Abstract
Introduction: The relationship between some metabolic and cardiovascular risk factors (CVRF) and cognitive impairment (CI) defined as mild cognitive impairment (MCI) and dementia, is controversial.
Objective: Describe the cardiovascular and metabolic risk factors that are associated with cognitive impairment in adults from Bogotá.
Materials and methods: A cross-sectional study, where the state of cognitive functions (normal, MCI or dementia) was evaluated in two phases, in adults older than 50 years, autonomous, non-institutionalized, using neuropsychological tests and neuropsychiatric protocol. Its cardiovascular and metabolic risk by self-reported history and standardized anthropometric measurements were documented.
Results: Of 1045 adults surveyed, the mean age of the group was 68 years(SD 8.6), and the mean education level was 8 years(SD 6.0), 76% were women, 56% had hypertension(HT), 40% dyslipidemia, 37% were smokers, 36% were overweight, 28% presented hypothyroidism, 25% were obese, 17% drank alcohol and 16% were diabetic. MCI was associated with incomplete high school education OR:3.01(95% CI 1.80-5.05) and aged between 70 and 79 years OR:2.06(95%CI 1.32-3.23). Dementia was associated with lower scholarity, incomplete-primary OR:11.20(95%CI 4.99-25.12), complete-primary OR 7.91(95% CI.3.44-18.16), incomplete-high school OR: 2.87(95% CI 1.17-7.01), age over 80 years OR:7.68(95%CI 3.49-16.90); and suffer hypertension OR:1.45(95%CI 1.03- 2.05)
Conclusion: Low education, older age and hypertension are in order, the most important risk factors for the development of dementia in our population. Adults between 70 and 79 with incomplete high school have higher risk of MCI.
References
HALVARI OT. Envejecimiento y ciclo de vida.: Organización Mundial de la Salud.; 2012. Availablefrom:http://www.who.int/features/factfiles/ageing/ageing_facts/es/.
PRADILLA G. Demencia: La epidemia silenciosa del III Milenio. Salud UIS,36. 2004; 36:138-145
CHEN RH, JIANG XZ, ZHAO XH, QIN YL, GU Z, GU PL, ET AL. Risk factors of mild cognitive impairment in middle aged patients with type 2 diabetes: a cross-section study. Ann Endocrinol (Paris). 2012;73(3):208-12.
WIMO A, WINBLAD B, JÖNSSON L. The worldwide societal costs of dementia: Estimates for 2009. Alzheimers Dement. 2010;6(2):98-103.
GOMBOJAV B, YI SW, SULL JW, NAM CM, OHRR H. Combined effects of cognitive impairment and hypertension on total mortality in elderly people: the Kangwha Cohort study. Gerontology. 2011;57(6):490-6.
HARWOOD DG, KALECHSTEIN A, BARKER WW, STRAUMAN S, ST GEORGE-HYSLOP P, IGLESIAS C, ET AL. The effect of alcohol and tobacco consumption, and apolipoprotein E genotype, on the age of onset in Alzheimer's disease. Int J Geriatr Psychiatry. 2010;25(5):511-8.
ANNERBO S, LÖKK J. A clinical review of the association of thyroid stimulating hormone and cognitive impairment. ISRN Endocrinol. 2013;2013:856017.
LUCK T, LUPPA M, BRIEL S, RIEDEL-HELLER SG. Incidence of mild cognitive impairment: a systematic review. Dement Geriatr Cogn Disord. 2010;29(2):164-75.
MOON SY, NA DL, SEO SW, LEE JY, KU BD, KIM SY, ET AL. Impact of white matter changes on activities of daily living in mild to moderate dementia. Eur Neurol. 2011;65(4):223-30.
SOLFRIZZI V, D'INTRONO A, COLACICCO AM, CAPURSO C, DEL PARIGI A, BALDASSARRE G, ET AL. Alcohol consumption, mild cognitive impairment, and progression to dementia. Neurology. 2007;68(21):1790-9.
