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Updated: Jun 27, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Effects of hypertension and hypercholesterolemia on cognitive functioning in patients with alzheimer disease
Felicia C Goldstein1, Angela V Ashley, Yohannes W Endeshaw
1Department of Neurology, Emory University School of Medicine, Atlanta, GA 30329, USA. fgoldst@emory.edu
Insights
Vascular comorbidities like hypertension and high cholesterol worsen specific cognitive functions in Alzheimer disease (AD) patients. Managing these risk factors is crucial for preserving cognitive abilities in individuals with AD.
Area of Science:
- Neurology
- Gerontology
- Cardiovascular Medicine
Background:
- Vascular comorbidities (VCs) such as hypertension and hypercholesterolemia are prevalent in Alzheimer disease (AD) patients.
- The impact of VCs on the specific cognitive domains affected in AD requires further elucidation.
Purpose of the Study:
- To investigate the association between vascular comorbidities and the cognitive phenotype in patients diagnosed with Alzheimer disease.
- To determine if the number or severity of VCs correlates with specific cognitive deficits.
Main Methods:
- Seventy-four AD patients were assessed for objective blood pressure and serum cholesterol levels.
- A comprehensive neuropsychological evaluation was performed, assessing attention, memory, language, visuomotor/visuospatial skills, and executive functioning.
- Multiple regression analyses were conducted, controlling for demographic factors, overall cognitive status, and other relevant health conditions like diabetes and cardiac disease.
Main Results:
- An increased number of vascular comorbidities, independent of their severity, was significantly associated with poorer performance in several cognitive areas.
- Specific cognitive deficits linked to VCs included verbal and visual recall, visuoconstructive and spatial analysis, verbal reasoning, and set shifting.
- These findings were observed after controlling for demographic variables and overall cognitive status.
Conclusions:
- Vascular comorbidities are demonstrably linked to specific cognitive impairments in individuals with Alzheimer disease.
- Potential mechanisms include the detrimental effects of VCs on cerebrovascular integrity, such as white matter disruption.
- Effective management of hypertension and hypercholesterolemia is vital for patients diagnosed with AD to mitigate cognitive decline.
Abstract:
This study investigated the relationship between the vascular comorbidities (VCs) of hypertension and hypercholesterolemia and the cognitive phenotype of Alzheimer disease (AD). Seventy-four AD patients underwent objective measurement of blood pressure and serum cholesterol levels, and they received a detailed neuropsychologic evaluation examining attention, memory, language, visuomotor/visuospatial skills, and executive functioning. Multiple regression analyses controlling for demographic variables, overall cognitive status, and the presence of diabetes/cardiac disease indicated that an increase in the number of VCs, but not their severity, was associated with poorer verbal and visual recall, visuoconstructive and spatial analysis, verbal reasoning, and set shifting. The findings demonstrate that VCs are associated with specific aspects of cognitive functioning in AD patients. The mechanisms likely involve the effects of VCs on cerebrovascular disease including white matter disruption. The results highlight the importance of controlling these risk factors in patients who carry the diagnosis of AD.
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