The influence of hypertension, diabetes, lipid disorders and the presence of the APOE4 allele on the cognitive functions of patients over 65 years of age.

Unlabelled: Diabetes mellitus (DM) and hypertension (HA) are common diseases in the population of people over 65 years of age. Many studies show the impact of the long-lasting decompensation of these chronic diseases, often diagnosed in middle age, on the cognitive functioning of elderly patients.

Results: There is almost 30% prevalence of cognitive impairment among patients diagnosed with arterial hypertension. Possible explanation includes intensification of inflammatory processes in the central nervous system, influence on cerebral blood flow and acceleration of atherosclerosis. Another analyzed factor is the presence of diabetes. DM impacts the development of Alzheimer's disease. The inflammatory processes are intensified by advanced glycation products promoting atherosclerotic changes in blood vessels. In addition to that, the presence of hypoglycemic episodes significantly increases the risk of dementia. Moreover, approximately 78% of adult diabetic patients are also diagnosed with arterial hypertension, resulting in the coexistence of these CNS damaging mechanisms. The effect of elevated total cholesterol concentration on cognitive performance is still under debate and more research is needed. The role of the presence of ApoE4 in the development of cognitive dysfunctions, including Alzheimer's disease is emphasized.

Conclusions: In daily medical practice, extraordinary attention should be paid to control of chronic diseases of the patient, especially in the middle age. It improves cognitive functioning, possibly extending the quality-adjusted life year expectancy.