Is cognitive status of the Cretan elderly aged ≥ 75 years associated with known behavioral and vascular risk factors?
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This study aimed to examine the association of blood hypertension and certain behavioral risk factors with cognitive decline in elderly individuals.
A subsample of 92 elderly people aged ≥ 75 years was taken from 411 people (aged 65+ years) living in a rural area of Crete, Greece. Detailed medical and family/social history data were recorded on a standard validated health card, and cognitive disorders were assessed using the Mini Mental State Examination (MMSE). The participants were evaluated for behavioral risk factors such as physical inactivity, smoking, alcohol consumption and dietary habits. Multiple logistic regression analysis was conducted to assess the risk (odds ratios, OR) of cognitive impairment.
The mean age of participants was 80.8 ± 4.3 years old with 66.3% being married, and their MMSE mean score was 23.4 ± 4.6; 46.7% had severe and/or mild symptoms of cognitive decline, while more than half (67.4%) had been diagnosed with hypertension. Living alone (OR: 3.48, p = 0.034), being physically inactive (OR: 5.65, p = 0.046) and low consumption of fruits and vegetables (OR: 4.16, p = 0.018) were found to increase the odds of cognitive impairment, while elderly people with hypertension were also found to have lower odds of cognitive impairment (OR: 0.42, p > 0.05).
Although the observational character of this study carries some potential limitations, the reverse association of cognitive capacity with hypertension constitutes a ‘paradox’ phenomenon and is in contrast to the current literature. Further research with a larger sample is needed to better understand the observed association.
KeywordsElderly Cognitive status Cardiovascular disease Hypertension Risk factor Primary care
Mini Mental State Examination
Compliance with ethical standards
Research Involving Human Participants
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the University Hospital of Heraklion, Crete, Greece (no. 82, 3/20.07.2005) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflict of interest
The authors declare that they have no conflict of interest.
- Anyfantakis D, Symvoulakis EK, Linardakis M, Shea S, Panagiotakos D, Lionis C (2015) Effect of religiosity/spirituality and sense of coherence on depression within a rural population in Greece: the Spili III project. BMC Psychiatry 15:173. https://doi.org/10.1186/s12888-015-0561-3 CrossRefPubMedPubMedCentralGoogle Scholar
- Chobanian A, Bakris G, Black H, Cushman W, Green L, Izzo JJ et al (2003) Seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42:1206–1252. https://doi.org/10.1161/01.HYP.0000107251.49515.c2 CrossRefPubMedGoogle Scholar
- Iadecola C, Yaffe K, Biller J, Bratzke LC, Faraci FM, Gorelick PB et al (2016) Impact of hypertension on cognitive function: a scientific statement from the American Heart Association. Hypertension. https://doi.org/10.1161/hyp.0000000000000053
- Igase M, Kohara K, Miki T (2012) The association between hypertension and dementia in the elderly. Int J Hypertens 2012. https://doi.org/10.1155/2012/320648
- Linardakis M, Smpokos E, Papadaki A, Komninos ID, Tzanakis N, Philalithis A (2013) Prevalence of multiple behavioral risk factors for chronic diseases in adults aged 50+, from eleven European countries—the SHARE study (2004). Prev Med 57:168–172. https://doi.org/10.1016/j.ypmed.2013.05.008S0091-7435(13)00153-9 CrossRefPubMedGoogle Scholar
- Mottaghi T, Amirabdollahian F, Haghighatdoost F (2017) Fruit and vegetable intake and cognitive impairment: a systematic review and meta-analysis of observational studies. Eur J Clin Nutr. https://doi.org/10.1038/s41430-017-0005-x
- Peters R, Beckett N, Forette F, Tuomilehto J, Clarke R, Ritchie C et al (2008) Incident dementia and blood pressure lowering in the hypertension in the very elderly trial cognitive function assessment (HYVET-COG): a double-blind, placebo controlled trial. Lancet Neurol 7:683–689. https://doi.org/10.1016/S1474-4422(08)70143-1 CrossRefPubMedGoogle Scholar
- Stefanaki IN, Shea S, Linardakis M, Symvoulakis EK, Wynyard R, Lionis C (2014) Exploring the association of sense of coherence, and spiritual and religious beliefs in a rural population group on the island of Crete, Greece. Int J Psychiatry Med 47:207–230. https://doi.org/10.2190/PM.47.3.cA77312T027135110 CrossRefPubMedGoogle Scholar
- Vergetaki A, Papadaki A, Linardakis M, Kafatos A (2018) Changes in 10-year cardiovascular risk and behavioral risk factors in men in Crete, Greece, since the seven countries’ study (1960–1997). J Public Health. https://doi.org/10.1007/s10389-017-0879-z
- Watfa G, Benetos A, Kearney-Schwartz A, Labat C, Gautier S, Hanon O et al (2015) Do arterial hemodynamic parameters predict cognitive decline over a period of 2 years in individuals older than 80 years living in nursing homes? The PARTAGE study. J Am Med Dir Assoc 16:598–602. https://doi.org/10.1016/j.jamda.2015.01.098 CrossRefPubMedGoogle Scholar
- WHO (2002) The World health report 2002: reducing risks, promoting healthy life: overview. GenevaGoogle Scholar
- Yeung W, Chan Y (2007) The positive effects of religiousness on mental health in physically vulnerable populations: a review on recent empirical studies and related theories. Int J Psychosoc Rehabil 11:37–52Google Scholar