Blood Pressure

Hendrie, Hugh C.; Albert, Marilyn S.; Butters, Meryl A.; et al. “The NIH Cognitive and Emotional Health Project: Report of the Critical Evaluation Study Committee.” Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association January 2006; Vol. 2 (1): 12–32.
 Full text available free online (21 pages)

• An expert panel convened by the NIH summarizes the current state of knowledge about brain health and identifies more than 40 factors that may influence cognitive and emotional health in older adults. Although the evidence suggests that combinations of factors may be more important over time than any single factor, the link between high blood pressure and loss of mental sharpness is found to be the strongest across studies.

Launer, Lenore .J.; Ross, G.W.; Petrovich, H.; Masaki, Kamal H.; Foley, Daniel J.; White, Lon R.; and Havlik, R.J. "Midlife Blood Pressure and Dementia: The Honolulu-Asia Aging Study." Neurobiology of Aging 2000; Jan. – Feb., Vol. 21 (1): 49 – 55.

• Japanese-American men who had untreated high blood pressure in middle age were at increased risk for both Alzheimer’s disease and vascular dementia. Data are from the Honolulu-Asia Aging Study, a long-term, federally funded population study of how vascular and other factors might increase risk of dementia, contribute to degeneration of the brain’s nerve cells, or lead to co-existing illnesses that increase the risk of dementia.

Diabetes

Arvanitakis, Zoe; Wilson, Robert S.; Bienias, Julia L.; Evans, Denis A.; and Bennett, David A. "Diabetes Mellitus and Risk of Alzheimer Disease and Decline in Cognitive Function." Archives of Neurology May 2004; 61: 661 – 666.

• Data suggest that study participants who reported any history diabetes had a 65 percent greater risk of eventually developing Alzheimer’s disease. From the Religious Orders Study, a long-term, federally funded investigation of various issues in aging and Alzheimer’s disease in retired members of the Catholic clergy.

Logroscino, Giancarlo; Kang, Jae Hee; and Grodstein, Francine. "Prospective Study of Type 2 Diabetes and Cognitive Decline in Women Aged 70 –81 Years." BMJ March 6, 2004; 328 (7439): 548. Full text available free online.

• Women with Type 2 diabetes had significantly greater risk of poor performance on cognitive tests. Data are from the Nurses’ Health Study, a major epidemiological investigation of risk factors for chronic diseases in women enrolling 121,700 registered nurses who were 30 to 55 years old in 1976. This study involved more than 18 ,000 of those nurses who are involved in the part of the investigation exploring cognitive function.

Ott, Alewijn; Stolk, R.P.; van Harskamp, F.; Pols, H.A.; Hofman, A.; and Breteler, Monique M. "Diabetes Mellitus and the Risk of Dementia: The Rotterdam Study." Neurology Dec. 10, 1999; 53 (9) 1907 – 1909.

• Having Type 2 diabetes nearly doubled the risk of developing dementia. Data are from the Rotterdam Study, a large population study launched in the Netherlands in 1990 to investigate risk factors for chronic diseases of the heart, nervous system, and eyes.

High Cholesterol

Kivipelto, Miia. "Cholesterol and Risk for Alzheimer’s Disease." Presented at the Alzheimer’s Association 9th International Conference on Alzheimer’s Disease and Related Disorders, Philadelphia, Penn., July 17 – 22, 2004. Abstract published in Neurobiology of Aging, July 2004, Vol. 25, S2: p. S6.

• Miia Kivipelto, M.D., Ph.D., an internationally recognized authority on the epidemiology of dementia from Finland’s University of Kuopio, summarized a growing body of evidence linking elevated midlife cholesterol levels and high intake of saturated fat to increased risk of Alzheimer’s disease.

Smoking

Ott, Alewijn; Andersen, K.; Dewey, M.E.; Letenneur, L.; and others. "Effect of Smoking on Global Cognitive Function in Nondemented Elderly." Neurology, March 23, 2004: pp. 920-924.

