Influence of hypertension on neurocognitive domains in nondemented Parkinson's disease patients.
Jacob D JonesCharles JacobsonMartina MurphyCatherine C PriceMichael S OkunDawn BowersPublished in: Parkinson's disease (2014)
Objective. Health comorbidities, particularly cardiovascular risk factors, are well known to pose risks for cognitive decline in older adults. To date, little attention has focused on the impact of these comorbidities on Parkinson's disease (PD). This study examined the prevalence and contribution of comorbidities on cognitive status in PD patients, above and beyond the effects of disease severity. Methods. A cross sectional design was used, including neuropsychological data on 341 PD patients without severe cognitive decline. Comorbidity data were collected via medical chart review. Data were analyzed using a series of multiple hierarchical regressions, controlling for PD-related disease variables. Results. Overall sample characteristics are 69% male, disease duration 9.7 years, Unified Parkinson's Disease Rating Scale 26.4, and age 64.7 years. Hypercholesterolemia (41.6%), hypertension (38.1%), and hypotension (30.2%) were the most reported comorbidities. The presence of hypertension significantly contributed to domains of executive function and verbal memory. The cooccurrence of orthostatic hypotension moderated the relationship between hypertension and executive function. Conclusions. This study on a large cohort of PD patients provides evidence for a detrimental influence of health comorbidities, particularly hypertension, on cognitive domains that have traditionally been conceptualized as being frontally and/or temporally mediated.
Keyphrases
- cognitive decline
- end stage renal disease
- blood pressure
- ejection fraction
- newly diagnosed
- healthcare
- mild cognitive impairment
- cardiovascular risk factors
- peritoneal dialysis
- physical activity
- patient reported outcomes
- metabolic syndrome
- electronic health record
- machine learning
- coronary artery disease
- type diabetes
- big data
- social media
- early onset
- health information
- health promotion