1
|
Kalisvaart ACJ, Abrahart AH, Coney AT, Gu S, Colbourne F. Intracranial Pressure Dysfunction Following Severe Intracerebral Hemorrhage in Middle-Aged Rats. Transl Stroke Res 2023; 14:970-986. [PMID: 36367666 PMCID: PMC10640482 DOI: 10.1007/s12975-022-01102-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/14/2022] [Accepted: 11/02/2022] [Indexed: 11/13/2022]
Abstract
Rising intracranial pressure (ICP) aggravates secondary injury and heightens risk of death following intracerebral hemorrhage (ICH). Long-recognized compensatory mechanisms that lower ICP include reduced cerebrospinal fluid and venous blood volumes. Recently, we identified another compensatory mechanism in severe stroke, a decrease in cerebral parenchymal volume via widespread reductions in cell volume and extracellular space (tissue compliance). Here, we examined how age affects tissue compliance and ICP dynamics after severe ICH in rats (collagenase model). A planned comparison to historical young animal data revealed that aged SHAMs (no stroke) had significant cerebral atrophy (9% reduction, p ≤ 0.05), ventricular enlargement (9% increase, p ≤ 0.05), and smaller CA1 neuron volumes (21%, p ≤ 0.05). After ICH in aged animals, contralateral striatal neuron density and CA1 astrocyte density significantly increased (12% for neurons, 7% for astrocytes, p ≤ 0.05 vs. aged SHAMs). Unlike young animals, other regions in aged animals did not display significantly reduced cell soma volume despite a few trends. Nonetheless, overall contralateral hemisphere volume was 10% smaller in aged ICH animals compared to aged SHAMs (p ≤ 0.05). This age-dependent pattern of tissue compliance is not due to absent ICH-associated mass effect (83.2 mm3 avg. bleed volume) as aged ICH animals had significantly elevated mean and peak ICP (p ≤ 0.01), occurrence of ICP spiking events, as well as bilateral evidence of edema (e.g., 3% in injured brain, p ≤ 0.05 vs. aged SHAMs). Therefore, intracranial compliance reserve changes with age; after ICH, these and other age-related changes may cause greater fluctuation from baseline, increasing the chance of adverse outcomes like mortality.
Collapse
Affiliation(s)
| | - Ashley H Abrahart
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
| | - Alyvia T Coney
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
| | - Sherry Gu
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Frederick Colbourne
- Department of Psychology, University of Alberta, Edmonton, AB, Canada.
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
2
|
Li X, Shi Y, Zhao D, Jin K, Zhu J, Wang Y. Unmet needs for rehabilitation service of middle-aged and older adult residents in Chengdu, Sichuan, China: A cross-sectional study. Sci Rep 2023; 13:11989. [PMID: 37491428 PMCID: PMC10368734 DOI: 10.1038/s41598-023-38960-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/18/2023] [Indexed: 07/27/2023] Open
Abstract
To investigate the unmet needs for rehabilitation services among middle-aged and older adults in Chengdu, Sichuan, China, and identify the associated factors. This cross-sectional study was conducted on middle-aged and older adults in Chengdu, Sichuan, China, between 2015 and 2016. The questionnaire included demographic data and questions about rehabilitation needs. Multivariable logistic regression analysis was used to identify the associated factors of unmet needs for rehabilitation services. Among 663 participants, 91.70% needed medical rehabilitation (608/663), 26.55% of who need auxiliary equipment (176/663), 77.07% of who need daily care and social participation (511/663), and 79.34% of who need recreational therapy activities (526/663), while < 30% required auxiliary equipment. Multivariate logistic regression analysis showed that residents who were married, had annual income < CNY 80,000, had no medical insurance, had three or more health problems, were aged ≥ 60, and the disability status were independently associated with unmet needs for rehabilitation services (all P < 0.05). Marital status, annual income, medical insurance, health problems, and disability might be factors independently associated with the unmet needs for rehabilitation services. Attention should be paid to the financial burden of the population on rehabilitation services, and in addition to the disabled, the slow patients should also be given priority.
Collapse
Affiliation(s)
- Xichun Li
- Department of Rehabilitation Medicine, Chengfei Hospital, Chengdu, 610073, People's Republic of China
| | - Yingxi Shi
- Department of Medical Oncology, School of Medicine UESTC, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China
| | - Dan Zhao
- Department of Medical Oncology, School of Medicine UESTC, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China
| | - Ke Jin
- Department of Medical Oncology, School of Medicine UESTC, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China
| | - Jianmei Zhu
- Department of Medical Oncology, School of Medicine UESTC, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China
| | - Ying Wang
- Department of Medical Oncology, School of Medicine UESTC, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China.
| |
Collapse
|
3
|
Ribeiro FS, Crivelli L, Leist AK. Gender inequalities as contributors to dementia in Latin America and the Caribbean: what factors are missing from research? THE LANCET. HEALTHY LONGEVITY 2023:S2666-7568(23)00052-1. [PMID: 37182531 DOI: 10.1016/s2666-7568(23)00052-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 05/16/2023] Open
Abstract
The current knowledge of modifiable risk factors for dementia comes mainly from high-income countries. In Latin America and Caribbean countries, where the burden of gender and socioeconomic inequalities is greater than in high-income countries, the prevalence of dementia is also higher and disease onset is earlier, especially among women, even after adjustments for life expectancy. In this Personal View, we discuss socioeconomic modifiable risk factors for dementia established by previous studies and postulate further harmful and often hidden factors faced by women that might influence the gender-specific timing of onset and general prevalence of dementia. We emphasise some of the effects of gender roles, their direct and indirect effects on dementia, and how they disproportionately impact women. Finally, we highlight the importance of bringing hidden risk factors to open discussion to promote research with high-quality data and to encourage public policies to promote and preserve women's health.
Collapse
Affiliation(s)
- Fabiana S Ribeiro
- Department of Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Lucía Crivelli
- Department of Cognitive Neurology, FLENI, Buenos Aires, Argentina
| | - Anja K Leist
- Department of Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| |
Collapse
|
4
|
Shimada H, Bae S, Harada K, Makino K, Chiba I, Katayama O, Lee S. Association between driving a car and retention of brain volume in Japanese older adults. Exp Gerontol 2023; 171:112010. [PMID: 36336251 DOI: 10.1016/j.exger.2022.112010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/23/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Driving cessation is a major negative life event that has been associated with a decline in health conditions including dementia. The increase in activity owing to the expansion of life space is a possible explanation for the positive relationship between driving and brain health. The present study examined the association between driving, life space, and structural brain volume in older individuals. METHODS High-resolution magnetic resonance imaging was employed to examine the brain volume in 1063 older adults. Participants were classified as non-drivers, those who drove <7 days a week, and everyday drivers. They were further classified into a non-driving group, an active group (drove 10 km at least once a week), and a less-active group (drove 10 km less than once a week). RESULTS The hippocampal volume was greater in drivers than in non-drivers. Occipital cortex volume was greater in low-frequency drivers than in non-drivers and high-frequency drivers. Active drivers exhibited larger temporal cortex volumes than less-active drivers, larger cingulate cortex volumes than non-drivers and less-active drivers, and larger hippocampal volumes than non-drivers. CONCLUSION Driving was associated with hippocampal brain atrophy attenuation, with active drivers exhibiting decreased brain atrophy in the temporal and cingulate cortices.
Collapse
Affiliation(s)
- Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan.
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| |
Collapse
|
5
|
Min KD, Kim JS, Park YH, Shin HY, Kim C, Seo SW, Kim SY. New assessment for residential greenness and the association with cortical thickness in cognitively healthy adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 778:146129. [PMID: 33714817 DOI: 10.1016/j.scitotenv.2021.146129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/26/2021] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Recent evidence suggests that neurological health could be improved with the intervention of local green space. A few studies adopted cortical thickness, as an effective biomarker for neurodegenerative disorder, to investigate the association with residential greenness. However, they relied on limited data sources, definitions or applications to assess residential greenness. Our cross-sectional study assessed individual residential greenness using an alternative measure, which provides a more realistic definition of local impact and application based on the type of area, and investigated the association with cortical thickness. METHODS The study population included 2542 subjects who participated in the medical check-up program at the Health Promotion Center of the Samsung Medical Center in Seoul, Korea, from 2008 to 2014. The cortical thickness was calculated by each of the four and global lobes from brain MRI. For greenness, we used the enhanced vegetation index (EVI) that detects canopy structural variation by adjusting background noise based on satellite imagery data. To assess individual exposure to residential greenness, we computed the maximum annual EVI before the date of a medical check-up and averaged it within 750 m from subjects' homes to represent an average walking distance. Finally, we assessed the association with cortical thickness by urban and non-urban populations using multiple linear regression adjusting for individual characteristics. RESULTS The average global cortical thickness and EVI were 3.05 mm (standard deviation = 0.1 mm) and 0.31 (0.1), respectively. An interquartile range increase in EVI was associated with 11 μm (95% confidence interval = 3-20) and 9 μm (1-16) increases in cortical thickness of the parietal and occipital regions among the urban population. We did not find associations in non-urban subjects. CONCLUSIONS Our findings confirm the association between residential greenness and neurological health using alternative exposure assessments, indicating that high exposure to residential greenness can prevent neurological disorders.
Collapse
Affiliation(s)
- Kyung-Duk Min
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Ji Sun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yu Hyun Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hee Young Shin
- Health Promotion Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea.
