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Effects of Hypertension and Hypercholesterolemia on Cognitive Functioning in Patients With Alzheimer Disease

Goldstein, Felicia C. PhD*; Ashley, Angela V. MD*; Endeshaw, Yohannes W. MD; Hanfelt, John PhD; Lah, James J. MD, PhD*; Levey, Allan I. MD, PhD*

Alzheimer Disease & Associated Disorders: October-December 2008 - Volume 22 - Issue 4 - p 336-342
doi: 10.1097/WAD.0b013e318188e80d
Original Articles

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.

Departments of *Neurology

Geriatric Medicine

Biostatistics, Emory University School of Medicine, Atlanta, GA

Supported by the Senator Mark Hatfield Award from the Alzheimer's Association and The Emory Alzheimer's Disease Research Center (NIH-NIA 5 P50 AG025688).

Reprints: Felicia C. Goldstein, PhD, Neurology Department, Wesley Woods Health Center, 1841 Clifton Road, N.E., Atlanta, GA 30329 (e-mail:

Received for publication October 1, 2007; accepted July 24, 2008

Portions of the research were presented at the 35th Annual Meeting of the International Neuropsychological Society, Portland, OR, February 2007.

© 2008 Lippincott Williams & Wilkins, Inc.