THE ROLE OF ARTERIAL HYPERTENSION ON COGNITIVE DECLINE OF ELDERLY PATIENTS WITH ALZHEIMER'S AND VASCULAR COGNITIVE IMPAIRMENT

Arterial hypertension (AH) and cognitive impairments frequently coexist among elderly. The aim of our study was to examine the association between AH and cognitive decline among elderly patients with Alzheimer’s disease (AD), Vascular cognitive impairment (VCI) and mixed (AD and VCI) cognitive impairment (MD). Material and methods: We examined 100 patients with AH (on average age of 76.72±7.59 years, 28 males and 72 females, 24 with AD, 38 with VCI and 38 with MD) and 46 patients without AH (on average age of 76.67±7.28 years, 20 males and 26 females, 14 with AD, 18 with VCI and 14 with MD) twice (with interval of 2 years) with the following neuropsychological battery: Mini Mental State Examination (MMSE), Isaac’s Set Test (IST for verbal fluency), Literal fluency Test (LFT; variant M-O-H-A in Bulgarian, 1 minute for every letter), Clock Drawing Test (CDT), 10 Words Test (for working memory, delayed recall and recognition (10/20words), Bulgarian variant), Digit Symbol Substitution test (DSST 90sec), Digit Span Test (DST forward and backward) and 21 Hamilton Depression Scale (HDS). Results: AH itself was not associated with additional cognitive decline. Its role is modified by other factors such as duration of AH, the age of onset of AH, its control and coexistence of more than 4 other vascular risk factors. Conclusions: The existence of AH itself has no negative effects on cognitive functions. However, its impact on cognition is modified by other important factors such as longer duration and poor control of AH and coexistence of other vascular risk factors.