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
| |
Collapse
|
6
|
GIPSON CD, BIMONTE-NELSON HA. Interactions between reproductive transitions during aging and addiction: promoting translational crosstalk between different fields of research. Behav Pharmacol 2021; 32:112-122. [PMID: 32960852 PMCID: PMC7965232 DOI: 10.1097/fbp.0000000000000591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Discovery of neural mechanisms underlying neuropsychiatric disorders within the aging and addiction fields has been a main focus of the National Institutes of Health. However, there is a dearth of knowledge regarding the biological interactions of aging and addiction, which may have important influences on progression of disease and treatment outcomes in aging individuals with a history of chronic drug use. Thus, there is a large gap in these fields of research, which has slowed progress in understanding and treating substance use disorders (SUDs) as well as age-related diseases, specifically in women who experience precipitous reproductive cycle transitions during aging. The goal of this review is to highlight overlap of SUDs and age-related processes with a specific focus on menopause and smoking, and identify critical gaps. We have narrowed the focus of the review to smoking, as the majority of findings on hormonal and aging influences on drug use have come from this area of research. Further, we highlight female-specific issues such as transitional menopause and exogenous estrogen use. These issues may impact drug use cessation as well as outcomes with aging and age-related neurodegenerative diseases in women. We first review clinical studies for smoking, normal aging, and pathological aging, and discuss the few aging-related studies taking smoking history into account. Conversely, we highlight the dearth of clinical smoking studies taking age as a biological variable into account. Preclinical and clinical literature show that aging, age-related pathological brain disease, and addiction engage overlapping neural mechanisms. We hypothesize that these putative drivers interact in meaningful ways that may exacerbate disease and hinder successful treatment outcomes in such comorbid populations. We highlight areas where preclinical studies are needed to uncover neural mechanisms in aging and addiction processes. Collectively, this review highlights the need for crosstalk between different fields of research to address medical complexities of older adults, and specifically women, who smoke.
Collapse
Affiliation(s)
- Cassandra D. GIPSON
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY
- Arizona Alzheimer’s Consortium
| | | |
Collapse
|
7
|
Tai Chi Training Evokes Significant Changes in Brain White Matter Network in Older Women. Healthcare (Basel) 2020; 8:healthcare8010057. [PMID: 32182844 PMCID: PMC7151065 DOI: 10.3390/healthcare8010057] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Cognitive decline is age relevant and it can start as early as middle age. The decline becomes more obvious among older adults, which is highly associated with increased risk of developing dementia (e.g., Alzheimer’s disease). White matter damage was found to be related to cognitive decline through aging. The purpose of the current study was to compare the effects of Tai Chi (TC) versus walking on the brain white matter network among Chinese elderly women. Methods: A cross-sectional study was conducted where 42 healthy elderly women were included. Tai Chi practitioners (20 females, average age: 62.9 ± 2.38 years, education level 9.05 ± 1.8 years) and the matched walking participants (22 females, average age: 63.27 ± 3.58 years, educational level: 8.86 ± 2.74 years) underwent resting-state functional magnetic resonance imaging (rsfMRI) scans. Diffusion tensor imaging (DTI) and graph theory were employed to study the data, construct the white matter matrix, and compare the brain network attributes between the two groups. Results: Results from graph-based analyses showed that the small-world attributes were higher for the TC group than for the walking group (p < 0.05, Cohen’s d = 1.534). Some effects were significant (p < 0.001) with very large effect sizes. Meanwhile, the aggregation coefficient and local efficiency attributes were also higher for the TC group than for the walking group (p > 0.05). However, no significant difference was found between the two groups in node attributes and edge analysis. Conclusion: Regular TC training is more conducive to optimize the brain functioning and networking of the elderly. The results of the current study help to identify the mechanisms underlying the cognitive protective effects of TC.
Collapse
|
8
|
Gyanwali B, Shaik MA, Tan CS, Vrooman H, Venketasubramanian N, Chen C, Hilal S. Mixed-location cerebral microbleeds as a biomarker of neurodegeneration in a memory clinic population. Aging (Albany NY) 2019; 11:10581-10596. [PMID: 31767809 PMCID: PMC6914397 DOI: 10.18632/aging.102478] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/08/2019] [Indexed: 11/25/2022]
Abstract
Cerebral microbleeds (CMBs) in the lobar and deep locations are associated with two distinct pathologies: cerebral amyloid angiopathy and hypertensive arteriopathy. However, the role of mixed-location CMBs in neurodegeneration remains unexplored. We investigated the associations between strictly lobar, strictly deep and mixed-location CMBs with markers of neurodegeneration. This study recruited 477 patients from a memory clinic who underwent 3T MRI scans. CMBs were categorized into strictly lobar, strictly deep and mixed-location. Cortical thickness, white matter volume and subcortical structural volumes were quantified using Free-Surfer. Linear regression models were performed to assess the association between CMBs and cerebral atrophy, and the mean difference (β) and 95% confidence intervals (CIs) were reported. In the regression analyses, mixed-location CMBs were associated with smaller cortical thickness of limbic region [β= -0.01; 95% CI= -0.02, -0.00, p=0.007) as well as with smaller accumbens volume [β= -0.01; 95% CI= -0.02, -0.00, p=0.004) and presubiculum region of hippocampus [β= -0.01; 95% CI= -0.02, -0.00, p=0.002). Strictly lobar CMBs were associated with smaller total white matter volume [β= -0.03; 95% CI= -0.04, -0.01, p<0.001] and with region specific white matter volumes. The underlying mechanism requires further research and may involve shared mechanisms of vascular dysfunction and neurodegeneration.
Collapse
Affiliation(s)
- Bibek Gyanwali
- Memory Aging and Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Muhammad Amin Shaik
- Ageing Research Institute for Society and Education, Nanyang Technological University, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Henri Vrooman
- Departments of Radiology and Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Christopher Chen
- Memory Aging and Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Saima Hilal
- Memory Aging and Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Departments of Epidemiology and Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
9
|
Morsund ÅH, Ellekjær H, Gramstad A, Reiestad MT, Midgard R, Sando SB, Jonsbu E, Næss H. The development of cognitive and emotional impairment after a minor stroke: A longitudinal study. Acta Neurol Scand 2019; 140:281-289. [PMID: 31265131 DOI: 10.1111/ane.13143] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 06/05/2019] [Accepted: 06/26/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To study the development of cognitive and emotional symptoms between 3 and 12 months after a minor stroke. MATERIAL AND METHODS We included patients from stroke units at hospitals in the Central Norway Health Authority and from Haukeland University Hospital. We administered a selection of cognitive tests, and the patients completed a questionnaire 3 and 12 months post-stroke. Cognitive impairment was defined as impairment of ≥2 cognitive tests. RESULTS A total of 324 patients completed the 3-month testing, whereas 37 patients were lost to follow-up at 12 months. The results showed significant improvement of cognitive function defined as impairment of ≥2 cognitive tests (P = .03) from months 3 to 12. However, most patients still showed cognitive impairment at 12 months with a prevalence of 35.4%. There is significant association between several of the cognitive tests and hypertension and smoking (P = .002 and .05). The prevalence of depression, but not anxiety, increased from 3 to 12 months (P = .04). The prevalence of fatigue did not change and was thus still high with 29.5% after 12 months. CONCLUSIONS This study shows that an improvement of cognitive function still occurs between 3 and 12 months. Despite this, the prevalence of mostly minor cognitive impairment still remains high 12 months after the stroke. The increasing prevalence of depressive symptoms highlights the importance of being vigilant of depressive symptoms throughout the rehabilitation period. Furthermore, high prevalence of fatigue persisted.
