CPY3399 - Systematic Literature Review: CVD and Cognition in Adults

This report systematically reviews the association between cardiovascular disease (CVD) and cognitive function in older adults. It details the search strategy, including keywords like "Vascular risk," "cognit*," and databases used, adhering to PRISMA guidelines. The review process involved phrase searc...Read More

Running head: CARDIOVASCULAR DISEASE AND COGNITION IN OLDER ADULT 1
Cardiovascular Disease and Cognition in Older Adult
Name
Institution

CARDIOVASCULAR DISEASE AND COGNITION IN OLDER ADULT 2
Cardiovascular Disease and Cognition in Older Adult
Introduction
In essence, the overall modification of an individual’s lifestyle factors is tipped to
improve vascular health and possibly reducing the risk of a rather cognitive decline in dementia
in the older adult. Apparently, modification of lifestyle factors including obesity, hypertension,
obesity, physical inactivity, depression, and smoking is like to reduce the overall prevalence of
Alzheimer’s diseases among the older adult. Given the recurrence of cardiovascular factor, there
are various models that have been developed that are aimed at predicting an individual’s risk of
cardiovascular diseases or stroke in future that is based on the combinations of risk factor
(D’agostino, Vasan, Pencina, Wolf, Cobain, M., Massaro, & Kannel, 2008). The aspect of
health-related co-morbidities among the older population has become highly prevalent in
contemporary society. In this light, the investigation on the effect of cardiovascular as well as
health-related risk factors on the overall cognitive function is, therefore, relevant to the
population particularly among the older adult (Stephan & Brayne, 2008). This paper intends to
discuss the general keywords that will be useful in finding the relevant article to the chosen topic
as well as describing and commenting on the search strategy that has been adopted.
Selection Criteria of Search terms and Search Strategy
Ideally, the review for this study is undertaken based on the PRISMA statement. As a
result, the combinations of the following terms were considered in the search process: “Vascular
risk”, “cardiovascular risk”, “cardiovascular health”, “stroke risk”, “ cognit*”, “dementia”,
“Framingham”, “CAIDE”, and “Alzheimer”. Notably, all these searches were restricted to those
articles that have been published in English. There is one article that was included that passed the
criteria of electronic search (SLH). As a result, the chosen articles in the review were included

CARDIOVASCULAR DISEASE AND COGNITION IN OLDER ADULT 3
based on the following criteria: the overall examined cardiovascularly or rather the assessment
models of stroke risk, the details regarding cognitive test scores which were availed at two or
even more time points, and the average longitudinal population-based design of the study at
hand.
Search Strategies
One of the apparent search strategies that w applicable for this study was phrase
searching where it allows one to search for two or more words as a rather exact phrase. Unless
one assumes otherwise, most databases are set to assume the Boolean AND connector, meaning
that all searched words have to be presented for a specific record so that it can be listed in the
overall search results. When searching a phrase using this strategy, it is always advisable to
enclose a particular search term in quotes thus retrieving fewer terms. For instance, the review
used some specific terms phrases such as the “cardiovascular health” and “Vascular risk” thus
narrowing down to specific terms in the search engines. Additionally, the review included a
search technique called truncation that is often used in a database where a word ending is
replaced by a particular symbol. In this light, the symbol that was used was the asterisk (*)
(Kaffashian, Dugravot, Elbaz, Shipley, Sabia, Kivimäki, & Singh-Manoux, 2013). The use of
truncation technique was because it allows different forms of words to be searched
simultaneously. For instance, during the search, the term that was truncated was “cognit*” thus
giving room for more searches.
During the search, there were 56, 000 publications identified, which 2,087 were mainly
duplicates and thus after the titles as well as the abstracts were reviewed particularly for the
eligibility test, about 50 publications were retained for a full-text review (Norton S, Matthews
FE, Barnes DE, Yaffe K, & Brayne 2014). In total, about 8 publications met the criteria for

