Demansın kardiyovasküler sebepleri

Geriatrik bir sendrom olan demans, dünya çapında yaşlı popülasyondaki artış ve gelişmiş tanı araçları sebebiyle  giderek artan bir sağlık problemidir. Demans insidansı 75 yaşından önce düşüktür ve ileri yaş gruplarında bile yaşla birlikte katlanarak artmaktadır. Demans ve kalp sağlığı yakın ilişki içindedir. Koroner arter hastalığı risk faktörleri, atriyal fibrilasyon, kalp yetmezliği ve kardiyovasküler hastalıklar için verilen bazı ilaçlar sistemik etkiler ile demansa neden olabilir ve demansı kötüleştirebilir. Erken yaşta kardiyovasküler hastalıkların önlenmesi ve tedavisi için uygun ilaç seçimi primer kardiyovasküler hastalığın yanı sıra demans prognozunu etkileyebilir.
Anahtar Kelimeler:

kardiyovasküler, demans, yaşlı

Cardiovascular causes of dementia

Dementia, as a geriatric syndrome,  is an increasing concern as the ageing population grows worldwide and it is more common due to enhanced diagnostic tools. The incidence of dementia is low before 75 years of age and increases exponentially with age, even in the oldest age groups.  Dementia and heart health are in close relationship.  Coronary artery disease risk factors, atrial fibrillation, heart failure and some medications given for cardiovascular diseases can lead to dementia via systemic effects and also worsen dementia. Prevention and treatment of cardiovascular disease in early ages and the choice of medications may affect prognosis of dementia as well as primary cardiovascular disease.

___

  • 1. Daviglus ML, Bell CC, Berrettini W et al. NIH state-of-the science conference statement: preventing Alzhemier' s disease and cognitive decline. NIH Consens State Sci Statements. 2010; 27: 1-27.
  • 2. Kızıl ET. Other Dementias. J Psychiatry-Special Topics 2017; 10: 37-43
  • 3. Fratiglioni L, Viitanen M, von Strauss E, Tontodonati V, Herlitz A, Winblad B. Very old women at highest risk of dementia and Alzheimer’s disease: incidence data from the Kungsholmen project, Stockholm. Neurology1997; 48: 132–38.
  • 4. Rowe CC, Ellis KA, Rimajova M, Bourgeat P et al. Amyloid imaging results from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging. Neurobiol Aging 2010; 31: 1275–83.
  • 5. Whitmer RA, Sidney S, Selby J, Johnston SC, Yaffe K. Midlife cardiovascular risk factors and risk of dementia in late life. Neurology 2005; 64: 277–81.
  • 6. Kivipelto M, Helkala EL, Laakso MP et al. Midlife vascular risk factors and Alzheimer’s disease in later life: longitudinal, population based study. BMJ 2001; 322: 1447–51.
  • 7. Love S, Miners JS. Cerebrovascular disease in aging and Alzhemier's disease. Acta Neuropathol 2016; 131: 645-58.
  • 8. Rönnemaa E, Zethelius B, Lannfelt L, Kilander L.Vascular risk factors and dementia: 40 year follow-up of a population-based cohort. Dement Geriatr Cogn Disord 2011; 31:460-66.
  • 9. Launer LJ, Masaki K, Petrovitch H, Foley D, Havlik RJ. The association between midlife blood pressure levels and late-life cognitive function. The Honolulu Asia Aging Study. JAMA 1995; 274: 1846-51.
  • 10. Goldenstein FC, Allan I. Levery, Steenland NK. High Blood Pressure and Cognitive Decline in Mild Cognitive Impairment. J Am Geriatr Soc 2013; 61: 67-73.
  • 11. Mahoney JR, Verghese J, Goldin Y, Lipton R, Holtzer R. Alerting, orienting, and executive attention in older adults. J.Int Neuropsychol Soc 2010; 16: 877-89.
  • 12. Gasecki D, Kwarciany M, Nyka W, Narkiewic K. Hypertension, Brain Damage and Cognitive Decline. Curr Hypertens Rep 2013; 15: 547-58.
  • 13. Raz N, Rodrigue KM, Kennedy KM, Acker JD. Vascular health and longitudinal changes in brain and cognition in middle-aged and older adults. Neuropsychology 2007; 21: 149-57.
  • 14. Waldenstein SR, Rice SC, Thayer JF, Najjar SS, Scuteri A, Zonderman AB. Pulse pressure and pulse wave velocity are related to cognitive decline in the Baltimore Longitudinal Study of Aging. Hypertension 2008; 51: 99-104
  • 15. Gorelick PB, Scuteri A, Black SE et al.Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the AHA/ASA. Stroke 2011; 42: 2672-713.
  • 16. Jennings JR, Mendelson DN, Muldoon MF et al. Regional grey matter shrinks in hypertensive individuals despite successful lowering of blood pressure. J Hum Hypertens 2012; 26: 295-305.
  • 17. Williams B, Mancia G, Spiering W et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal 2018; 39: 3021-104
  • 18. Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Hypertension. 2018; 138: 426-83
  • 19. Newman AB, Fitzpatrick AL, Lopez O et al. Dementia and Alzhemier's disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort. J Am Geriatr Soc 2005; 53: 1101-107.
  • 20. Eichner JE, Dunn ST, Perveen G, Thompson DM, Stewart KE, Stroehla BC. Apolipoprotein-E polymorphism and cardiovascular disease: a HuGE review. Am J Epidemiol 2002; 155: 487-95.
  • 21. Pappolla MA, Bryant-Thomas TK, Herbert D et al. Mild hypercholesterolemia is an early risk factor for the development of Alzhemier amyloid pathology. Neurology 2003; 6: 199-205.
  • 22. Catapano AL,Graham I, Backer GD et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. European Heart Journal 2016; 37: 2999–3058
  • 23. Azad N, Lemay G. Management of chronic heart failure in the older population.Journal of Geriatric Cardiology 2014; 11: 329-37
  • 24. Cermakova P, Eriksdotter M, Lund LH, Winblad B, Religa P, Religa D. Heart failure and Alzhemier's disease. Journal of Internal Medicine 2015; 277; 406-25.
  • 25. Jefferson AL. Cardiac output as a potencial risk factor for abnormal brain aging. J Alzhei mers Dis 2010; 20: 813-21
  • 26. Jefferson AL, Himali JJ, Au R et al. Relation of left ventricular ejection fractionto cognitive aging (from the Framingham Heart Study) Am J Cardiol 2011; 108: 1346-51.
  • 27. Paulson OB, Jarden JO, Godtfredsen J,Vorstrup S. Cerebral blood flow in patients with congestive heart failure treated with captopril. Am J Med 1984; 76: 91-95
  • 28. Tulner LR, Van Campen JP, Kuper IM et al. Reasons for under-treatment with oral anticoagulants in frail geriatric outpatients with atrial fibrillation: a prospective, descriptive study. Drugs Aging 2010; 27: 39-50.
  • 29. Soto ME, van Kan GA, Nourhashemi F et al. Anjiotensin-converting enzyme inhibitors and Alzhemier's disease progression in older adults: results from the Reseau sur IaMaladie d'Alzheimer Francais Cohort. J Am Geriatr Soc 2013; 61: 1482-88.
  • 30. Kwok CS, Loke YK, Hale R, Potter JF, Myint PK. Atrial fibrillation and incidence of dementia: a systematic review and meta-analysis. Neurology 2011; 76: 914–22.
  • 31. Schneider JA, Wilson RS, Cochran EJ et al. Relation of cerebral infarctions to dementia and cognitive function in older persons. Neurology 2003; 60: 1082–1088.
  • 32. Ezekowitz MD, James KE, Nazarian SM et al. Silent cerebral infarction in patients with nonrheumatic atrial fibrillation. The Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators. Circulation 1995; 92: 2178–82
  • 33. Lavy S, Stern S, Melamed E, Cooper G, Keren A, Levy P. Effect of chronic atrial fibrillation on regional cerebral blood flow. Stroke 1980; 11: 35–38
  • 34. Petersen P, Kastrup J, Videbaek R, Boysen G. Cerebral blood flow before and after cardioversion of atrial fibrillation. J Cereb Blood Flow Metab 1989; 9: 422–25
  • 35. Dublin S, Anderson ML, Hecbert SR et al. Neuropathologic Changes Associated With Atrial Fibrillation in a Population-Based Autopsy Cohort. J Gerontol A Biol Sci Med Sci 2014; 69: 609–15.
  • 36. Poggesi A, Inzitari D, Pantoni L. Atrial fibrillation and cognition epidemiological data and possible mechanisms. Stroke 2015; 46: 3316-21
Turkish Journal of Clinics and Laboratory-Cover
  • ISSN: 2149-8296
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2010
  • Yayıncı: DNT Ortadoğu Yayıncılık AŞ
Sayıdaki Diğer Makaleler