Collapse
Affiliation(s)
- Åse H. Morsund
- Department of Neurology Møre and Romsdal Health Trust, Molde Hospital Molde Norway
- Department of Neuromedicine and Movement Science Norwegian University of Science and Technology Trondheim Norway
| | - Hanne Ellekjær
- Department of Neuromedicine and Movement Science Norwegian University of Science and Technology Trondheim Norway
- Stroke Unit, Department of Internal Medicine, St Olav's Hospital University Hospital of Trondheim Trondheim Norway
| | - Arne Gramstad
- Department of Neurology Haukeland University Hospital Bergen Norway
- Department of Biological and Medical Psychology University of Bergen Bergen Norway
| | - Magnus T. Reiestad
- Department of Psychiatry Møre and Romsdal Health Trust, Molde Hospital Molde Norway
| | - Rune Midgard
- Department of Neurology Møre and Romsdal Health Trust, Molde Hospital Molde Norway
- Unit for Applied Clinical Research Norwegian University of Science and Technology Trondheim Norway
| | - Sigrid B. Sando
- Department of Neuromedicine and Movement Science Norwegian University of Science and Technology Trondheim Norway
- Department of Neurology, St Olavs Hospital University Hospital of Trondheim Trondheim Norway
| | - Egil Jonsbu
- Department of Psychiatry Møre og Romsdal Health Trust Molde Norway
- Department of Mental Health Norwegian University of Science and Technology Trondheim Norway
| | - Halvor Næss
- Department of Neurology Haukeland University Hospital Bergen Norway
- Centre for Age‐related Medicine Stavanger University Hospital Stavanger Norway
- Institute of Clinical Medicine University of Bergen Bergen Norway
| |
Collapse
|
10
|
Filippi M, Preziosa P, Rocca MA. Brain mapping in multiple sclerosis: Lessons learned about the human brain. Neuroimage 2019; 190:32-45. [DOI: 10.1016/j.neuroimage.2017.09.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/07/2017] [Accepted: 09/09/2017] [Indexed: 02/07/2023] Open
|
11
|
Rathi S, Chopra M, Chouduri G, Sharma P, Madan K, Chhabra M, Rai RR, Govil A, Konar A, Goenka M, Agarwal M, Mukherjee J, Thorat V, Salunkhe S, Abraham P, Nagral A, Jhaveri A, Bhat N, Varghese J, R.S. A, Ravishankar, Reddy DC, Dhiman RK. Prevalence of Minimal Hepatic Encephalopathy in Patients With Liver Cirrhosis: A Cross-Sectional, Clinicoepidemiological, Multicenter, Nationwide Study in India: The PREDICT Study. J Clin Exp Hepatol 2019; 9:476-483. [PMID: 31516264 PMCID: PMC6728606 DOI: 10.1016/j.jceh.2018.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 09/19/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The study aimed at assessing the prevalence and clinical profile of minimal hepatic encephalopathy (MHE) in patients with cirrhosis using neuropsychological assessment and at understanding the management practices of MHE in the Indian clinical setting. METHODS This cross-sectional, clinicoepidemiological study conducted at 20 sites enrolled liver cirrhosis patients with Grade 0 hepatic encephalopathy according to West-Haven Criteria. Patients were subjected to mini-mental state examination and those with a score of ≥24 were assessed using psychometric hepatic encephalopathy score. Short Form-36 questionnaire was administered to assess the impact on health-related quality of life. RESULTS Of the 1260 enrolled patients, 1114 were included in the analysis. The mean age was 49.5 years and majority were males (901 [81%]). The prevalence of MHE was found to be 59.7% (665/1114) based on the psychometric hepatic encephalopathy score of ≤-5. Alcohol-related liver disease was the most common etiology (482 [43.27%]) followed by viral infection (239 [21.45%]). Past smokers as well as those currently smoking were more likely to have MHE than nonsmokers. A significant association was found between tobacco chewing, smoking, alcohol consumption, diabetes, and the presence of MHE. Multivariable analysis revealed smoking as the only parameter associated with MHE. A total of 300 (26.9%) patients were on prophylaxis with lactulose/lactitol or rifaximin. These patients were less likely to have MHE as compared to those not on prophylaxis (odds ratio, 0.67; 95% confidence interval, 0.50-0.88; P = 0.005). CONCLUSION The disease burden of MHE is quite substantial in patients with cirrhosis with no apparent cognitive defect. Smoking, whether past or current, has significant association with the presence of MHE. Although MHE has been shown to adversely affect quality of life, prophylaxis for MHE is not routinely practiced in the Indian setting.The study has been registered under clinical trials registry of India (CTRI/2014/01/004306).
Collapse
Key Words
- ALD, alcohol-related liver disease
- CI, confidence interval
- DST, Digit Symbol Test
- FCT, figure connection test
- HE, hepatic encephalopathy
- HRQL, health-related quality of life
- MCS, mental component summary
- MELD, model for end-stage liver disease
- MHE, minimal hepatic encephalopathy
- MMSE, mini-mental state examination
- NCT, number connection test
- PCS, physical component summary
- PHES
- PHES, psychometric hepatic encephalopathy score
- SF-36, Short Form-36
- cirrhosis
- covert hepatic encephalopathy
- hepatic encephalopathy
- lactulose
- minimal hepatic encephalopathy
- quality of life
Collapse
Affiliation(s)
- Sahaj Rathi
- Postgraduate Institute of Medical Research, Chandigarh, India
| | - Madhu Chopra
- Postgraduate Institute of Medical Research, Chandigarh, India
| | | | | | - Kaushal Madan
- Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurgoan, India
| | | | | | - Anurag Govil
- Santokba Durlabhji Memorial Hospital, Jaipur, India
| | | | | | | | | | | | | | - Philip Abraham
- PD Hinduja Hospital and Medical Research Centre, Mumbai, India
| | | | | | - Naresh Bhat
- Columbia Asia Referral Hospital, Bangalore, India
| | | | - Arun R.S.
- Madras Medical Mission, Chennai, India
| | | | | | - Radha K. Dhiman
- Postgraduate Institute of Medical Research, Chandigarh, India,Address for correspondence: Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
| |
Collapse
|
12
|
Effects of Aging on Cortical Neural Dynamics and Local Sleep Homeostasis in Mice. J Neurosci 2018; 38:3911-3928. [PMID: 29581380 PMCID: PMC5907054 DOI: 10.1523/jneurosci.2513-17.2018] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 01/13/2023] Open
Abstract
Healthy aging is associated with marked effects on sleep, including its daily amount and architecture, as well as the specific EEG oscillations. Neither the neurophysiological underpinnings nor the biological significance of these changes are understood, and crucially the question remains whether aging is associated with reduced sleep need or a diminished capacity to generate sufficient sleep. Here we tested the hypothesis that aging may affect local cortical networks, disrupting the capacity to generate and sustain sleep oscillations, and with it the local homeostatic response to sleep loss. We performed chronic recordings of cortical neural activity and local field potentials from the motor cortex in young and older male C57BL/6J mice, during spontaneous waking and sleep, as well as during sleep after sleep deprivation. In older animals, we observed an increase in the incidence of non-rapid eye movement sleep local field potential slow waves and their associated neuronal silent (OFF) periods, whereas the overall pattern of state-dependent cortical neuronal firing was generally similar between ages. Furthermore, we observed that the response to sleep deprivation at the level of local cortical network activity was not affected by aging. Our data thus suggest that the local cortical neural dynamics and local sleep homeostatic mechanisms, at least in the motor cortex, are not impaired during healthy senescence in mice. This indicates that powerful protective or compensatory mechanisms may exist to maintain neuronal function stable across the life span, counteracting global changes in sleep amount and architecture. SIGNIFICANCE STATEMENT The biological significance of age-dependent changes in sleep is unknown but may reflect either a diminished sleep need or a reduced capacity to generate deep sleep stages. As aging has been linked to profound disruptions in cortical sleep oscillations and because sleep need is reflected in specific patterns of cortical activity, we performed chronic electrophysiological recordings of cortical neural activity during waking, sleep, and after sleep deprivation from young and older mice. We found that all main hallmarks of cortical activity during spontaneous sleep and recovery sleep after sleep deprivation were largely intact in older mice, suggesting that the well-described age-related changes in global sleep are unlikely to arise from a disruption of local network dynamics within the neocortex.
Collapse
|
13
|
Temporal Lobe Atrophy May Be Underrecognized in Older Patients with New-Onset Epilepsy. Can J Neurol Sci 2017; 43:731-4. [PMID: 27670215 DOI: 10.1017/cjn.2016.275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
14
|
Daulatzai MA. Dysfunctional Sensory Modalities, Locus Coeruleus, and Basal Forebrain: Early Determinants that Promote Neuropathogenesis of Cognitive and Memory Decline and Alzheimer’s Disease. Neurotox Res 2016; 30:295-337. [DOI: 10.1007/s12640-016-9643-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/08/2016] [Accepted: 06/10/2016] [Indexed: 12/22/2022]
|
15
|
The bidirectional association between reduced cerebral blood flow and brain atrophy in the general population. J Cereb Blood Flow Metab 2015; 35:1882-7. [PMID: 26154865 PMCID: PMC4635245 DOI: 10.1038/jcbfm.2015.157] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/07/2015] [Accepted: 05/26/2015] [Indexed: 11/09/2022]
Abstract
The question remains whether reduced cerebral blood flow (CBF) leads to brain atrophy or vice versa. We studied the longitudinal relation between CBF and brain volume in a community-dwelling population. In the Rotterdam Study, 3011 participants (mean age 59.6 years (s.d. 8.0)) underwent repeat brain magnetic resonance imaging to quantify brain volume and CBF at two time points. Adjusted linear regression models were used to investigate the bidirectional relation between CBF and brain volume. We found that smaller brain volume at baseline was associated with a steeper decrease in CBF in the whole population (standardized change per s.d. increase of total brain volume (TBV)=0.296 (95% confidence interval (CI) 0.200; 0.393)). Only in persons aged ⩾65 years, a lower CBF at baseline was associated with steeper decline of TBV (standardized change per s.d. increase of CBF=0.003 (95% CI -0.004; 0.010) in the whole population and 0.020 (95% CI 0.004; 0.036) in those aged ⩾65 years of age). Our results indicate that brain atrophy causes CBF to decrease over time, rather than vice versa. Only in persons aged >65 years of age did we find lower CBF to also relate to brain atrophy.
Collapse
|
16
|
Cho H, Kim C, Kim HJ, Ye BS, Kim YJ, Jung NY, Son TO, Cho EB, Jang H, Lee J, Kang M, Shin HY, Jeon S, Lee JM, Kim ST, Choi YC, Na DL, Seo SW. Impact of smoking on neurodegeneration and cerebrovascular disease markers in cognitively normal men. Eur J Neurol 2015; 23:110-9. [PMID: 26264353 DOI: 10.1111/ene.12816] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 06/05/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Smoking is a major risk factor for cognitive decline and dementia. However, the exact pathobiology of smoking remains unknown. The effects of smoking on cortical thickness as a biomarker of neurodegeneration or white matter hyperintensities and lacunes as biomarkers of cerebrovascular burden were concurrently evaluated. METHODS Our study included 977 cognitively normal men who visited a health promotion centre and underwent medical check-ups, including 3.0 T magnetic resonance imaging. Participants were categorized into never smoker, past smoker or current smoker groups and pack-years and the years of smoking cessation were used as continuous variables. RESULTS The current smoker group exhibited cortical thinning in frontal and temporo-parietal regions compared with the never smoker group. These effects were particularly prominent in smokers with a high cumulative exposure to smoking in the current smoker group. However, there was no association between smoking and the severity of white matter hyperintensity or number of lacunes. CONCLUSION Our findings indicate that smoking might impact on neurodegeneration rather than cerebrovascular burdens in cognitively normal men, suggesting that smoking might be an important modifiable risk factor for the development of Alzheimer's disease.
