In the last years several studies have underlined the considerable importance of cardiovascular risk factors in cognitive performances: arterial hypertension is associated with vascular dementia and it is also a relevant factor of the late onset dementia of Alzheimer’s type (LO-DAT). We evaluated the cognitive and affective status of patients in our hypertension ambulatory by use MMSE, GDS (15 items), ADL, IADL and Modified Cumulative Illness Rating Scale (CIRS).We used as well as OMS Hypertension Guide Lines 1999, DSM IV criteria, NINCS-ARDRA and NINCS-AIREN Criteria. MATERIALS AND METHODS: Data about 165 patients, males and females between 65-88 years old are reported. Systolic Blood Pressure < 220 mmHg and Diastolic Blood Pressure < 140mmHg, median plasmatic total cholesterol 227mg/dL. Cardiovascular Risk (CR) was evaluated by use of Multiple Risk Factor Assessment Equations. Homocysteine levels were normal. ADL and IADL were well performed. In this report comorbility was considered an exclusion criteria, so that patients without important comorbility (CIRS>2) were enrolled. All patients were in active-treatment: 37 in Ace-inibitors therapy, 10 in additional therapy with diuretics and 30 in add therapy with Ca-antagonist; 4 in B-blockers; 26 in Ca-antagonist; 6 only on a diet; 51 in other additional therapy. The median MMSE was 26.673+3.06 and MMSE score was: ³ 24: 89 % of patients, 23-20: 9 %, £ 19: 2 %. Median GDS was 4.913 + 3.55 and GDS score was < 6: 70 % of pz., 6-10:19 %, 11-15: 11%, not completely correspondent to the clinical diagnosis. While there isn’t correlation between MMSE-GDS vs total cholesterol and MMSE vs CR (p=0.329), on the contrary we found that GDS is significantely related to CR (p=0.0406). Cognitive status (MMSE > 24) was normal in 54% of patients in ACE-inhibitors treatment, in 50% in B-blockers and in 38.4% in Ca- antagonist. Furthermore affective status was normal (GDS < 6) in 74% of patients in ACE- treatment and 28% in Ca-antagonist. We have started to treat 34 depressed patients with SSRI and we are revaluating them in order to investigate wether changes in functinal status are coming. At the moment depression seems to be over. CR factors were immodified. CONCLUSIONS: In our elderly treated patients, hypertension was associated with a low cognitive impairment and low affective disorders. Depression significantly increases with CR. We need more time to evaluate changes in CR factors and functional status.
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