Klinik biyokimyada biyolojik varyasyon: referans değişim değeri ve bireysellik indeksi

Erdem ÇOKLUK

Total diz artroplastisinde insizyon kapatılırken diz pozisyonunun, postoperatif ağrı ve fonksiyona etkisi

Çağdaş PAMUK

Mitral anüler kalsifikasyon ile prognostik nütrisyonel indeks arasındaki korelasyon

Veysel Ozan TANIK, Hilal Erken PAMUKÇU

Kesitsel bir araştırma: Kolesterol oranlarının akut iskemik inme şiddeti üzerine etkisi var mı?

Bilgin ÖZTÜRK, Miraç Aysen ÜNSAL

Mitral anüler kalsifikasyon ile prognostik nutrisyonel indeks arasındaki koreleasyon

Veysel Ozan TANIK, Hilal ERKEN PAMUKÇU

Neisseria meningitidis serogrup B menenjiti tanısı alan bir olgu nedeniyle alınan infeksiyon kontrol önlemlerinin gözden geçirilmesi

Özlem ÖZEL, Kerime ALTUNAY, Salih CESUR, Çiğdem ATAMAN HATİPOĞLU, Kader ARSLAN, Sami KIRIKLI

Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri

Elif Hande ÖZCAN ÇETİN, Mehmet Serkan ÇETİN, Hasan Can KÖNTE, Nezaket Merve YAMAN, Bahar TEKİN TAK, Firdevs Ayşenur EKİZLER, Özcan ÖZEKE, Serkan TOPALOĞLU, Dursun ARAS

Hesperidinin iyonlaştırıcı radyasyonun neden olduğu karaciğer hasarı üzerine koruyucu etkileri

Bengü Gülhan AYDIN, Özcan PİŞKİN, Yılmaz BAŞ, Kemal KARAKAYA, Özlem ELMAS, Murat CAN, Çağatay BÜYÜKUYSAL

Köpek ısırığı sonrası Proteus penneri'ye bağlı yara infeksiyonu gelişen olgu

Metin ÖZSOY, Selin ŞENOL, Salih CESUR, Hüseyin ESMER, Şükran SEVİM, Sami KIRIKLI, Sultan GÜL

Gensini skoru pompa destekli koroner arter baypas greftleme sonrası gelişen atriyal fibrilasyonun öngördürücüsüdür

Orçun ÇİFTÇİ, Haldun MÜDERRİSOĞLU, Emir KARAÇAĞLAR, Arzu AKGÜN