Journal
INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY
Volume 33, Issue 2, Pages 288-297Publisher
WILEY
DOI: 10.1002/gps.4735
Keywords
Parkinson; cognition; vascular risk factors; hypertension; pulse pressure; dementia; metabolic syndrome
Categories
Funding
- Parkinson Society Canada
- Canadian Institutes of Health Research (CIHR)-Institute of Neurosciences, Mental Health, and Addiction [201210]
- Reseau Parkinson Quebec (Fonds de recherche en sante du Quebec)
- CIHR-Institute of Aging [266909]
- Alzheimer Society Research Program
- Pacific Alzheimer Research Foundation
- Michael J. Fox Foundation for Parkinson's Research
- AbbVie
- Avid Radiopharmaceuticals
- Biogen Idec
- Bristol-Meyers Squibb
- Covance
- GE Healthcare
- Genentech
- GlaxoSmithKline
- Eli Lilly and Company
- Lundbeck
- Merck
- Meso Scale Discovery
- Pfizer Inc.
- Piramal Imaging
- Roche group
- Servier
- UCB
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ObjectivesHypertension, dyslipidemia, diabetes, and obesity are well-established risk factors for cognitive impairment and dementia in older adults. In contrast, previous studies that have assessed the impact of vascular risk factors (VRFs) on cognition in Parkinson's disease (PD) have had methodological limitations and reported conflicting findings. We address this question in a large well-characterized cohort of de novo PD patients. MethodsA total of 367 untreated and non-demented patients aged 50years and older with early PD (H&Y=1.0-2.0) underwent a comprehensive clinical and neuropsychological assessment at baseline and 24months later. A series of linear mixed models were used to determine the effects of VRFs on cognition while controlling for patient and disease characteristics. The outcomes included norm-referenced Z-scores of global cognition, visuospatial skills, verbal episodic memory, semantic verbal fluency, attention, and working memory tests. ResultsA longer history of hypertension and a higher pulse pressure were significant predictors of lower Z-scores on immediate and delayed free recall, recognition, and verbal fluency tests. On average, every 10 mmHg increase in pulse pressure was associated with a 0.08 reduction on the cognitive Z-scores. The effects were independent of age, education, disease duration, motor impairment, medication, and depressive symptoms. Other VRFs were not associated with cognitive outcomes. ConclusionsOur results are consistent with previous studies suggesting that hypertension exerts a detrimental effect on memory and verbal fluency in early PD. Management of blood pressure and cardiovascular health may be important to reduce risk of cognitive decline in PD. Copyright (c) 2017 John Wiley & Sons, Ltd.
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