title: Relationship between cognitive impairment and apparent diffusion coefficient values from magnetic resonance-diffusion weighted imaging in elderly hypertensive patients.
abstract: BACKGROUND
  The purpose of this study was to determine a new method for the early diagnosis and assessment of mild cognitive impairment in elderly individuals with hypertension. Elderly hypertensive patients with cognitive impairment were assessed by the Montreal Cognitive Assessment (MoCA) and Clinical Dementia Rating Assessment (CDR). Cognitive results were compared to apparent diffusion coefficient (ADC) values from magnetic resonance-diffusion weighted imaging.
  
  
  METHODS
  A total of 191 patients were categorized into four groups: a control group (normal cognition and no hypertension; n=20); a normal group (hypertension and normal cognition; n=33); an mild cognitive impairment group (n=80); and a vascular dementia group (n=58). The MoCA and CDR tests were used to determine cognition. ADC values in eight brain regions were calculated with magnetic resonance-diffusion weighted imaging. Other characteristics were evaluated, eg, blood pressure, MoCA, and CDR scores, and the comparisons of the four groups were made.
  
  
  RESULTS
  The MoCA and CDR scores differed among the four groups (P<0.001). Systolic and diastolic blood pressure values increased as cognitive function declined (P<0.001). Cognitive function declined as ADC values increased, and they differed between elderly people with and without hypertension (P<0.001). Among elderly hypertensive participants, ADC values were significantly increased in the cortex and hippocampus.
  
  
  CONCLUSIONS
  The MoCA and CDR tests were sufficiently sensitive to evaluate cognition. Blood pressure was closely related to cognition, as well as to functional and structural changes in the brain. These alterations were evidenced through changes in the ADC values and were most obvious in the cortex and hippocampus. Greater cognitive decline was observed in elderly participants with hypertension compared to those without. As hypertensive stage increased, greater ADC values were observed.
authors.affiliation: Emergency Department, Huashan Hospital North, Fudan University, Shanghai, People's Republic of China.
authors.forename: Yanwei
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Emergency Department, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.affiliation: Cardiology Division, Huashan Hospital North, Fudan University, Shanghai, People's Republic of China ; Cardiology Division, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Haiming
authors.initials: H
authors.lastname: Shi
authors.affiliation: Emergency Department, Huashan Hospital North, Fudan University, Shanghai, People's Republic of China.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: Xia
authors.affiliation: Cardiology Division, Huashan Hospital North, Fudan University, Shanghai, People's Republic of China ; Cardiology Division, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Sun
mesh_terms: D000368:Aged; D002681:China; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests
keywords: Clinical Dementia Rating Assessment; Montreal Cognitive Assessment; hypertension; mild cognitive impairment
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