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P4–151: Visit‐to‐visit blood pressure variability and cognitive decline in Alzheimer's disease: Sub‐analysis of results of the EXPECT trial
Author(s) -
Shin Joon Hyun,
Choi Seong
Publication year - 2013
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2013.05.1542
Subject(s) - clinical dementia rating , dementia , medicine , blood pressure , mini–mental state examination , neurocognitive , vascular dementia , cardiology , physical therapy , disease , cognition , psychiatry
Background: In recent studies, bloodpressurevariability (BPV) and cerebral autoregulation are associated with vascular dementia. However, the relationships between BPV and Alzheimer’s disease are obscure yet. Methods: This is a sub-analysis of Exelon Patch and combination with mEmantine Comparative Trial (EXPECT), a multicenter prospective randomized open-label study. Subjects for enrollment were selected from 206 patients with 5 time of measurement of blood pressure during EXPECT trial. Standard deviation (SD) and coefficient of variance (CV) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were used as BPV parameters. The baseline and end of study scores of Korean Mini-Mental State Examination (K-MMSE), Clinical Dementia Rating (CDR) scale and other neurocognitive measures and functional status such as the Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-cog), Frontal Assessment Battery (FAB), Caregiver-Administered Neuropsychiatric Inventory (CGANPI-12), the Korean version of the Cohen Mansfield Agitation Inventory (CMAI-K) and the Alzheimer’s Disease Cooperative Study-ADL (ADCSADL) were compared with BPV parameters. Results: The study consisted of 145 patients (32 men; age 74.3767.64). In the bivariate analysis, DBPCV was correlated with final K-MMSE score, final ADAS-Cog score, and changes of K-MMSE score as well as the changes of ADCS-ADL score. SBPSD was also correlated with the changes of ADCS-ADL score. In the linear regression analysis, the final K-MMSE score and the changes of KMMSE score was only correlated with DBP-CVand the changes of ADCSADLS score was correlated with only SBP-SD. Conclusions: BPV, especially DBP variability in Alzheimer’s Disease may has correlation with poor cognitive function and rapid progressive of cognitive dysfunction.