Cognitive Disorders and Dementia in Hypertension

Abstract

Cognitive functions may be defined as mental or “thinking” functions, including all verbal and nonverbal cerebral functions involved in the processing of information: learning, memory, perception, association, abstract reasoning, planning, and so on. In normal aging, there is a slight decline of cognitive functions, especially of memory for recent daily-life events (short-term episodic memory). By contrast, dementia denotes a syndrome of persistent cognitive deterioration, severe enough to interfere with daily activities. Some 20% of all people over the age of 80 yr suffer from dementia. There are two major subgroups of dementia disorders: neurodegenerative dementia, including Alzheimer disease; and vascular dementia. The borderlines between no dementia and dementia are not clear cut. Alzheimer disease, and in some cases vascular dementia, has an insidious onset and a slowly progressive course. In early stages of Alzheimer disease, the patient is forgetful but does not otherwise fulfill the criteria for dementia. Thus, the differential diagnosis between normal aging and early dementia is often difficult. Research is now focusing on how to define early cognitive decline, and on attempts to identify potentially treatable risk factors. In our clinical practice, we have, in the last few years, encountered an increasing number of patients with mild cognitive impairment who are asking for treatment to slow down progress of this condition.