SIERRA C, DOMÉNECH M, CAMAFORT M, COCA A. Hypertension and mild cognitive impairment. Curr Hypertens Rep. 2012;14(6):548-55.
MULÈ G, CALCATERRA I, NARDI E, CERASOLA G, COTTONE S. Metabolic syndrome in hypertensive patients: An unholy alliance. World J Cardiol. 2014;6(9):890-907.
RINCON F WC. Vascular cognitive impairment. [Curr Opin Neurol. 2013] - PubMed - NCBI: Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.; 2013. 2013 Feb;26(1):29-36.:[Available from: http://catalogo.fucsalud.edu.co:2080/pubmed/23254555.
CRAFT S. The role of metabolic disorders in Alzheimer disease and vascular dementia: two roads converged. Arch Neurol. 2009;66(3):300-5.
GANGULI M, FU B, SNITZ BE, HUGHES TF, CHANG CC. Mild cognitive impairment: Incidence and vascular risk factors in a population-based cohort. Neurology. 2013.
SEO SW, LEE JM, IM K, PARK JS, KIM SH, KIM ST, ET AL. Cardiovascular risk factors cause cortical thinning in cognitively impaired patients: relationships among cardiovascular risk factors, white matter hyperintensities, and cortical atrophy. Alzheimer Dis Assoc Disord. 2012;26(2):106-12.
DHIKAV V, ANAND K. Potential predictors of hippocampal atrophy in Alzheimer's disease. Drugs Aging. 2011;28(1):1-11.
KOEPSELL TD, MONSELL SE. Reversion from mild cognitive impairment to normal or near-normal cognition: risk factors and prognosis. Neurology. 2012;79(15):1591-8.
TOKUCHI R, HISHIKAWA N, KURATA T, SATO K, KONO S, YAMASHITA T, ET AL. Clinical and demographic predictors of mild cognitive impairment for converting to Alzheimer's disease and reverting to normal cognition. J Neurol Sci. 2014.
PRADILLA GA, BORIS E. VESGA A. FIDIAS E. LEÓN-SARMIENTO Y GRUPO GENECO4. Estudio neuroepidemiológico nacional (EPINEURO) colombiano. Rev Panam Salud Publica/Pan Am J Public Health. Rev Panam Salud Pública. 2003 Aug; 14 (2):104-111.
PEDRAZA OL, SANCHÉZ E, PLATA SJ, MONTALVO C, GALVIS P, CHIQUILLO A, ET AL. Puntuaciones del MoCA y el MMSE en pacientes con deterioro cognitivo leve y demencia en una clínica de memoria en Bogotá. Acta Neurol Colomb 2014: 22-30 ISSN 0120-8748
CANO C, RUIZ A, PLATA S, MATALLANA D, MONTAÑES P, BENITO M, ET AL. Capacidad operativa de una prueba de tamizado en el diagnóstico temprano de la Enfermedad de Alzheimer [Operational capacity of a screening test in early diagnosis of Alzheimer's disease]. Revista de la Asociación Colombiana de Gerontología y Geriatría 2002 16[3], 428-430.
PETERSEN RC, SMITH GE, WARING SC, IVNIK RJ, TANGALOS EG, KOKMEN E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999;56(3):303-8.
Association: AP. Diagnostic and statistical manual of mental disorders DSM IV. 1994.
GOLDSTEIN FC, LEVEY AI, STEENLAND NK. High blood pressure and cognitive decline in mild cognitive impairment. J Am Geriatr Soc. 2013;61(1):67-73.
SACHDEV PS, LIPNICKI DM, CRAWFORD J, REPPERMUND S, KOCHAN NA, TROLLOR JN, ET AL. Factors Predicting Reversion from Mild Cognitive Impairment to Normal Cognitive Functioning: A Population-Based Study. PLoS One. 2013;8 (3):e59649. doi: 10.1371/journal.pone.0059649.
