Hypertension and Dementia in the Elderly: The Leisure World Cohort Study

Recent studies have highlighted the deleterious role of cardiovascular risk factors, including hypertension, on the incidence of dementia. Although midlife hypertension is associated with later development of dementia, the role of late-life hypertension remains unclear. We explored the association of hypertension and its treatment with incident dementia in 13978 older (median = 74 years) adults followed from 1981 to 2010 (median = 13 years) and calculated risk estimates using Cox regression analysis in two age groups (<75 and 75+ years) in men and women separately. Dementia status was determined from in-person evaluations, followup questionnaires, hospital data, and death certificates. In the older women, current users of blood pressure medication at baseline had a 26% increased risk of dementia (95% CI 1.06–1.51). In the younger men, those with untreated hypertension and those with past use of blood pressure medication use had about a 30% nonsignificant increased risk of dementia. High blood pressure and its treatment appear to have different effects in men and women and in the old and older

Lifestyle Practices and Cardiovascular Disease Mortality in the Elderly: The Leisure World Cohort Study

Modifiable behavioral risk factors are major contributing causes of death, but whether the effects are maintained in older adults is uncertain. We explored the association of smoking, alcohol consumption, caffeine intake, physical activity, and body mass index on cardiovascular disease (CVD) mortality in 13,296 older adults and calculated risk estimates using Cox regression analysis in four age groups (<70, 70–74, 75–79, and 80+ years). The most important factor was current smoking, which increased risk in all age-sex groups. In women, alcohol consumption (≤3 drinks/day) was related to decreased (15–30%) risk in those <80 years old; in men, 4+ drinks/day was associated with reduced (15–30%) risk. Active 70+ year olds had 20–40% lower risk. Both underweight and obese women were at increased risk. Lifestyle practices impact CVD death rates in older adults, even those aged 80+ years. Not smoking, moderate alcohol consumption, physical activity, and normal weight are important health promoters in our aging population

Longitudinal Assessment of Cognitive Function by Clock Drawing in Older Adults

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Cerebral Microbleeds in a Stroke Prevention Clinic.

The objective of this study is to assess the effectiveness of a stroke clinic in stroke prevention and progression of cerebral microbleeds (CMB). We conducted a retrospective observational study of patients who visited a stroke clinic between January 2011 and March 2017. Susceptibility-weighted imaging (SWI) MRI studies were obtained at baseline and follow-up visits to identify new infarctions and CMB progression. Patients with CMB who also underwent brain computed tomography (CT) imaging were identified and their cerebral arterial calcification was quantified to evaluate the relationship between the extent of intracranial calcification and CMB burden. A total of 64 stroke patients (mean age 73.1 ± 11.0, 47% males) had CMB on baseline and follow-up MRI studies. During a mean follow-up period of 22.6 months, four strokes occurred (4/64, 6%; 3 ischemic, 1 hemorrhagic), producing mild neurological deficit. Progression of CMB was observed in 54% of patients with two MRIs and was significantly associated with length of follow-up. Subjects with intracranial calcification score &gt; 300 cm3 had higher CMB count than those with scores &lt;300 cm3 at both baseline (12.6 ± 11.7 vs. 4.9 ± 2.2, p = 0.02) and follow-up (14.1 ± 11.8 vs. 5.6 ± 2.4, p = 0.03) MRI evaluations. Patients with CMB had a relatively benign overall clinical course. The association between CMB burden and intracranial calcification warrants further study