Kenneth G Pugh

Publications (2)9.93 Total impact

• Article: Selective impairment of frontal-executive cognitive function in african americans with cardiovascular risk factors.

  Kenneth G Pugh, Dan K Kiely, William P Milberg, Lewis A Lipsitz
  [show abstract] [hide abstract]
  ABSTRACT: To determine whether a summary cardiovascular risk score is associated with an increased risk of frontal-executive cognitive impairment. Cross-sectional study. Subjects were recruited from senior centers, senior housing complexes, and communities in the Boston metropolitan area. Forty-three predominantly female elderly African Americans. Cardiovascular risk factors were assessed during an interview and clinical examination. For each subject, the total number of cardiovascular (CV) risk factors was summed to compute a CV risk score. A battery of neuropsychological tests was administered that examined memory, visuospatial abilities, and frontal-executive functions. Cognitive test scores were transformed into domain-specific (memory, visuospatial, frontal-executive) composite z scores. Cognitive impairment for each composite z score was defined as performance less than the median for the study group. Multivariate logistic regression was used to examine the relationship between the CV risk score and the risk for cognitive impairment in the three cognitive domains of interest. After controlling for age and education, the CV risk score was associated only with frontal-executive cognitive impairment (odds ratio (OR)=2.44, 95% confidence interval (CI)=1.06-5.65). The CV risk score was not associated with the risk of memory (OR=1.30, 95% CI=0.64-2.67) or visuospatial impairment (OR=1.49, 95% CI=0.66-3.36). Greater CV risk scores were associated with an increased likelihood of having frontal-executive cognitive impairment. CV risk factors may exert a specific deleterious effect on frontal-executive cognitive abilities as opposed to memory or visuospatial functions. Associated executive dysfunction may compromise the ability of patients with CV risk factors to comply with recommendations for risk reduction.
  Journal of the American Geriatrics Society 11/2003; 51(10):1439-44. · 3.74 Impact Factor
• Source

  Available from: Lewis A Lipsitz

  Article: The microvascular frontal-subcortical syndrome of aging.

  Kenneth G Pugh, Lewis A Lipsitz
  [show abstract] [hide abstract]
  ABSTRACT: Many features of aging suggest dysfunction in both frontal and subcortical regions. Connections between the two areas form a series of pathways that critically influence various aspects of cognition, motor control, affect, and as recently discovered, normal urinary function. Age-related changes in the structure and integrity of these circuits may be associated with cognitive impairment, mood disorders, loss of balance, falls, and urinary dysfunction. In addition, cardiovascular risk factors in elderly people are associated with the development of cerebral microangiopathic changes in both the periventricular white matter and basal ganglia. These lesions are common, usually unsuspected, and were previously believed to be clinically innocuous. However, increasing evidence supports a role for these lesions as a cause for both dysfunction in frontal-subcortical systems, and many clinical features of aging that account for substantial disability. Because this form of cerebrovascular disease is potentially preventable, interventions that address risk factors for the development of cerebral microangiopathy may go a long way in preventing disability for the next generation of elderly persons.
  Neurobiology of Aging 23(3):421-31. · 6.19 Impact Factor