Sallis JF, Haskell WL, Wood PD, Fortmann SP, Rogers T, Blair SN, Paffenbarger RS Jr. Physical activity assessment methodology in the Five-City Project. Am J Epidemiol. 1985;121(1):91–106.
    1. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J. 1965;14:61–65.
    1. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–186. doi: 10.1093/geront/9.3_Part_1.179.
    1. Jorm AF. A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): development and cross-validation. Psychol Med. 1994;24(1):145–153. doi: 10.1017/S003329170002691X.
    1. Jorm AF. The Informant Questionnaire on cognitive decline in the elderly (IQCODE): a review. Int Psychogeriatr. 2004;16(3):275–293. doi: 10.1017/S1041610204000390.
    1. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6.
    1. Solomon PR, Hirschoff A, Kelly B, Relin M, Brush M, DeVeaux RD, Pendlebury WW. A 7 minute neurocognitive screening battery highly sensitive to Alzheimer's disease. Arch Neurol. 1998;55(3):349–355. doi: 10.1001/archneur.55.3.349.
    1. del Ser Quijano T, Sanchez Sanchez F, Garcia de Yebenes MJ, Otero Puime A, Zunzunegui MV, Munoz DG. [Spanish version of the 7 Minute screening neurocognitive battery. Normative data of an elderly population sample over 70] Neurologia. 2004;19(7):344–358.
    1. González-Montalvo JI. Creación y validación de un test de lectura para el diagnóstico del deterioro mental en el anciano. Universidad Complutense de Madrid; 1991.
    1. Wechsler D. Wechsler Memory Scale - Revised manual. San Antonio, TX: Psychological Corporation; 1987.
    1. Kaplan E, Goodglass H, Weintraub S. In: Evaluación de la afasia y trastornos relacionados. Second. Goodglass H, Kaplan E, editor. Madrid: Panamericana; 1986. Test de vocabulario de Boston.
    1. Goodglass H, Kaplan E. Evaluación de la afasia y de trastornos relacionados. Madrid: Panamericana; 1986.
    1. Babcock H. An experiment in the measurement of mental deterioration. Archieves of Psychology. 1930;117:105.
    1. Rey A. Test de copia de la figura compleja. Madrid: TEA; 1987.
    1. Benton AL. TRVB. Test de Retención Visual de Benton. Madrid: TEA; 1981.
    1. Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000;55(11):1621–1626.
    1. Piatt AL, Fields JA, Paolo AM, Troster AI. Action (verb naming) fluency as an executive function measure: convergent and divergent evidence of validity. Neuropsychologia. 1999;37(13):1499–1503. doi: 10.1016/S0028-3932(99)00066-4.
    1. Reisberg B, Ferris SH, de Leon MJ, Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982;139(9):1136–1139.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera