Cardiovascular Comorbidities and Cognitive Impairment

Abstract

Various grades of cognitive impairment generally occur in older adults over the age of 55, where cardiovascular risk factors such as diabetes and/or hypertension, coronary artery disease, or cerebrovascular accidents are also common. Cognitive impairment occurs in various forms, from mild or amnesia such as forgetting today's date to more ominous and progressive forms, such as frank dementia. Over 5 million people worldwide suffer from dementia, most of whom live in low- and middle-income countries. It has been envisaged from the beginning that dementia or cognitive impairment has neurodegenerative origins. However, recent studies have indicated that dementia may have a mixed origin or may be preceded by vascular insult and then neurodegenerative pathology. From a pathophysiological standpoint, one of the puzzling questions in the field of cognitive impairment and comorbidities is that it is not clear whether cardiovascular comorbidity or cognitive impairment comes first. Cognitive impairment negatively affects mobility and fitness and this can potentially contribute to development of hypertension or/and diabetes. The present review examines this perplexing situation and tries to anser whether the comorbid conditions are innocent bystanders to cognitive impairment or they play greater causative roles. The rationale of the review is that it is possible to address these cardiovascular risk factors for dementia prevention and hence it summarizes the evidence related to cardiovascular risk factors and cognitive impairment.