Poster Presentations P3 S477

P3-091 AMBULATORY BLOOD PRESSURE AND

COGNITIVE FUNCTION IN NONDEMENTED

OLDER ADULTS: FINDINGS OF THE MARACAIBO

AGING STUDY

Carmen A. Gonzalez-Rojas1, Gloria Pino-Ramirez1,2,

Angelica G. Partida1, Egle R. Silva1, Gladys E. Maestre1,3, 1University of

Zulia, Maracaibo, Venezuela; 2Rafael Urdaneta University, Maracaibo,Venezuela; 3Columbia University, New York, NY, USA.

Contact e-mail: gonzalez.rojas.carmen@gmail.com

Background: Little is known about the influence of day/night blood pres-

sure (BP) variations on specific cognitive functions. The goal of this

study was to determine the effects of levels and variation in blood pres-

sure, assessed by ambulatory blood pressure monitoring (ABPM), on spe-

cific cognitive domains in healthy, non-demented, community dwelling

elders. A comprehensive battery of neuropsychological tests was used

to evaluate cognitive functions. Methods: 400 female and 195 male par-

ticipants of the Maracaibo Aging Study (MAS) underwent ABPM with

Spacelabs 90207 monitors for 24 h. The subjects also underwent neuro-

psychological, neuropsychiatric, physical assessments, and laboratory

tests that included total plasma homocysteine (Hcy), clinical chemistry,

and ApoE genotyping. Multiple regression models were used to evaluate

relationships between results of cognitive tests and BP parameters. Re-

sults: Sitting casual and median 24-h diastolic blood pressure (DBP)

but not systolic blood pressure (SBP), were significantly lower in women

than men. 75.5% of women and 77.7% of men had high blood pressure

(>140/90 mmHg); 43.2% of women and 29% of men had isolated sys-

tolic hypertension (>140/10% nocturnal drop in SBP were classified as

dippers, which included 23.8% of women and 33.3% of men (p ¼0.02). After adjustment for age, education, Hcy, and ApoE-e4 status,

there were significant gender differences in the associations between cog-

nitive functions and blood pressure parameters. In women, scores on

BVRT Matching and delayed recall tests had significant negative correla-

tions with 24 h and nocturnal SBP. In men, BVRT Matching scores, but

not delayed recall tests, were correlated with nocturnal SBP. Male dippers

had higher scores than non-dippers in the tests of similarities, BVRT

Matching, and delayed recognition, but female dippers and non-dippers

did not exhibit different performances in any of the cognitive variables.

Conclusions: Specific cognitive functions were related to median day

and night SBP and DBP, assessed by ABPM, but the relationships dif-

fered between genders. Reduced nocturnal BP drop was associated with

specific cognitive deficits in men. Further studies are required to clarify

the mechanisms underlying these findings.

P3-092 SEVERITY OF DIABETES AND SHORT-TERM RISK

OF DEMENTIA IN MIDDLE AGED MEN: THE

CALIFORNIA MEN’S HEALTH STUDY

Rachel A. Whitmer, Valerie Crooks, Stephen Van Den Eeden,

Charles P. Quesenberry, Barbara Sternfeld, Bette J. Caan, Kaiser Perma-nente Division of Research, Oakland, CA, USA. Contact e-mail: raw@dor.

kaiser.org

Background: Although elderly individuals with diabetes are at a greater

risk of dementia, less is known about the control and/or management of

diabetes and the short term risk of dementia in middle aged individuals.

The goal of this study was to evaluate diabetes severity and short term

risk of dementia in a large cohort of middle aged men. Methods: We

evaluated the association between diabetes severity (type of treatment

and glycosylated hemoglobin {HbA1c}) and risk of dementia among

31,631 participants in the California Men’s Health Study, a prospective

cohort of Northern California Kaiser Permanente (KP) members, ages

45-69 (mean age 58), initiated in 2002. Sociodemographic variables

were collected via questionnaire, while diabetes information was gathered

from the KP Diabetes Registry. Initial diagnoses of dementia were col-

lected from medical records in primary care, neurology, and neuropsychol-

ogy from 2003-2007. Cox proportional hazard models adjusted for age,

race, education, marital status, body mass index, smoking, heart disease

and stroke were used to investigate the association between diabetes sever-

ity and four year risk of dementia. Results: Fourteen percent of the par-

ticipants had diabetes (4544) and 332 were diagnosed with dementia

during the follow-up. Those with diabetes had a 72% greater risk of de-

mentia (adjusted hazards ratio {aHR} ¼ 1.72, 95% confidence intervals

{CI}, 1.33,2.19) versus those without diabetes. Those with diabetes and

insulin treated had nearly a 300% greater risk of dementia (aHR ¼3.99, 95% CI 2.21, 7.21); those with diabetes and using oral medications