Collapse
Affiliation(s)
- H Cho
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - C Kim
- Department of Preventive Medicine and the Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Korea
| | - H J Kim
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B S Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Y J Kim
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - N-Y Jung
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - T O Son
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - E B Cho
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Jang
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J Lee
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Kang
- Centre for Health Promotion, Samsung Medical Centre, Seoul, Korea
| | - H-Y Shin
- Centre for Health Promotion, Samsung Medical Centre, Seoul, Korea
| | - S Jeon
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - J-M Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - S T Kim
- Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-C Choi
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - D L Na
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Centre, Samsung Medical Centre, Seoul, Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - S W Seo
- Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Centre, Samsung Medical Centre, Seoul, Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| |
Collapse
|
17
|
Buratti L, Balucani C, Viticchi G, Falsetti L, Altamura C, Avitabile E, Provinciali L, Vernieri F, Silvestrini M. Cognitive deterioration in bilateral asymptomatic severe carotid stenosis. Stroke 2014; 45:2072-7. [PMID: 24903984 DOI: 10.1161/strokeaha.114.005645] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE This study aimed to monitor cognitive performance during a 3-year period in subjects with bilateral asymptomatic severe internal carotid artery stenosis and to explore the role of cerebral hemodynamics and atherosclerotic disease in the development of cognitive dysfunction. METHODS One hundred fifty-nine subjects with bilateral asymptomatic severe internal carotid artery stenosis were included and prospectively evaluated for a 3-year period. At entry, demographics, vascular risk profile, and pharmacological treatments were defined. Cognitive status was evaluated using the Mini-Mental State Examination at baseline and at follow-up. Cerebral hemodynamics was assessed by transcranial Doppler-based breath-holding index test. As a measure of the extent of systemic atherosclerotic disease, common carotid artery intima-media thickness was measured. A cutoff for pathological values was set at 0.69 for breath-holding index and 1.0 mm for intima-media thickness. RESULTS The risk of decreasing in Mini-Mental State Examination score increased progressively from patients with bilaterally normal to those with unilaterally abnormal breath-holding index, reaching the highest probability in patients with bilaterally abnormal breath-holding index (P<0.0001). Pathological values of intima-media thickness did not influence the risk of Mini-Mental State Examination score change. CONCLUSIONS Our findings suggest that patients with asymptomatic bilateral severe internal carotid artery stenosis may be at risk of developing cognitive impairment. The evaluation of the hemodynamic status, besides providing insights about the possible mechanism behind the cognitive dysfunction present in carotid atherosclerotic disease, may be of help for the individuation of subjects deserving earlier and more aggressive treatments.
Collapse
Affiliation(s)
- Laura Buratti
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.)
| | - Clotilde Balucani
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.)
| | - Giovanna Viticchi
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.)
| | - Lorenzo Falsetti
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.)
| | - Claudia Altamura
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.)
| | - Emma Avitabile
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.)
| | - Leandro Provinciali
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.)
| | - Fabrizio Vernieri
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.)
| | - Mauro Silvestrini
- From the Neurological Clinic, Marche Polytechnic University, Ancona, Italy (L.B., G.V., E.A., L.P., M.S.); Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY (C.B.); Internal and Subintensive Medicine, Ospedali Riuniti Ancona, Ancona, Italy (L.F.); and Neurology Unit, Campus Bio-Medico University, Rome, Italy (C.A., F.V.).
| |
Collapse
|
18
|
Xiong Y, Wong A, Wong K, Chu WCW, Hu X, Chen X, Wong KS, Wong STC, Liu X, Mok V. Predictors for cortical gray matter volume in stroke patients with confluent white matter changes. J Neurol Sci 2014; 338:169-73. [PMID: 24468539 DOI: 10.1016/j.jns.2013.12.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/24/2013] [Accepted: 12/27/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Our previous study found that cortical gray matter (cGM) volume predicted vascular cognitive impairment independent of age-related white matter changes (WMC). We aimed to investigate predictors for cGM volume in ischemic stroke patients with confluent WMC. METHODS One-hundred post-stroke patients with confluent WMC were recruited into the study. All volumetric measures were standardized by intracranial volume as volume ratio. Univariate analyses and multivariate linear regression models were used to test relationship of cGM volume with basic demography, vascular risk factors, APOE status, WMC volume (periventricular and deep WMC), infarct measures (volume, number and location) and microbleed (number, presence and location). RESULTS After controlling for significant variables in the univariate analyses, multivariate linear regression models found that old age (β=-0.288, p=0.001), low triglyceride (β=0.194, p=0.027), periventricular WMC (PVWMC) (β=-0.392, p<0.001) and presence of thalamic microbleed (β=-0.197, p=0.041) were independently predictive of less cGM volume ratio. CONCLUSIONS Age, PVWMC and left thalamic microbleed predict less cGM volume.
Collapse
Affiliation(s)
- Yunyun Xiong
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China; Department of Psychological Studies and Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, China
| | - Adrian Wong
- Department of Psychological Studies and Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, China
| | - Kelvin Wong
- Bioinformatics and Imaging Programmatic Cores, The Methodist Hospital Research Institute, Weill Cornell Medical College, Houston, TX, USA
| | - Winnie C W Chu
- Department of Radiology and Organ Imaging, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Xintao Hu
- Bioinformatics and Imaging Programmatic Cores, The Methodist Hospital Research Institute, Weill Cornell Medical College, Houston, TX, USA
| | - Xiangyan Chen
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Ka Sing Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Stephen T C Wong
- Bioinformatics and Imaging Programmatic Cores, The Methodist Hospital Research Institute, Weill Cornell Medical College, Houston, TX, USA
| | - Xinfeng Liu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China
| | - Vincent Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China.
| |
Collapse
|
19
|
Haley AP, Gonzales MM, Tarumi T, Tanaka H. Dyslipidemia links obesity to early cerebral neurochemical alterations. Obesity (Silver Spring) 2013; 21:2007-13. [PMID: 23512296 PMCID: PMC3695042 DOI: 10.1002/oby.20332] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 12/13/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To examine the role of hypertension, hyperglycemia, and dyslipidemia in potentially accounting for obesity-related brain vulnerability in the form of altered cerebral neurochemistry. DESIGN AND METHODS Sixty-four adults, ages 40-60 years, underwent a health screen and proton magnetic resonance spectroscopy ((1) H MRS) of occipitoparietal gray matter to measure N-acetyl aspartate (NAA), choline (Cho), myo-inositol (mI), and glutamate (Glu) relative to creatine (Cr). The causal steps approach and nonparametric bootstrapping were utilized to assess if fasting glucose, mean arterial pressure or peripheral lipid/lipoprotein levels mediate the relationship between body mass index (BMI) and cerebral neurochemistry. RESULTS Higher BMI was significantly related to higher mI/Cr, independent of age and sex. BMI was also significantly related to two of the proposed mediators, triglyceride, and HDL-cholesterol, which were also independently related to increased mI/Cr. Finally, the relationship between BMI and mI/Cr was significantly attenuated after inclusion of triglyceride and HDL-cholesterol into the model, one at a time, indicating statistical mediation. CONCLUSIONS Higher triglyceride and lower HDL levels statistically account for the association between BMI and myo-inositol, pointing toward a potentially critical role for dyslipidemia in the development of cerebral neurochemical alterations in obesity.
Collapse
Affiliation(s)
- Andreana P. Haley
- The University of Texas at Austin, Department of Psychology, 108 E. Dean Keeton Stop A8000, Austin, TX 78712-1043, USA
- University of Texas Imaging Research Center, 3925B West Braker Lane, Austin, TX 78759, USA
| | - Mitzi M. Gonzales
- The University of Texas at Austin, Department of Psychology, 108 E. Dean Keeton Stop A8000, Austin, TX 78712-1043, USA
| | - Takashi Tarumi
- The University of Texas at Austin, Department of Kinesiology and Health Education, 1 University Station, D3700, Austin, TX 78712, USA
| | - Hirofumi Tanaka
- The University of Texas at Austin, Department of Kinesiology and Health Education, 1 University Station, D3700, Austin, TX 78712, USA
| |
Collapse
|
20
|
Vieira RT, Caixeta L, Machado S, Silva AC, Nardi AE, Arias-Carrión O, Carta MG. Epidemiology of early-onset dementia: a review of the literature. Clin Pract Epidemiol Ment Health 2013; 9:88-95. [PMID: 23878613 PMCID: PMC3715758 DOI: 10.2174/1745017901309010088] [Citation(s) in RCA: 193] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/18/2013] [Accepted: 04/18/2013] [Indexed: 11/22/2022]
Abstract
Presenile Dementia or Early Onset Dementia (EOD) is a public health problem, it differs from Senile Dementia, and encloses a significant number of cases; nevertheless, it is still poorly understood and underdiagnosed. This study aims to review the prevalence and etiology of EOD, comparing EOD with Senile Dementia, as well as to show the main causes of EOD and their prevalence in population and non-population based studies. The computer-supported search used the following databases: Pubmed/Medline, ISI Web of Knowledge and Scielo. The search terms were alcohol-associated dementia, Alzheimer's disease, dementia, Creutzfeldt-jakob disease, dementia with lewy bodies, early onset dementia, frontotemporal lobar degeneration, Huntington's disease, mixed dementia, neurodegenerative disorders, Parkinson's disease dementia, presenile dementia, traumatic brain injury, vascular dementia. Only papers published in English and conducted from 1985 up to 2012 were preferentially reviewed. Neurodegenerative diseases are the most common etiologies seen in EOD. Among the general population, the prevalence of EOD was found to range between 0 to 700 per 100.000 habitants in groups of 25-64 years old, with an increasing incidence with age. The progression of EOD was found to range between 8.3 to 22.8 new cases per 100.000 in those aged under 65 years. Alzheimer's disease (AD) is the major etiology, followed by Vascular Dementia (VaD) and Frontotemporal Lobar Degeneration (FTLD). A larger number of epidemiological studies to elucidate how environmental issues contribute to EOD are necessary, thus, we can collaborate in the planning and prevention of services toward dementia patients.
