Date Approved

12-17-2020

Embargo Period

12-18-2020

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Psychology

College

College of Science & Mathematics

First Advisor

Arigo, Danielle

Second Advisor

Libon, David J.

Third Advisor

Fife, Dustin

Keywords

Alzheimer's Disease, Cognitive Impairment, Dementia, Neuropsychology, Vascular Dementia

Subject(s)

Dementia; Cardiovascular diseases in old age

Disciplines

Clinical Psychology

Abstract

Objective: Cardiovascular risks (CVR) such as hypertension and hyperlipidemia play a critical role in the emergence of dementia syndromes. Medication to treat CVR may not obviate downstream risk for cognitive change.

Methods: To examine the relation between history of treatment with medications to treat CVR and cognitive outcomes, participants were seen at time points ~7 years apart, completed neuropsychological evaluations, assessed for history of treatment with medication associated with hypertension and hyperlipidemia as indicators of CVR, and classified into 3 groups: Not Treated, Inconsistently Treated, and Consistently Treated. Regression models associating neuropsychological outcome measures of cognition and CVR were explored and refined within a "test dataset," and analyses were replicated using an independent "validation dataset."

Result: Most outcome measures were not significant, including episodic memory and executive tests. A main effect was found for hypertension for the Similarities subtest and the Digit Symbol Test; participants with no hypertension treatment history obtained better scores compared to other groups. While some measures were sensitive to impairment, MRI parameters were not associated with CVR indicators.

Conclusion: Between group differences on outcome measures of cognition were detectable in the presence of well-controlled blood pressure, indicating that downstream cognitive consequences persist in the presence of intervention for hypertension.

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