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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Longitudinal trajectories of cognitive decline among older adults with cardiovascular disease

Ozioma C Okonkwo1, Ronald A Cohen, John Gunstad

  • 1Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry Street, Baltimore, MD 21205, USA. ozioma@jhmi.edu

Cerebrovascular Diseases (Basel, Switzerland)
|August 10, 2010
PubMed

Insights

Cognitive decline in cardiovascular disease (CVD) patients is measurable and varies by cognitive domain. Cardiac surgery impacts cognitive decline trajectory, but heart failure does not, suggesting lifestyle changes may help prevent vascular cognitive impairment (VCI).

Area of Science:

  • Neuroscience
  • Cardiology
  • Gerontology

Background:

  • Cardiovascular disease (CVD) is a known risk factor for vascular cognitive impairment (VCI).
  • The long-term cognitive trajectory in CVD patients remains unclear.
  • This study prospectively examines cognitive decline in older adults with CVD.

Purpose of the Study:

  • To investigate the temporal pattern, rate, and hierarchy of cognitive decline in CVD patients.
  • To assess the influence of cardiac surgery and heart failure on cognitive trajectories.
  • To identify potential preventive measures for cognitive decline in CVD.

Main Methods:

  • 172 older adults with CVD underwent neuropsychological testing at baseline, 12, and 36 months.
  • Random coefficient regressions analyzed temporal cognitive changes.
  • Effects of heart failure and cardiac surgery on cognitive trajectories were examined.

Main Results:

  • Cognitive decline was linear for language and attention-executive function-psychomotor speed; curvilinear for visuospatial abilities, memory, and overall cognition.
  • Visuospatial abilities showed the greatest decline.
  • Heart failure did not alter cognitive decline rate; cardiac surgery slowed overall cognitive decline deceleration.

Conclusions:

  • Neurocognitive function measurably declines in CVD patients, with domain-specific patterns.
  • Cognitive decline is not solely due to normal aging.
  • Cardiac surgery, unlike heart failure, significantly influences cognitive decline trajectory, highlighting potential for interventions.
Abstract

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