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Cognitive performance of demented, depressed patients with cardiovascular pathology – without and with diabetes mellitus: a preliminary report of a cross-sectional study

In this preliminary cross-sectional study diabetes mellitus coupled with cardiovascular pathology has no additional impact on the cognitive performance in demented and depressed patients.

Valentin Bragin, MD, PhD, Gary Shereshevsky(1), Ilya Bragin (1,2), Arina Gorskaya(1), Ryan Meylikh(1), Yuri Kotliarov(3), Gjumrakch Aliev(4).

  1. Stress Relief and Memory Training Center, Brooklyn, NY, USA,
  2. Upstate Medical University, Syracuse, New York, USA
  3. Trans-NIH Center for Human Immunology (CHI), National Institutes of Health (NIH) Bethesda, MD, USA
  4. Electron Microscopy Research Center, San Antonio, TX, USA

Poster presentation at the Alzheimer’s Association International Conference, Boston, 13–18 July 2013

Background:
Cardiovascular pathology and diabetes are well-documented risk factors in Alzheimer’s dementia. We postulate that diabetes coupled with cardiac problems has an additional impact on the cognitive performance in demented and depressed people. The aim of this study was to investigate differences in the cognitive profiles of the patients with cardiovascular problems, versus those with both cardiac problems and diabetes.

Methods:
A total of 134 subjects with dementia and depression (96 females, 8 males) age of 77.3 ± 5.64 (67– 90), education (12.7 ± 3.30 years) underwent cognitive testing during their initial visits to the clinic. Data was collected from the charts of patients who have at least one of the following three cardiovascular pathologies: hypertension, dyslipidemia, and coronary artery disease (CAD) and are either without diabetes (subgroup 1) or with diabetes (subgroup 2). The cognitive battery included the Mini Mental State Exam (MMSE); clock drawing (CDT), verbal fluency category (VFC) and letters (VFL) tasks; simple motor speed (SMS), reaction time (RT), and go/no-go (GNG) tests. Performance, errors and average (ms) were calculated for 60 targets in these tests. Statistical analysis included descriptive statistics and Wilcoxon signed-rank test.

Results:
All patients had depression and memory problems. The length of depression and memory loss was 37.9 ± 22.1 and 34.5 ± 20.4 months, respectively. Much of the cohort had anxiety (81.5%) and insomnia (80.45%). A significant number of patients had hypertension (85.0 %), dyslipidemia (73.9%), CAD (66.4 %), diabetes (29.6%), history of head trauma (25.9%), or stroke (17.8%). For the whole group the MMSE was 25.8 ± 4.09, CDT – 2.9 ± 1.10, VFC – 9.0 ± 3.89, and VFL – 8.1 ± 4.31. The average time was 311.9 ± 155.63 ms for SMS, 366.8 ± 155.59 ms for RT, and 476.2 ± 114.08 ms for GNG. On every cognitive test there were no statistical differences between the two subgroups.

Conclusions:
Based on these preliminary data, we could suggest that diabetes did not have an additional impact on the cognitive performance in demented depressed people with cardiovascular pathologies.

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