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Nonlinear Relations of Cardiovascular Risk Factors to Neuropsychological Function and Dementia

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Handbook of Systems and Complexity in Health

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Abstract

Cardiovascular diseases are the leading cause of morbidity and mortality in the United States and most westernized nations [1]. Cardiovascular risk factors and diseases confer substantial increase in risk for ischemic and hemorrhagic stroke [2]. Yet, outside the context of clinical stroke, the brain is an under-recognized target organ of a spectrum of cardiovascular diseases. Although it has long been known that cardiovascular risk factors and diseases contribute to the development of vascular (previously known as multi-infarct) dementia, we now know that similar risk is conferred for Alzheimer’s disease (AD) [3]. Importantly, long before clinical manifestations of stroke or dementia are apparent, cardiovascular risk factors are also known to negatively impact the brain and neurocognitive function. Evidence suggests that cardiovascular risk factors elevate risk of concurrent cognitive dysfunction, as well as accelerated cognitive aging.

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Notes

  1. 1.

    The safety of statin medications is currently under review. The FDA (http://www.fda.gov/Drugs/DrugSafety/ucm256581.htm#Simvastatin_;06-08-2011) has warned against the use of high dose simvastatin as the risk of muscle injury increases exponentially with dose increase, though the cardiovascular outcomes do not differ for low or high dose use (Lancet. 2010; 376(9753):1658–69). As statins involve the CYP3A4-pathway the risk issues potentially relate to all statins.

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Acknowledgements

Adapted in part from: (a) Waldstein SR, Wendell CR, Hosey MM, Seliger SL, Katzel LI. Cardiovascular disease and neurocognitive function. In: Armstrong C, Morrow LA, editors. Handbook of medical neuropsychology: applications of cognitive neuroscience. New York: Springer; 2010, (b) Waldstein SR, Wendell CR, Katzel LI. Hypertension and neurocognitive function: blood pressure and beyond. In: Whitfield K, editor. Annual review of gerontology and geriatrics. New York: Springer; 2010. p. 113–132, and (c) Waldstein SR, Wendell CR, Hosey MM. Applications of neurocognitive assessment in behavioral medicine. In: Steptoe A, editor. Handbook of behavioral medicine. New York: Springer; 2010. p. 125–36.

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Authors and Affiliations

  1. Department of Psychiatry, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, 21287, USA

    Carrington R. Wendell Ph.D.

  2. Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Leslie I. Katzel M.D., Ph.D. & Shari R. Waldstein Ph.D.

  3. Geriatric Research Education & Clinical Center, Baltimore VA Medical Center, Room 4B-189, Baltimore, MD, 20201, USA

    Leslie I. Katzel M.D., Ph.D. & Shari R. Waldstein Ph.D.

  4. Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA

    Shari R. Waldstein Ph.D.

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  1. Carrington R. Wendell Ph.D.
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    Joachim P. Sturmberg

  2. Northern Ontario School of Medicine, Merchandise Mart Plaza, Suite 1212 222, Chicago, 60654, Illinois, USA

    Carmel M. Martin

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Wendell, C.R., Katzel, L.I., Waldstein, S.R. (2013). Nonlinear Relations of Cardiovascular Risk Factors to Neuropsychological Function and Dementia. In: Sturmberg, J., Martin, C. (eds) Handbook of Systems and Complexity in Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4998-0_24

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