Collapse
Affiliation(s)
- Renata Teles Vieira
- Dementia Outpatient Unit, Hospital of the Clinics, Federal University of Goiás, Brazil
| | | | | | | | | | | | | |
Collapse
|
21
|
Adam S, Bonsang E, Grotz C, Perelman S. Occupational activity and cognitive reserve: implications in terms of prevention of cognitive aging and Alzheimer's disease. Clin Interv Aging 2013; 8:377-90. [PMID: 23671387 PMCID: PMC3650883 DOI: 10.2147/cia.s39921] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
This paper investigates the relationship between the concept of activity (including both professional and nonprofessional) and cognitive functioning among older European individuals. In this research, we used data collected during the first wave of SHARE (Survey on Health, Ageing and Retirement in Europe), and a measurement approach known as stochastic frontier analysis, derived from the economic literature. SHARE includes a large population (n > 25,000) geographically distributed across Europe, and analyzes several dimensions simultaneously, including physical and mental health activity. The main advantages of stochastic frontier analysis are that it allows estimation of parametric function relating cognitive scores and driving factors at the boundary and disentangles frontier noise and distance to frontier components, as well as testing the effect of potential factors on these distances simultaneously. The analysis reveals that all activities are positively related to cognitive functioning in elderly people. Our results are discussed in terms of prevention of cognitive aging and Alzheimer's disease, and regarding the potential impact that some retirement programs might have on cognitive functioning in individuals across Europe.
Collapse
Affiliation(s)
- Stéphane Adam
- Unité de Psychologie de la Sénescence, University of Liège, Belgium.
| | | | | | | |
Collapse
|
22
|
Peters R. Blood pressure, smoking and alcohol use, association with vascular dementia. Exp Gerontol 2012; 47:865-72. [PMID: 22664578 DOI: 10.1016/j.exger.2012.05.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 05/21/2012] [Accepted: 05/24/2012] [Indexed: 11/19/2022]
Abstract
The success of the ageing global population brings with it a growth in the number of dementia sufferers. Older adults are at highest risk of dementia and are likely to manifest both vascular and Alzheimer's pathology. Blood pressure also changes with ageing and there is evidence linking high blood pressure in midlife to an increased risk of later dementia. Data from later life is sparser. A number of intervention trials have been carried out with antihypertensives and have shown mixed results with regard to cognitive and dementia outcomes (both dementia overall and of vascular and Alzheimer's types). Meta-analyses have in general not found an association between blood pressure lowering and reduced dementia incidence, although the number of cases reported in the placebo controlled trials is invariably lower in the actively treated group. Systematic reviews and meta-analyses have also been published with regard to smoking and alcohol use and incident dementia. Despite mixed reports, overall smoking was associated with an increased risk of later dementia and alcohol with a 'U' or 'J' shaped relationship. Following the systematic reviews subsequent publications tend to report similar findings. The literature in this area suffers from differing populations, lengths of follow up and assessments of both risk factor and outcome. However, at present, maintenance of cognitive function would seem to be best served by treating cardiovascular risk factors in accordance with current guidelines, controlling blood pressure, reducing smoking and if consuming alcohol doing so in moderation. This review will concentrate on the prevention of dementia and attempt to provide an overview of the evidence relating to vascular related dementia and the potential risk factors of hypertension, alcohol use and smoking behaviour.
Collapse
Affiliation(s)
- Ruth Peters
- Imperial Clinical Trials Unit, School of Public Health, St Mary's Campus, London W2 1PG, USA.
| |
Collapse
|
23
|
Meier IB, Manly JJ, Provenzano FA, Louie KS, Wasserman BT, Griffith EY, Hector JT, Allocco E, Brickman AM. White matter predictors of cognitive functioning in older adults. J Int Neuropsychol Soc 2012; 18:414-27. [PMID: 22390883 PMCID: PMC3565460 DOI: 10.1017/s1355617712000227] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Few studies have applied multiple imaging modalities to examine cognitive correlates of white matter. We examined the utility of T2-weighted magnetic resonance imaging (MRI) -derived white matter hyperintensities (WMH) and diffusion tensor imaging-derived fractional anisotropy (FA) to predict cognitive functioning among older adults. Quantitative MRI and neuropsychological evaluations were performed in 112 older participants from an ongoing study of the genetics of Alzheimer's disease (AD) in African Americans. Regional WMH volumes and FA were measured in multiple regions of interest. We examined the association of regional WMH and an FA summary score with cognitive test performance. Differences in WMH and FA were compared across diagnostic groups (i.e., normal controls, mild cognitive impairment, and probable AD). Increased WMH volume in frontal lobes was associated with poorer delayed memory performance. FA did not emerge as a significant predictor of cognition. White matter hyperintensity volume in the frontal and parietal lobes was increased in MCI participants and more so in AD patients relative to controls. These results highlight the importance of regionally distributed small vessel cerebrovascular disease in memory performance and AD among African American older adults. White matter microstructural changes, quantified with diffusion tensor imaging, appear to play a lesser role in our sample.
Collapse
Affiliation(s)
- Irene B. Meier
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Frank A. Provenzano
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Karmen S. Louie
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Ben T. Wasserman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Erica Y. Griffith
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Josina T. Hector
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Elizabeth Allocco
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
| |
Collapse
|
24
|
Williams VJ, Leritz EC, Shepel J, McGlinchey RE, Milberg WP, Rudolph JL, Lipsitz LA, Salat DH. Interindividual variation in serum cholesterol is associated with regional white matter tissue integrity in older adults. Hum Brain Mapp 2012; 34:1826-41. [PMID: 22438182 DOI: 10.1002/hbm.22030] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 12/06/2011] [Accepted: 12/07/2011] [Indexed: 01/24/2023] Open
Abstract
Prior research has demonstrated links among vascular health and the occurrence of stroke, mild cognitive decline, and dementia in older adults. However, little is known about whether normal variation in vascular indicators may be related to changes in neural tissue integrity. Even less is known about how the brain is affected by cholesterol levels in the normal to moderate risk range, leading up to overt disease pathology. This study examined associations between serum lipid levels and DTI indicators of white matter (WM) structural integrity in a sample of 125 generally healthy older adults aged 43-87 years. Whole-brain voxelwise analysis, controlling for age and gender, revealed low density lipoprotein levels (LDL) as the most robust correlate of regional WM structural integrity of the measured lipids. Higher LDL was associated with decreased WM integrity in right frontal and temporal regions, the superior longitudinal fasciculus and internal/external capsules. Increasing LDL was associated with increased radial and axial diffusivity; however, more widespread statistical effects were found for radial diffusivity. These findings suggest that normal interindividual variation in lipid levels is associated with compromised regional WM integrity, even in individuals below clinical thresholds for hyperlipidemia. Given the prevalence of cholesterol-associated sequelae in older adults, and mounting evidence suggesting a vascular role in the etiology of dementia, the current data suggest that understanding the relationship between cholesterol and brain tissue microstructure may have important clinical implications for early detection of vascular-related cognitive disorders and optimal regulation of serum lipids to maintain neural health in older adults.
Collapse
Affiliation(s)
- Victoria J Williams
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, Massachusetts, USA
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Abstract
The incidence of dementia increases steeply with age in older people, although from the tenth decade the slope may be smoother, perhaps reflecting different pathological processes in the oldest old. The prevalence depends upon interaction of age with other factors (e.g., comorbidities, genetic or environmental factors) that in turn are subject to change. If onset of dementia could be postponed by modulating its risk factors, this could significantly affect its incidence. Analysis of risk and protection factors should take into account the critical period during which these factors play a role. For example, the impact of education and diabetes mellitus occurs in early- and midlife, respectively, while maintaining optimal physical and mental activity and controlling vascular factors later in life may slow the rate of cognitive decline. Modifying factors need to be evaluated for different clinical groups, taking into account genetic background, age, and duration at exposure. The aim of the present article is to try to take stock of epidemiological data concerning factors affecting the prevalence of dementia and predict future developments, as well as to look for possible interventions that could affect outcome.
Collapse
Affiliation(s)
- T A Treves
- Memory Disorders Clinic, Rabin Medical Center, Petach Tikva, Israel
| | | |
Collapse
|
26
|
Smoking-related prospective memory deficits in a real-world task. Drug Alcohol Depend 2012; 120:1-6. [PMID: 21726964 DOI: 10.1016/j.drugalcdep.2011.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 06/08/2011] [Accepted: 06/09/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Smokers, previous smokers and a never smoked group were compared on self-reported and real world prospective memory (PM - the cognitive ability of remembering to carry out particular actions at some future point in time). METHODS Twenty-seven current smokers, 24 people who had never smoked and 18 previous smokers were compared using an existing groups design. Scores on the long and short term PM subscales of the Prospective and Retrospective Memory Questionnaire (PRMQ) and scores on a Real World Prospective Memory Task (RWPMT) constituted the dependent measures. Smoking and other drug use were assessed by a Recreational Drug Use Questionnaire. The Hospital Anxiety and Depression Scale gauged levels of anxiety and depression. The National Adult Reading Test measured IQ, and retrospective memory was measured using the PRMQ. Gender, age, anxiety and depression, IQ, alcohol use and the retrospective memory scores, were measured as covariates and controlled for in the analysis. RESULTS A series of univariate ANCOVAs were applied to the main PM data across the three groups, controlling for variations in age, gender, mood, IQ, alcohol use and retrospective memory scores. These revealed no significant between-group differences on self-reported PM; however smokers recalled significantly fewer action-location combinations than the never smoked and previous smoker groups on the objective RWPMT. CONCLUSIONS Existing smokers showed reduced performance on RWPMT when compared to the never smoked group and previous smokers. Real-world PM impairments should be added to a growing list of neuropsychological sequelae associated with persistent smoking.
