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P2‐086: CITICOLINE IN COGNITIVE IMPAIRMENT: AN OLD DRUG WITH NEW PERSPECTIVES
Author(s) -
Gareri Pietro,
Castagna Alberto,
Lacava Roberto,
Cotroneo Antonino Maria,
Putignano Salvatore,
De Sarro Giovambattista
Publication year - 2014
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.2014.05.760
Subject(s) - citicoline , medicine , tolerability , dementia , vascular dementia , pharmacology , neurodegeneration , cognitive decline , drug , pharmacodynamics , alzheimer's disease , neuroscience , bioinformatics , pharmacokinetics , disease , psychology , adverse effect , biology
accounting for antihypertensive medication intake.Methods:A total of 625 participants without dementia from The 90+ Study (age range 90-103) were evaluated at the baseline examination, which included cognitive and neurological assessments, sitting BP measurement, and assessment of medications. Participants’ cognitive status was re-evaluated every six months for up to 10 years (range 1 month-10 years, mean 2.8 years, standard deviation 2.0). BP readings (in mmHg) were classified as non-hypertensive (<120 systolic, <80 diastolic), pre-hypertensive (120-139 systolic or 80-89 diastolic), stage-1 hypertensive (140-159 systolic or 90-99 diastolic), and stage-2 hypertensive (160+ systolic or 100+ diastolic). Cox regression models, with age as the time scale, were used to evaluate survival until dementia diagnosis (using DSM-IV criteria). Models were adjusted for education and a dichotomous indicator for concurrent use of any antihypertensive medication.Results:At follow up examinations, 259 individuals were identified with dementia. 73.5% of participants reported current intake of antihypertensive medications. Participants with pre-hypertension had a decreased, although non significant, risk for dementia (Table). In a trend of decreasing risks, individuals with stage-1 hypertension had an even lower risk and individuals with stage-2 hypertension had the lowest risk of dementia (0.57, 95% CI 0.33-1.00, p 1⁄40.0511). A test for trend showed a significant protective effect (c 2, p 1⁄40.043) with increasing levels of hypertension. Current use of any anti-hypertensive medications was not related to dementia risk (Hazard Ratio1⁄40.96, p 1⁄40.77). Conclusions: Contrary to studies showing that hypertension is a risk factor for dementia when present at younger ages, it appears to be protective in the oldestold. The effect appears to be independent of antihypertensive medications and a dose-response is indicated. Our results suggest that, in relation to cognitive health, the current standard of care for hypertension may not be beneficial in the oldest-old.