• On a standard test of cognitive function, smokers in a large European study declined at an annual rate five times faster than individuals who never smoked. Data are from the European Community Concerted Action Against Epidemiology of Dementia (EURODEM), a study enrolling more than 9,000 adults age 65 and older to identify risk factors and preventive strategies for dementia.

Stroke and Cerebrovascular Disease

Honig, L.S.; Tang, M.X.; Albert, S.; Costa, R.; Luchsinger, J.; Manly, Jennifer; Stern, Y.; and Mayeux, Richard. "Stroke and the Risk of Alzheimer Disease." Archives of Neurology Dec. 2003; 60 (12): 1707 – 1712.

• This study of nearly 2,000 Medicare enrollees found a higher risk of Alzheimer’s disease in those who had a history of stroke. Alzheimer risk increased even more for those who also had high blood pressure, diabetes or heart disease in addition to a history of stroke. However, in the absence of stroke, only diabetes was an independent risk factor for Alzheimer’s disease in this study.

Snowdon, David A.; Greiner, Lydia H.; Mortimer, James A.; Markesbery, William R.; and others. "Brain Infarction and the Clinical Expression of Alzheimer Disease: The Nun Study." JAMA March 12, 1997; 277 (10): 813 – 817.

• The Nun Study is an investigation of aging and Alzheimer’s disease in nearly 700 School Sisters of Notre Dame who have agreed to participate in various kinds of testing and to donate their brains to the study after death. One key finding is that sisters who have hallmark Alzheimer brain abnormalities are more likely to have had symptoms of dementia if they also had strokes or "clogged arteries" in the brain.

Multliple Cardiovascular Risk Factors

Kivipelto, Miia; Anttila, Tiia; Fratiglioni, Laura; Winblad, Bengt; Nissinen, Aulikki; Soininen, Hilkka. "Body Mass Index, Clustering of Vascular Risk Factors, and the Risk of Dementia: A Longitudinal, Population-Based Study." Presented at the Alzheimer’s Association 9th International Conference on Alzheimer’s Disease and Related Disorders, Philadelphia, Penn., July 17 – 22, 2004. Abstract published in Neurobiology of Aging, July 2004, Vol. 25, S2: p. S311.

• Data from a decades-long study under way at Stockholm’s Karolinska Institute suggest that individuals who are obese or who have high blood pressure or high cholesterol in middle age are all at increased risk for Alzheimer’s disease. Those who have all three conditions have a six-fold increase in risk.

Luchsinger, J.A; Reitz, C.; Honig, L.S.; Tang, M.-X.; Shea, Steven; and Mayeux, R. "Aggregation of vascular risk factors and risk of incident Alzheimer disease." Neurology, Aug. 23, 2005; 65: 545 - 551.

• This study explored the link between Alzheimer’s and high blood pressure, heart disease, diabetes and smoking in more than 1,100 white, Hispanic and African-American older adults. Those with three or more of these vascular risk factors had more than three-and-one-half times the risk of developing Alzheimer’s as those with none. Diabetes and smoking were the strongest risk factors by themselves.

Stern, Paul C. and Carstensen, Laura, editors. The Aging Mind: Opportunities in Cognitive Research. National Academy Press. For full details on this publication, please see the Overview section.

• Evidence that high blood pressure, heart disease and diabetes have a negative effect on cognitive health as we age is summarized on pages 42 – 43 and 193 – 203.

R.A. Whitmer, Ph.D.; S. Sidney, M.D.; J. Selby, M.D.; S. Claiborne Johnston, M.D.; and K. Jaffe, M.D. "Midlife cardiovascular risk factors and risk of dementia in late life." Neurology 2005; Jan. 25: 77 - 81.

• A decades-long study of more than 8,000 members of Kaiser Permanente of Northern California suggests that individuals in their early 40s who smoke or have diabetes, high cholesterol or high blood pressure have an increased risk of developing dementia later in life. Each specific factor raises risk from 20 to 40 percent and having all four more than doubles risk.