Collapse
|
27
|
Isaac V, Sim S, Zheng H, Zagorodnov V, Tai ES, Chee M. Adverse Associations between Visceral Adiposity, Brain Structure, and Cognitive Performance in Healthy Elderly. Front Aging Neurosci 2011; 3:12. [PMID: 21949507 PMCID: PMC3171695 DOI: 10.3389/fnagi.2011.00012] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 08/25/2011] [Indexed: 12/22/2022] Open
Abstract
The link between central adiposity and cognition has been established by indirect measures such as body mass index (BMI) or waist–hip ratio. Magnetic resonance imaging (MRI) quantification of central abdominal fat has been linked to elevated risk of cardiovascular and cerebro-vascular disease. However it is not known how quantification of visceral fat correlates with cognitive performance and measures of brain structure. We filled this gap by characterizing the relationships between MRI measures of abdominal adiposity, brain morphometry, and cognition, in healthy elderly. Methods: A total of 184 healthy community dwelling elderly subjects without cognitive impairment participated in this study. Anthropometric and biochemical markers of cardiovascular risk, neuropsychological measurements as well as MRI of the brain and abdomen fat were obtained. Abdominal images were segmented into subcutaneous adipose tissue and visceral adipose tissue (VAT) adipose tissue compartments. Brain MRI measures were analyzed quantitatively to determine total brain volume, hippocampal volume, ventricular volume, and cortical thickness. Results: VAT showed negative association with verbal memory (r = 0.21, p = 0.005) and attention (r = 0.18, p = 0.01). Higher VAT was associated with lower hippocampal volume (F = 5.39, p = 0.02) and larger ventricular volume (F = 6.07, p = 0.02). The participants in the upper quartile of VAT had the lowest hippocampal volume even after adjusting for age, gender, hypertension, and BMI (b = −0.28, p = 0.005). There was a significant age by VAT interaction for cortical thickness in the left prefrontal region. Conclusion: In healthy older adults, elevated VAT is associated with negative effects on cognition, and brain morphometry.
Collapse
Affiliation(s)
- Vivian Isaac
- Cognitive Neuroscience Laboratory, Neuroscience and Behavioural Disorders Program, Duke-National University of Singapore Graduate Medical School Singapore
| | | | | | | | | | | |
Collapse
|
28
|
Moretti R, Torre P, Antonello RM, Esposito F, Bellini G. Gait and equilibrium in subcortical vascular dementia. Curr Gerontol Geriatr Res 2011; 2011:263507. [PMID: 21547149 PMCID: PMC3085296 DOI: 10.1155/2011/263507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 01/11/2011] [Accepted: 01/18/2011] [Indexed: 11/17/2022] Open
Abstract
Subcortical vascular dementia is a clinical entity, widespread, even challenging to diagnose and correctly treat. Patients with this diagnosis are old, frail, often with concomitant pathologies, and therefore, with many drugs in therapy. We tried to diagnose and follow up for three years more than 600 patients. Study subjects were men and women, not bedridden, aged 68-94 years, outpatients, recruited from June, 1st 2007 to June, 1st 2010. We examined them clinically, neurologically, with specific consideration on drug therapies. Our aim has been to define gait and imbalance problem, if eventually coexistent with the pathology of white matter and/or with the worsening of the deterioration. Drug intake interference has been detected and considered.
Collapse
Affiliation(s)
- Rita Moretti
- Medicina Clinica, Ambulatorio Complicanze Internistiche Cerebrali, Dipartimento Universitario Clinici di Scienze Mediche Tecnologiche e Traslazionali, Università Degli Studi di Trieste, Ospedale di Cattinara, Strada Fiume 447, 34149 Trieste, Italy
| | - Paola Torre
- Medicina Clinica, Ambulatorio Complicanze Internistiche Cerebrali, Dipartimento Universitario Clinici di Scienze Mediche Tecnologiche e Traslazionali, Università Degli Studi di Trieste, Ospedale di Cattinara, Strada Fiume 447, 34149 Trieste, Italy
| | - Rodolfo M. Antonello
- Medicina Clinica, Ambulatorio Complicanze Internistiche Cerebrali, Dipartimento Universitario Clinici di Scienze Mediche Tecnologiche e Traslazionali, Università Degli Studi di Trieste, Ospedale di Cattinara, Strada Fiume 447, 34149 Trieste, Italy
| | - Francesca Esposito
- Medicina Clinica, Ambulatorio Complicanze Internistiche Cerebrali, Dipartimento Universitario Clinici di Scienze Mediche Tecnologiche e Traslazionali, Università Degli Studi di Trieste, Ospedale di Cattinara, Strada Fiume 447, 34149 Trieste, Italy
| | - Giuseppe Bellini
- Medicina Clinica, Ambulatorio Complicanze Internistiche Cerebrali, Dipartimento Universitario Clinici di Scienze Mediche Tecnologiche e Traslazionali, Università Degli Studi di Trieste, Ospedale di Cattinara, Strada Fiume 447, 34149 Trieste, Italy
| |
Collapse
|
29
|
Sex differences in grey matter atrophy patterns among AD and aMCI patients: results from ADNI. Neuroimage 2011; 56:890-906. [PMID: 21356315 DOI: 10.1016/j.neuroimage.2011.02.060] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/14/2011] [Accepted: 02/20/2011] [Indexed: 11/21/2022] Open
Abstract
We used longitudinal magnetic resonance imaging (MRI) data to determine whether there are any gender differences in grey matter atrophy patterns over time in 197 individuals with probable Alzheimer's disease (AD) and 266 with amnestic mild cognitive impairment (aMCI), compared with 224 healthy controls participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). While previous research has differentiated probable AD and aMCI groups from controls in brain atrophy, it is unclear whether and how sex plays a role in patterns of change over time. Using regional volumetric maps, we fit longitudinal models to the grey matter data collected at repeated occasions, seeking differences in patterns of volume change over time by sex and diagnostic group in a voxel-wise analysis. Additionally, using a region-of-interest approach, we fit longitudinal models to the global volumetric data of predetermined brain regions to determine whether this more conventional approach is sufficient for determining sex and group differences in atrophy. Our longitudinal analyses revealed that, of the various grey matter regions investigated, males and females in the AD group and the aMCI group showed different patterns of decline over time compared to controls in the bilateral precuneus, bilateral caudate nucleus, right entorhinal gyrus, bilateral thalamus, bilateral middle temporal gyrus, left insula, and right amygdala. As one of the first investigation to model more than two time points of structural MRI data over time, our findings add insight into how AD and aMCI males and females differ from controls and from each other over time.
Collapse
|
30
|
Smoking and everyday prospective memory: a comparison of self-report and objective methodologies. Drug Alcohol Depend 2010; 112:234-8. [PMID: 20800391 DOI: 10.1016/j.drugalcdep.2010.06.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Revised: 06/24/2010] [Accepted: 06/25/2010] [Indexed: 11/20/2022]
Abstract
AIMS To examine whether persistent smoking leads to impairments in self-reported and objective measures of prospective memory (PM: the cognitive ability to remember to carry out activities at some future point in time). METHODS An opportunity sample of 18 existing smokers and 22 who had never smoked were compared. An existing-groups design was utilised, comparing a smoking group with a never-smoked control group as the independent factor. Scores on the sub-scales of the Prospective and Retrospective Memory Questionnaire (PRMQ) and scores on the Cambridge Prospective Memory Test (CAMPROMPT) constituted the dependent factors. Age, mood, other drug use, strategy scores and IQ were also measured. Each participant was tested in a laboratory setting. Self-reported PM lapses were measured using the PRMQ. The CAMPROMPT was used as an objective measure of PM. Alcohol and other drug use were assessed by a Recreational Drug Use Questionnaire. The Hospital Anxiety and Depression Scale gauged levels of anxiety and depression. A strategy scale measured the number of strategies used to aid memory. The National Adult Reading Test measured IQ. RESULTS After observing no between-group differences on age, mood, alcohol use, strategy use, and IQ, smokers and the never-smoked did not differ on the self-reported lapses measured on the PRMQ. However, smokers recalled significantly fewer items on the CAMPROMPT than the never-smoked group. CONCLUSION The results of the present study suggest that persistent smoking leads to impairments in everyday PM.
Collapse
|
31
|
The complex interplay of cardiovascular system and cognition: how to predict dementia in the elderly? Int J Cardiol 2010; 150:123-9. [PMID: 21094551 DOI: 10.1016/j.ijcard.2010.10.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 10/23/2010] [Indexed: 12/16/2022]
Abstract
Prevalence of dementing illnesses is expected to grow due to aging of the population throughout the world. Vascular dementia and Alzheimer's disease share several risk factors and are nowadays considered two ends of a continuum rather than two distinct entities. Traditional cardiovascular risk markers such as diabetes, dyslipidemia, hypertension, metabolic syndrome and adiposity in mid-life are harbingers of cognitive decline, Alzheimer's disease and vascular dementia later in life. In aged populations, only diabetes has been more constantly associated with the development of cognitive dysfunction, while other risk markers have shown more mixed results. Normal aging, co-morbidities and other changes connected to cognitive decline make the interpretation of the risk markers in the elderly challenging and probably explain these contradictory findings. Control of cardiovascular risk factors has been linked to beneficial effects in terms of cognition in cross-sectional and prospective follow up studies, but the results of interventional trials have been disappointing. More research in this area is needed, specifically, placebo-controlled randomized trials in both mid-life and late-life with cognitive dysfunction as a primary endpoint.
