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Cognition and Chronic Disease

  • John E. Morley
    Correspondence
    Address correspondence to John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S Grand Blvd, M238, St. Louis, MO 63104.
    Affiliations
    Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
    Search for articles by this author
      There is increasing evidence that in middle-aged and older persons, chronic diseases are associated with cognitive dysfunction.
      • Gonzalez-Colaco Harmand M.
      • Meillon C.
      • Rullier L.
      • et al.
      Cognitive decline after entering a nursing home: A 22-year follow-up study of institutionalized and noninstitutionalized elderly people.
      Both congestive heart failure and atrial fibrillation have been strongly associated with cognitive decline.
      • Ampadu J.
      • Morley J.E.
      Heart failure and cognitive dysfunction.
      • Hui D.S.
      • Morley J.E.
      • Mikolajczak P.C.
      • Lee R.
      Atrial fibrillation: A major risk factor for cognitive decline.
      In this issue of the Journal, a meta-analysis found that mild cognitive impairment (MCI) was present in 35% of persons with congestive heart failure with a mean age of 75.3 years.
      • Yohannes A.M.
      • Chen W.
      • Moga A.M.
      • et al.
      Cognitive impairment in chronic obstructive pulmonary disease and chronic heart failure: A systematic review and meta-analysis of observational studies.
      Persons undergoing coronary artery bypass surgery demonstrate postoperative cognitive impairment 6 months after surgery.
      • Perez-Belmonte L.M.
      • San Roman-Teran C.M.
      • Jimenez-Navarro M.
      • et al.
      Assessment of long-term cognitive impairment after off-pump coronary-artery bypass grafting and related risk factors.
      Lower levels of the ankle-brachial index are associated with cognitive impairment and increased risk of progression to MCI.
      • Espeland M.A.
      • Newman A.B.
      • Sink K.
      • et al.
      LIFE study group
      Associations between ankle-brachial index and cognitive function: Results from the lifestyle interventions and independence for elders trial.
      Cognitive impairment, which is unrecognized, is associated with a greater risk of hospital readmissions.
      • Agarwal K.S.
      • Kazim R.
      • Xu J.Q.
      • et al.
      Unrecognized cognitive impairment and its effect on heart failure readmissions of elderly adults.
      All of these findings correlate well with the evidence that white matter hyperintensities (leukoaraiosis) are in important cause of cognitive impairment.
      • Morley J.E.
      White matter lesion (leukoaraiosis): A major cause of falls.
      • Ogama N.
      • Sakurai T.
      • Shimizu A.
      • Toba K.
      Regional white matter lesions predict falls in patients with amnestic mild cognitive impairment and Alzheimer’s disease.
      • Ferriera J.P.
      • Kearney Schwartz A.
      • Wafta G.
      • et al.
      Memory alterations and white matter hyperintensities in elderly hypertensive patients: The ADELAHYDE-2 study.
      • Morley J.E.
      • Farr S.A.
      Alzheimer mythology: A time to think out of the box.
      Persons with leukoaraiosis are also more likely to have cognitive motoric syndrome or cognitive frailty.
      • Wu Y.H.
      • Liu L.K.
      • Chen W.T.
      • et al.
      Cognitive function in individuals with physical frailty but without dementia or cognitive complaints: Results from the I-Lan Longitudinal Aging study.
      • Dartigues J.F.
      • Amieva H.
      Cognitive frailty: Rational and definition from an (I.A.N.A./I.A.G.G.) International consensus group.
      • Morley J.E.
      Cognitive frailty: A new geriatric syndrome?.
      • Doi T.
      • Verghese J.
      • Shimada H.
      • et al.
      Motoric cognitive risk syndrome: Prevalence and risk factors in Japanese seniors.
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        Heart failure and cognitive dysfunction.
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        Unrecognized cognitive impairment and its effect on heart failure readmissions of elderly adults.
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        White matter lesion (leukoaraiosis): A major cause of falls.
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