CARDIOVASCULAR DISEASE AND COGNITION IN OLDER ADULT 4
inclusion and, therefore, they were retained. The main reason why the other articles were
excluded was that the articles reviewed individual cardiovascular risk factors instead of using a
cardiovascular disease risk model. Nonetheless, it was impossible to conduct a meta-analysis as a
result of the variability that lied between studies as well as the differences in the overall inclusion
of the variables that lied in the same risk model. The searched terms could then lead to a
somehow narrow down to more specific search terms.
The searched articles were often excluded if in case they only explored individual risk
factors consisted of a cross-sectional study model, or if they involved the result of the cognitive
test in the model (Dregan, Stewart, & Gulliford, 2012). However, studies were not excluded
basing on the type of cardiovascular risk model, or rather the test battery of the
neuropsychological process that is used to assess the cognitive functions. Additionally, there was
no restriction on the sample age if only it was lying based on the older adult. Two main authors
(SLH and JD) were involved with searching the articles titles as well as the abstract (Imtiaz,
Tolppanen, Kivipelto, & Soininen, 2014). When there was certainty regarding the titles and the
abstracts of the articles obtained, it was passed for further investigation. After this, there was the
retrieval of the full article to be passed to the eligibility test (Siontis, Tzoulaki, Siontis, &
Ioannidis, 2012). The relevant reviews were as well retained while the references of these articles
were reviewed in case there were missing articles. This would allow the review to contain only
the relevant information that is guided by the focused topic.
Discussion
In essence, the systematic review of the longitudinal of the study that was based on the
population of the older adult came up with a wide variety CVD that has for long time been
associated with the cognitive decline or rather future risk of the overall cognitive impairment or

CARDIOVASCULAR DISEASE AND COGNITION IN OLDER ADULT 5
even dementia (Savva, Stephan, & Alzheimer’s Society Vascular Dementia Systematic Review
Group, 2010). However, there was no doubt a large variability of the study in the study
concerning the cognitive domains. Each article that was passed for the systematic review had
different research question formulated.
Conclusion
Overall, there was an observation of a strong association of the articles that were selected
to the cardiovascular diseases as well as cognition to the older adult. While there were different
search terms in relation to the topic at hand, the narrowing down of different searched articles
was useful to the relevant articles. The searched or rather the relevant articles assisted in coming
up with a different hypothesis as well as design and measures guiding the topic at hand.

CARDIOVASCULAR DISEASE AND COGNITION IN OLDER ADULT 6
References
D’agostino, R. B., Vasan, R. S., Pencina, M. J., Wolf, P. A., Cobain, M., Massaro, J. M., &
Kannel, W. B. (2008). General cardiovascular risk profile for use in primary care: the
Framingham Heart Study. Circulation, 117(6), 743-753.
Dregan, A., Stewart, R., & Gulliford, M. C. (2012). Cardiovascular risk factors and cognitive
decline in adults aged 50 and over: a population-based cohort study. Age and Ageing,
42(3), 338-345.
Imtiaz, B., Tolppanen, A. M., Kivipelto, M., & Soininen, H. (2014). Future directions in
Alzheimer's disease from risk factors to prevention. Biochemical pharmacology, 88(4),
661-670.
Kaffashian, S., Dugravot, A., Elbaz, A., Shipley, M. J., Sabia, S., Kivimäki, M., & Singh-
Manoux, A. (2013). Predicting cognitive decline A dementia risk score vs the
Framingham vascular risk scores. Neurology, 80(14), 1300-1306.
Norton S, Matthews FE, Barnes DE, Yaffe K, & Brayne C (2014). Potential for primary
prevention of Alzheimer's disease: an analysis of population-based data. Lancet Neurol
13:788–794.
Savva, G. M., Stephan, B. C., & Alzheimer’s Society Vascular Dementia Systematic Review
Group. (2010). Epidemiological studies of the effect of stroke on incident dementia: a
systematic review. Stroke, 41(1), e41-e46.
Siontis, G. C., Tzoulaki, I., Siontis, K. C., & Ioannidis, J. P. (2012). Comparisons of established
risk prediction models for cardiovascular disease: systematic review. Bmj, 344, e3318.
Stephan BC, Brayne C (2008). Vascular factors and prevention of dementia. Int Rev Psychiatry
20:344–356.

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