Collapse
|
32
|
Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults. Hypertens Res 2010; 33:1232-7. [DOI: 10.1038/hr.2010.171] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
33
|
Ward MA, Bendlin BB, McLaren DG, Hess TM, Gallagher CL, Kastman EK, Rowley HA, Asthana S, Carlsson CM, Sager MA, Johnson SC. Low HDL Cholesterol is Associated with Lower Gray Matter Volume in Cognitively Healthy Adults. Front Aging Neurosci 2010; 2. [PMID: 20725527 PMCID: PMC2914583 DOI: 10.3389/fnagi.2010.00029] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 06/26/2010] [Indexed: 02/05/2023] Open
Abstract
Dyslipidemia is common in adults and contributes to high rates of cardiovascular disease and may be linked to subsequent neurodegenerative and neurovascular diseases. This study examined whether lower brain volumes and cognition associated with dyslipidemia could be observed in cognitively healthy adults, and whether apolipoprotein E (APOE) genotype or family history of Alzheimer's disease (FHAD) alters this effect. T1-weighted magnetic resonance imaging was used to examine regional brain gray matter (GM) and white matter (WM) in 183 individuals (58.4 ± 8.0 years) using voxel-based morphometry. A non-parametric multiple linear regression model was used to assess the effect of high-density lipoprotein (HDL) and non-HDL cholesterol, APOE, and FHAD on regional GM and WM volume. A post hoc analysis was used to assess whether any significant correlations found within the volumetric analysis had an effect on cognition. HDL was positively correlated with GM volume in the bilateral temporal poles, middle temporal gyri, temporo-occipital gyri, and left superior temporal gyrus and parahippocampal region. This effect was independent of APOE and FHAD. A significant association between HDL and the Brief Visuospatial Memory Test was found. Additionally, GM volume within the right middle temporal gyrus, the region most affected by HDL, was significantly associated with the Controlled Oral Word Association Test and the Center for Epidemiological Studies Depression Scale. These findings suggest that adults with decreased levels of HDL cholesterol may be experiencing cognitive changes and GM reductions in regions associated with neurodegenerative disease and therefore, may be at greater risk for future cognitive decline.
Collapse
Affiliation(s)
- Michael A Ward
- Geriatric Research, Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital Madison, WI, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Taki Y, Kinomura S, Sato K, Goto R, Wu K, Kawashima R, Fukuda H. Correlation between degree of white matter hyperintensities and global gray matter volume decline rate. Neuroradiology 2010; 53:397-403. [PMID: 20625706 DOI: 10.1007/s00234-010-0746-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 06/28/2010] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Whether the degree of white matter hyperintensities (WMHs) shows a significant correlation with the rate of global gray matter volume decline over a period following initial baseline measurement remains unclear. The purpose of the present study was to reveal the relationship between the degree of WMHs at baseline and the rate of global gray matter volume decline by applying a longitudinal design. METHODS Using a 6-year longitudinal design and magnetic resonance images of the brains of 160 healthy individuals aged over 50 years and living in the community, we analyzed the correlation between degree of WMHs using Fazekas scaling at baseline and rate of global gray matter volume decline 6 years later. To obtain the rate of global gray matter volume decline, we calculated global gray matter volume and intracranial volume at baseline and at follow-up using a fully automated method. RESULTS The annual percentage change in the gray matter ratio (GMR, APC(GMR)), in which GMR represents the percentage of gray matter volume in the intracranial volume, showed a significant positive correlation with the degree of deep WMHs and periventricular WMHs at baseline, after adjusting for age, gender, present history of hypertension, and diabetes mellitus. CONCLUSION Our results suggest that degree of WMHs at baseline predicts the rate of gray matter volume decline 6 years later and that simple visual scaling of WMHs could contribute to predicting the rate of global gray matter volume decline.
Collapse
Affiliation(s)
- Yasuyuki Taki
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Aobaku, Sendai, Japan.
| | | | | | | | | | | | | |
Collapse
|
35
|
Knoops AJG, Gerritsen L, van der Graaf Y, Mali WPTM, Geerlings MI. Basal hypothalamic pituitary adrenal axis activity and hippocampal volumes: the SMART-Medea study. Biol Psychiatry 2010; 67:1191-8. [PMID: 20299006 DOI: 10.1016/j.biopsych.2010.01.025] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 12/16/2009] [Accepted: 01/08/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND It has frequently been hypothesized that high levels of glucocorticoids have deleterious effects on the hippocampus and increase risk for cognitive decline and dementia, but no large-scale studies in humans have examined the direct relation between hippocampal volumes and hypothalamic-pituitary-adrenal axis activity. METHODS Cross-sectional analyses within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART)-Medea study, an ancillary study to the SMART-MR study on brain changes on magnetic resonance imaging (MRI) among patients with arterial disease. In 575 patients (mean age 62 +/- 9 years), diurnal cortisol rhythm was assessed with six saliva samples, collected at awakening; at 30, 45, and 60 min thereafter; and at 10 pm and 11 pm. A low dose of dexamethasone (.5 mg) was administered at 11 pm, and saliva was sampled the next morning at awakening. Volumetric measurements of the hippocampus were performed on a three-dimensional fast field echo T1-weighted scan with isotropic voxels. RESULTS Mean total relative hippocampal volume was 6.0 +/- .7 mL. Linear regression analyses, adjusted for age, sex, vascular risk factors, and global brain atrophy showed that participants with higher evening levels and higher awakening levels after dexamethasone had smaller hippocampal volumes [B per SD (4.2) increase = -.09 mL; 95% confidence interval -.15 to -.03 mL and B per SD (2.5) increase = -.07 mL; 95% confidence interval -.13 to -.01 mL, respectively]. The awakening response was not significantly associated with hippocampal volumes. CONCLUSIONS In this population, higher evening cortisol levels and reduced suppression after dexamethasone were associated with smaller hippocampal volumes, independent of total brain volume. The cortisol response after awakening was not associated with hippocampal volume.
Collapse
Affiliation(s)
- Arnoud J G Knoops
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | | | | | | | | |
Collapse
|
36
|
Abstract
ABSTRACTThis study analyses the relationships between cognitive performance, social participation and behavioural risks, taking into account age and educational attainment. We examine individual data for 11 European countries and Israel from the first wave of the Survey on Health, Ageing and Retirement in Europe (SHARE). The stochastic frontier approach methodology enables us to identify different sources of plasticity on cognitive functioning while taking into account age-related decline in cognitive performance. Several social participation variables were examined: employment status, attending educational courses, doing voluntary or charity work, providing help to family, friends or neighbours, participating in sports, social or other clubs, in a religious organisation and in a political or community organisation, and we controlled for age, education, income, physical activity, body-mass index, smoking and drinking. In the pooled sample, the results clearly show that all kinds of social involvement enhance cognitive functions, in particular in work. Moreover, behavioural risks such as physical inactivity, obesity, smoking or drinking were clearly detrimental to cognitive performance. Models for men and women were run separately. For both genders, all social involvement indicators associated with better cognitive performance. The results varied by countries, however, particularly the signs of the associations with a number of indicators of social involvement and behavioural risks.
Collapse
|
37
|
Abstract
OBJECTIVES Few studies have investigated smoking and cognitive decline (CD) among older Mexican Americans. In this study, the authors explore the relationship between smoking status and cognitive changes over time in a large sample of community-dwelling older adults of Mexican descent. DESIGN Latent growth curve analyses were used to examine the decreasing growth in the number of correct responses on a test of cognitive functioning with increasing age (7 years with four data collection points). SETTING In-home interviews were obtained from participants residing in the Southwest United States. PARTICIPANTS Participants were community-dwelling older Mexican Americans. MEASUREMENTS Cognitive functioning was assessed at each of the four data collection points with the Mini-Mental State Examination. Participants' self-reports of health functioning and smoking status were obtained at baseline. RESULTS With the inclusion of health variables and other control variables, the effect of smoking status on cognitive functioning was significant such that the decrease in the number of correct responses over time was greater for smokers than for nonsmokers. CONCLUSIONS Smoking increases risk for CD among community-dwelling older Mexican Americans. There are numerous health benefits in quitting smoking, even for older adults who have been smoking for many years. Further efforts to ensure that smoking cessation and prevention programs are targeted toward Hispanics are necessary.
Collapse
|
38
|
Vlek ALM, Visseren FLJ, Kappelle LJ, Geerlings MI, Vincken KL, Mali WPTM, van der Graaf Y. Blood pressure and progression of cerebral atrophy in patients with vascular disease. Am J Hypertens 2009; 22:1183-9. [PMID: 19745819 DOI: 10.1038/ajh.2009.166] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Cerebral atrophy on brain magnetic resonance imaging (MRI) has been associated with vascular risk factors including hypertension. Progression of cerebral atrophy and its risk factors have not been studied in vascular disease patients. This study aimed to assess the progression of cerebral atrophy and to evaluate possible associations with blood pressure (BP) in patients with pre-existing vascular disease. METHODS A total of 331 patients with manifest vascular disease from the Second Manifestations of ARTerial Disease (SMART) Study underwent baseline and follow-up MRI scanning (mean follow-up 4.1 +/- 0.3 years). The annual change in brain and ventricular volume was calculated with an automated quantitative volumetric method. Associations between BP and change in brain and ventricular volumes and between BP and the occurrence of lacunar infarcts were analyzed. RESULTS At baseline mean age was 58 +/- 9 years and mean BP was 138/80 mm Hg. Mean annual decrease in brain tissue volume was 6.5 +/- 3.8 ml and mean annual increase in ventricular volume was 1.0 +/- 1.0 ml. There was no association observed between BP and annual change in brain or ventricular volume, but a clear association was found between BP and incident lacunar infarcts (odds ratio 1.57; 1.11-2.22 per s.d. increase in systolic BP (SBP)). CONCLUSIONS The magnitude of changes in brain tissue and ventricular volume in patients with vascular disease was comparable to the physiological changes described in normal people at a much higher age. Progression of cerebral atrophy in this population may be associated with advanced physiological aging, but is probably not caused by elevated BP.