HAYDEN KM, ZANDI PP, LYKETSOS CG, KHACHATURIAN AS, BASTIAN LA, CHAROONRUK G, ET AL. Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer Dis Assoc Disord. 2006;20(2):93-100.
HAJJAR I, HART M, CHEN YL, MACK W, NOVAK V, C CHUI H, ET AL. Antihypertensive therapy and cerebral hemodynamics in executive mild cognitive impairment: results of a pilot randomized clinical trial. J Am Geriatr Soc. 2013;61(2):194-201.
HARING B, LENG X, ROBINSON J, JOHNSON KC, JACKSON RD, BEYTH R, ET AL. Cardiovascular disease and cognitive decline in postmenopausal women: results from the Women's Health Initiative Memory Study. J Am Heart Assoc. 2013;Dec 18 2(6):e000369. doi: 10.1161/JAHA.113.000369.
IKRAM MA, VAN OIJEN M, DE JONG FJ, KORS JA, KOUDSTAAL PJ, HOFMAN A, ET AL. Unrecognized myocardial infarction in relation to risk of dementia and cerebral small vessel disease. Stroke. 2008;39(5):1421-6.
RHEE SY, PARK SY, HWANG JK, SON JI, CHIN SO, KIM YS, ET AL. Metabolic syndrome as an indicator of high cardiovascular risk in patients with diabetes: Analyses based on Korea National Health and Nutrition Examination Survey (KNHANES) 2008. Diabetol Metab Syndr. 2014;6(1):98.
DRISCOLL I, ESPELAND MA, WASSERTHEIL-SMOLLER S, GAUSSOIN SA, DING J, GRANEK IA, ET AL. Weight change and cognitive function: findings from the Women's Health Initiative Study of Cognitive Aging. Obesity (Silver Spring). 2011;19(8):1595-600.
ANSTEY KJ, CHERBUIN N, BUDGE M, YOUNG J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev. 2011;12(5):e426-37.
VIDONI ED, TOWNLEY RA, HONEA RA, BURNS JM, INITIATIVE ASDN. Alzheimer disease biomarkers are associated with body mass index. Neurology. 2011;77(21):1913-20.
REITZ C. Dyslipidemia and dementia: current epidemiology, genetic evidence, and mechanisms behind the associations. J Alzheimers Dis. 2012;30 Suppl 2:S127-45.
KIVIPELTO M, HELKALA EL, LAAKSO MP, HÄNNINEN T, HALLIKAINEN M, ALHAINEN K, ET AL. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study. BMJ. 2001;322(7300):1447-51.
MEZ J, COSENTINO S, BRICKMAN AM, HUEY ED, MANLY JJ, MAYEUX R. Dysexecutive versus amnestic Alzheimer disease subgroups: analysis of demographic, genetic, and vascular factors. Alzheimer Dis Assoc Disord. 2013;27(3):218-25.
PRINCE M, BRYCE R, ALBANESE E, WIMO A, RIBEIRO W, FERRIA CP. The global prevalence of dementia: A systematic review and meta-analysis. Alzheimer and Dementia 2013 (9):63-75 e2. doi: 10.1016/j.
HENAO-ARBOLEDA E, AGUIRRE-ACEVEDO DC, MUÑOZ C, PINEDA DA, LOPERA F. Prevalencia de deterioro cognitivo leve de tipo amnésico en una población colombiana [Prevalence of amnestic type mild cognitive impairment in a Colombian population]. Rev. Neurol. 2010; 46, 709-713.
ARTERO S, ANCELIN L, PORTET F, DUPUY A, BERR C, DARTIGUES JF ET AL. Risk profiles for mild cognitive impairment and progression to dementia are gender specific. J Neurol Neurosurg Psychiatry 2008;79 :979-984 doi: 10.1136/jnnp.2007.136903.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
