Blood pressure, smoking and alcohol use, association with vascular dementia

被引:33
作者
Peters, Ruth [1 ]
机构
[1] Sch Publ Hlth, Imperial Clin Trials Unit, London W2 1PG, England
关键词
Hypertension; Blood pressure; Vascular dementia; Vascular cognitive impairment; Alcohol; Smoking; Dementia; AGED; 75; YEARS; COGNITIVE DECLINE; RISK-FACTORS; ALZHEIMER-DISEASE; WINE CONSUMPTION; INCIDENT DEMENTIA; CIGARETTE-SMOKING; MAJOR SUBTYPES; DOUBLE-BLIND; FOLLOW-UP;
D O I
10.1016/j.exger.2012.05.018
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
The success of the ageing global population brings with it a growth in the number of dementia sufferers. Older adults are at highest risk of dementia and are likely to manifest both vascular and Alzheimer's pathology. Blood pressure also changes with ageing and there is evidence linking high blood pressure in midlife to an increased risk of later dementia. Data from later life is sparser. A number of intervention trials have been carried out with antihypertensives and have shown mixed results with regard to cognitive and dementia outcomes (both dementia overall and of vascular and Alzheimer's types). Meta-analyses have in general not found an association between blood pressure lowering and reduced dementia incidence, although the number of cases reported in the placebo controlled trials is invariably lower in the actively treated group. Systematic reviews and meta-analyses have also been published with regard to smoking and alcohol use and incident dementia. Despite mixed reports, overall smoking was associated with an increased risk of later dementia and alcohol with a 'U' or 'J' shaped relationship. Following the systematic reviews subsequent publications tend to report similar findings. The literature in this area suffers from differing populations, lengths of follow up and assessments of both risk factor and outcome. However, at present, maintenance of cognitive function would seem to be best served by treating cardiovascular risk factors in accordance with current guidelines, controlling blood pressure, reducing smoking and if consuming alcohol doing so in moderation. This review will concentrate on the prevention of dementia and attempt to provide an overview of the evidence relating to vascular related dementia and the potential risk factors of hypertension, alcohol use and smoking behaviour. (C) 2012 Elsevier Inc. All rights reserved.
引用
收藏
页码:865 / 872
页数:8
相关论文
共 82 条
[1]   Cardioprotective effects of light-moderate consumption of alcohol: A review of putative mechanisms [J].
Agarwal, DP .
ALCOHOL AND ALCOHOLISM, 2002, 37 (05) :409-415
[2]   24-Month effect of smoking cessation on cognitive function and brain structure in later life [J].
Almeida, Osvaldo P. ;
Garrido, Griselda J. ;
Alfonso, Helman ;
Hulse, Gary ;
Lautenschlager, Nicola T. ;
Hankey, Graeme J. ;
Flicker, Leon .
NEUROIMAGE, 2011, 55 (04) :1480-1489
[3]  
Alzheimer's Disease Society, 2007, DEM REP
[4]  
[Anonymous], 2004, 7 REP JOINT NAT COMM
[5]  
[Anonymous], 2002, REP WORLD POP AG 195, pxxvii
[6]  
Anstey K., 2006, PSYCHOSOM MED, V171, P333
[7]   Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies [J].
Anstey, Kaarin J. ;
von Sanden, Chwee ;
Salim, Agus ;
O'Kearney, Richard .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2007, 166 (04) :367-378
[8]   Alcohol Consumption as a Risk Factor for Dementia and Cognitive Decline: Meta-Analysis of Prospective Studies [J].
Anstey, Kaarin J. ;
Mack, Holly A. ;
Cherbuin, Nicolas .
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 2009, 17 (07) :542-555
[9]   Moderate wine consumption is associated with better cognitive test results: a 7 year follow up of 5033 subjects in the Troms⊘ Study [J].
Arntzen, K. A. ;
Schirmer, H. ;
Wilsgaard, T. ;
Mathiesen, E. B. .
ACTA NEUROLOGICA SCANDINAVICA, 2010, 122 :23-29
[10]   Fish, meat, and risk of dementia:: cohort study [J].
Barberger-Gateau, P ;
Letenneur, L ;
Deschamps, V ;
Pérès, K ;
Dartigues, JF ;
Renaud, S .
BRITISH MEDICAL JOURNAL, 2002, 325 (7370) :932-+