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      Global cognitive function correlates with P‐wave dispersion in frail hypertensive older adults

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          Abstract

          P‐Wave Dispersion (PWD) is an ECG parameter defined as the difference between the longest and the shortest P‐Wave duration. PWD has been associated with hypertension, a leading cause of age‐related cognitive decline. Moreover, hypertension is associated with vascular dementia and Alzheimer's Disease. Based on these considerations, we evaluated PWD and global cognitive function in frail hypertensive older adults with a previous diagnosis of cognitive decline. We evaluated consecutive frail hypertensive patients ≥65‐year‐old with a Mini‐Mental State Examination (MMSE) score <26. Patients with evidence of secondary hypertension, history of stroke, myocardial infarction, or therapy with beta‐blockers or acetylcholinesterase inhibitors were excluded. Beta‐blocker therapy causes a significant decrease in PWD; patients treated with acetylcholinesterase inhibitors were not included to avoid confounding effects on cognitive function. By examining 180 patients, we found that PWD significantly correlated with MMSE score. Strikingly, these effects were confirmed in a linear multivariate analysis with a regression model. To our knowledge, this is the first study showing that PWD correlates with global cognitive function in frail hypertensive older adults.

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          "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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            The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

            The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of revising the 1984 criteria for Alzheimer's disease (AD) dementia. The workgroup sought to ensure that the revised criteria would be flexible enough to be used by both general healthcare providers without access to neuropsychological testing, advanced imaging, and cerebrospinal fluid measures, and specialized investigators involved in research or in clinical trial studies who would have these tools available. We present criteria for all-cause dementia and for AD dementia. We retained the general framework of probable AD dementia from the 1984 criteria. On the basis of the past 27 years of experience, we made several changes in the clinical criteria for the diagnosis. We also retained the term possible AD dementia, but redefined it in a manner more focused than before. Biomarker evidence was also integrated into the diagnostic formulations for probable and possible AD dementia for use in research settings. The core clinical criteria for AD dementia will continue to be the cornerstone of the diagnosis in clinical practice, but biomarker evidence is expected to enhance the pathophysiological specificity of the diagnosis of AD dementia. Much work lies ahead for validating the biomarker diagnosis of AD dementia. Copyright © 2011. Published by Elsevier Inc.
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              Frailty in elderly people

              Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. In landmark studies, investigators have developed valid models of frailty and these models have allowed epidemiological investigations that show the association between frailty and adverse health outcomes. We need to develop more efficient methods to detect frailty and measure its severity in routine clinical practice, especially methods that are useful for primary care. Such progress would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                pasquale.mone@einsteinmed.edu
                gsantulli001@gmail.com
                Journal
                J Clin Hypertens (Greenwich)
                J Clin Hypertens (Greenwich)
                10.1111/(ISSN)1751-7176
                JCH
                The Journal of Clinical Hypertension
                John Wiley and Sons Inc. (Hoboken )
                1524-6175
                1751-7176
                01 March 2022
                May 2022
                : 24
                : 5 ( doiID: 10.1111/jch.v24.5 )
                : 638-643
                Affiliations
                [ 1 ] Department of Medicine, Division of Cardiology Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research Albert Einstein College of Medicine New York City NY USA
                [ 2 ] University Campania “Luigi Vanvitelli” Naples Italy
                [ 3 ] ASL Avellino Avellino Italy
                [ 4 ] University of Naples “Federico II” Naples Italy
                [ 5 ] ASL Naples Naples Italy
                [ 6 ] International Translational Research and Medical Education (ITME) Consortium Naples Italy
                Author notes
                [*] [* ] Correspondence

                Pasquale Mone, MD and Gaetano Santulli, MD, PhD, Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York City, NY, USA.

                Email: pasquale.mone@ 123456einsteinmed.edu ; gsantulli001@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-1484-0217
                https://orcid.org/0000-0001-7231-375X
                Article
                JCH14439
                10.1111/jch.14439
                9106080
                35229449
                5fb6f8eb-9718-42be-a49b-69e648b5b2c7
                © 2022 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 18 January 2022
                : 14 December 2021
                : 19 January 2022
                Page count
                Figures: 2, Tables: 2, Pages: 6, Words: 3475
                Categories
                Original Article
                Cognitive Function
                Custom metadata
                2.0
                May 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.6 mode:remove_FC converted:13.05.2022

                cognitive function,ecg,frailty,hypertension,older adults
                cognitive function, ecg, frailty, hypertension, older adults

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