a non-significant 36% greater risk (aHR ¼ 1.36, 95% CI 0.93, 2.1) and

those being treated for diabetes with behavioral changes a 40% non-signif-

icant risk increase (aHR ¼ 1.40, 95% CI 0.89, 2.1) versus those without

diabetes. Those with evidence of glycemic control (HbA1c < 7) had

a 50% greater risk (aHR ¼ 1.53, 95% CI 1.03, 2.28) versus those without

diabetes; while those with evidence of poor glycemic control (HbA1c � 9)

a 86% greater risk (aHR ¼ 1.86, 95% CI 1.1, 3.46). Conclusions: Even in

middle-age, diabetes severity is associated with increased short term risk

of dementia. Future studies should evaluate the role of diabetes control

on brain health.

P3-093 APOE EPSILON 4 ALLELE STATUS IN DEMENTIA

PATIENTS WITH SEVERE WHITE MATTER

CHANGE

Yun Jeong Hong1, Bora Yoon2, A-Hyun Cho1, Yong Soo Shim1,

Sung Chul Lim1, Yeong-In Kim1, Dong Won Yang1, 1Catholic University of

Korea, Seoul, Korea; 2Konyang University of Korea, Daejeon, Korea.Contact e-mail: hyj2009@hanmail.net

Background: The e4 allele of the APOE gene is known to be associated with

greater risk of AD. It also develops atherosclerosis, coronary heart disease,

hyperlipidemia and may also act as a risk factor of cerebrovascular disease.

There have been few studies that investigated the APOE e4 allele status in

dementia patients with severe white matter changes. This study aims to char-

acterize dementia patients with severe vascular damages with Apo E epsilon

genotype and clinical features. Methods: Out of 4500 subjects in the data

base, 438 patients with dementia and 152 normal controls were recruited.

This study was performed using data from multicenter study for dementia

in South Korea, named as the Clinical REsearch center for Dementia Of

South korea (CREDOS) initiated from November 2005. Patients were clas-

sified into three groups (mild, moderate, and severe) according to the degree

of white matter changes. Patients with mild white matter change were consid-

ered as AD (325 patients), and those with severe white matter change were

considered as SIVD (Subcortical Ischemic Vascular Dementia, 50 patients)

or mixed dementia (63 patients) according to the presence of neurologic

signs. Comparisons of APOE e4 allelic prevalence were made using chi-

square analysis. Results: APOE e4 allele was more prevalent in patients

with AD and mixed dementia than those with SIVD and normal controls

(p < 0.05). APOE e4 allele in the patients with neurologic signs (SIVD)

was not more prevalent than that in normal controls. Conclusions: APOE

e4 allele status of SIVD was not different from that of normal controls. De-

mentia with severe white matter changes may be heterogenous group which

includes pure SIVD and AD with vascular pathologies. We demonstrated the

prevalence of APOE e4 allele is different according to the presence of neu-

rologic signs in dementia patients with severe white matter changes.

P3-094 NEUROPSYCHOLOGICAL PERFORMANCE AND

DEMOGRAPHIC VARIABLES PREDICT FAMILIAL

ALZHEIMER GENETIC STATUS IN A SPANISH

SPEAKING SAMPLE

Christopher Nunez1, Xavier E. Cagigas1, Luis Medina2,

Yaneth Rodriguez-Agudelo3, Giovanni Coppola4, Jeffrey L. Cummings2,

John M. Ringman2, 1UCLA, Los Angeles, CA, USA; 2Easton Center for

Alzheimer’s Disease Research at UCLA, Los Angeles, CA, USA; 3National