Vascular risk factors and cognitive functioning in normal elderly
Recent research has suggested that vascular disease risk factors (VDRF) may contribute to cognitive impairment. The aim of the present study was to determine the relative contribution of VDRF to cognitive functioning and activities of daily living in a community-dwelling cohort of individuals aged 75-90. Participants were questioned about cigarette smoking and alcohol consumption, and a neurologist gathered information about prior diagnosis of vascular risk factors (i.e., hypertension, hypercholesterolemia, diabetes mellitus, arrhythmia, coronary artery disease, congestive heart failure, transient ischemic attack, and stroke). Volunteers also completed a one-hour neuropsychological test battery and questionnaires about levels of pain, symptoms of depression, and ability to perform activities of daily living. Sequential regression analyses revealed that number of vascular risk factors did not reliably predict performance on measures of verbal memory, attention/executive functioning, or visuospatial skills. However, older age was associated with lower performance on tests of verbal memory and attention/executive functioning, and female gender predicted higher verbal memory but lower visuospatial test scores. Although demographic variables accounted for the greatest percentage of variance in the regression models, pain was a significant predictor of visuospatial test scores, and symptoms of depression predicted performance on measures of attention/executive functioning. Only depressive symptoms predicted performance on the Instrumental Activities of Daily Living checklist. Thus, in this sample of relatively healthy elderly individuals, vascular risk factor burden did not reliably contribute to cognitive functioning or ability to perform activities of daily living. These findings are interpreted in terms of the theory of cognitive reserve (Stern, 2002).
0633: Cognitive therapy