Collapse
|
39
|
Grau-Olivares M, Arboix A. Mild cognitive impairment in stroke patients with ischemic cerebral small-vessel disease: a forerunner of vascular dementia? Expert Rev Neurother 2009; 9:1201-17. [PMID: 19673608 DOI: 10.1586/ern.09.73] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Ischemic cerebral small-vessel disease accounts for a third of acute cerebral ischemic events and contributes to the development of cognitive decline and dementia. Cerebral small-vessel disease can be visualized on MRI studies as lacunar infarcts, white matter lesions and cerebral microbleeds. In general, the short-term prognosis of ischemic cerebral small-vessel disease compared with other stroke subtypes is more favorable, with almost negligible early mortality, absence of neuropsychological impairment and excellent neurological recovery. However, it has been shown recently that the proportion of dementia caused by small-vessel disease ranges from 36 to 67%. On the other hand, patients with a first-ever lacunar infarction present with cognitive impairment (mainly executive dysfunction) in more than half of cases and more than 55% of patients fulfil the criteria of mild cognitive impairment of the vascular type. Moreover, patients with small-vessel disease have an increase in the mid- and long-term risk of death, stroke recurrence and dementia. Neuropsychological abnormalities in small-vessel disease occurred more frequently than previously recognized. Ischemic cerebral small-vessel disease should be regarded as a potentially severe condition prodrome of subcortical vascular dementia rather than a relatively benign disorder.
Collapse
Affiliation(s)
- Marta Grau-Olivares
- Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, E-08029 Barcelona, Spain.
| | | |
Collapse
|
40
|
Morrow LA, Snitz BE, Rodriquez EG, Huber KA, Saxton JA. High medical co-morbidity and family history of dementia is associated with lower cognitive function in older patients. Fam Pract 2009; 26:339-43. [PMID: 19584123 PMCID: PMC2743736 DOI: 10.1093/fampra/cmp047] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Risk factors for cognitive decline in ageing are multifactorial, including medical co-morbidities and familial genetic risk. OBJECTIVES To assess the effect of medical co-morbidity and family history of dementia on cognitive performance in older outpatients of family practitioners. METHODS Analysis of 535 outpatients from 11 practices aged 65 and older, without a diagnosis of dementia. Information on medical co-morbidities, family history of dementia and cognitive test data were obtained. RESULTS Patients were classified into high or low medical co-morbidities (<7 versus >8) and positive or negative family history of dementia. After controlling for age, education, gender and depression, global cognitive test scores, as well as memory, executive function, spatial ability and attention were significantly lower for persons having a high number of medical co-morbidities. Cognitive test scores were not significantly different for persons with or without a family history of dementia. A significant interaction between medical co-morbidities and family history of dementia was observed for the global cognitive score, executive function and spatial ability. Those persons with a high number of medical co-morbidities and positive family history of dementia had the lowest performance. Separate regression analysis assessing individual disease risk factors (e.g. hypertension and diabetes) did not find any relationship between specific medical variables and cognitive test scores for any of the subgroups. CONCLUSIONS A high number of medical co-morbidities in addition to a reported family history of dementia are particularly detrimental to cognitive performance in elderly non-demented family practice patients.
Collapse
Affiliation(s)
- Lisa A Morrow
- Department of Psychiatry, University of Pittsburgh, PA, USA.
| | | | | | | | | |
Collapse
|
41
|
Altérations cognitives liées au tabac. Presse Med 2009; 38:1241-52. [DOI: 10.1016/j.lpm.2009.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Revised: 01/14/2009] [Accepted: 01/30/2009] [Indexed: 01/19/2023] Open
|
42
|
Takahashi PY, Dyrbye LN, Thomas KG, Cedeno OQ, North F, Stroebel RJ, DeJesus RS, Targonski PV. The association of transient ischemic attack symptoms with memory impairment among elderly participants of the Third US National Health and Nutrition Examination Survey. J Geriatr Psychiatry Neurol 2009; 22:46-51. [PMID: 19073836 DOI: 10.1177/0891988708328218] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE Stroke is a well-known risk factor for vascular dementia. However, the association of transient ischemic attacks with cognitive impairment is less well-established. METHODS Records from Third National Health and Nutrition Examination Survey were abstracted for demographic and medical information for participants with an age >or=60 years who reported being free of stroke. Five self-reported symptoms (weakness, numbness, loss of vision, inability to speak, and severe dizziness) were used as surrogates representing transient ischemic attacks. Information on conventional risk factors for vascular dementia was also obtained. Multivariable logistic regression was used to examine risk factors for memory impairment. RESULTS 4617 participants were included with a sample-weighted prevalence of memory impairment of 6.6% (1417 participants). The final multivariable analysis revealed a significant association between transient weakness and memory impairment (odds ratio 1.52, 95% CI 1.11-2.07). The other 4 transient ischemic attacks symptoms were not significantly associated with memory impairment in the final model. Systolic blood pressure >140 was most strongly associated with prevalent memory impairment (odds ratio, 9.78, 95% CI 1.49-64.3). Other associated risk factors included non-white race, male gender, age, education <or=12 years, and history of any alcohol use. CONCLUSION Among transient ischemic attacks symptoms, self-reported weakness in the face, arm, or leg was significantly associated with memory impairment. This study indicates that transient ischemic attacks symptoms are, even in the absence of stroke, associated with memory impairment. Aggressive risk factor modification in patients with TIA symptoms may be warranted to prevent potential future memory loss.
Collapse
Affiliation(s)
- Paul Y Takahashi
- Department of Internal Medicine, Division of Primary Care Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Peters R, Poulter R, Warner J, Beckett N, Burch L, Bulpitt C. Smoking, dementia and cognitive decline in the elderly, a systematic review. BMC Geriatr 2008; 8:36. [PMID: 19105840 PMCID: PMC2642819 DOI: 10.1186/1471-2318-8-36] [Citation(s) in RCA: 184] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 12/23/2008] [Indexed: 11/27/2022] Open
Abstract
Background Nicotine may aid reaction time, learning and memory, but smoking increases cardiovascular risk. Cardiovascular risk factors have been linked to increased risk of dementia. A previous meta-analysis found that current smokers were at higher risk of subsequent dementia, Alzheimer's disease, vascular dementia and cognitive decline. Methods In order to update and examine this further a systematic review and meta-analysis was carried out using different search and inclusion criteria, database selection and more recent publications. Both reviews were restricted to those aged 65 and over. Results The review reported here found a significantly increased risk of Alzheimer's disease with current smoking and a likely but not significantly increased risk of vascular dementia, dementia unspecified and cognitive decline. Neither review found clear relationships with former smoking. Conclusion Current smoking increases risk of Alzheimer's disease and may increase risk of other dementias. This reinforces need for smoking cessation, particularly aged 65 and over. Nicotine alone needs further investigation.
Collapse
Affiliation(s)
- Ruth Peters
- Experimental Medicine and Toxicology Imperial College Faculty of Medicine, Hammersmith Campus, Du Cane Road, London, UK.
| | | | | | | | | | | |
Collapse
|
44
|
Mild cognitive impairment and event-related potentials in patients with cerebral atrophy and leukoaraiosis. Neurol Sci 2008; 29:411-6. [DOI: 10.1007/s10072-008-1057-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Accepted: 08/28/2008] [Indexed: 10/21/2022]
|
45
|
Nooyens ACJ, van Gelder BM, Verschuren WMM. Smoking and cognitive decline among middle-aged men and women: the Doetinchem Cohort Study. Am J Public Health 2008; 98:2244-50. [PMID: 18923116 DOI: 10.2105/ajph.2007.130294] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We studied the effect of smoking on cognitive decline over a 5-year period at middle age (43 to 70 years). METHODS In the Doetinchem Cohort Study, 1964 men and women in the Netherlands were examined for cognitive function at baseline and 5 years later. The association between smoking status and memory function, speed of cognitive processes, cognitive flexibility, and global cognitive function were assessed. RESULTS At baseline, smokers scored lower than never smokers in global cognitive function, speed, and flexibility. At 5-year follow-up, decline among smokers was 1.9 times greater for memory function, 2.4 times greater for cognitive flexibility, and 1.7 times greater for global cognitive function than among never smokers. Among ever smokers, the declines in all cognitive domains were larger with increasing number of pack-years smoked. CONCLUSIONS Interventions to prevent or stop people from smoking may postpone cognitive decline in middle-aged persons.
Collapse
Affiliation(s)
- Astrid C J Nooyens
- Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | | |
Collapse
|
46
|
Brickman AM, Schupf N, Manly JJ, Luchsinger JA, Andrews H, Tang MX, Reitz C, Small SA, Mayeux R, DeCarli C, Brown TR. Brain morphology in older African Americans, Caribbean Hispanics, and whites from northern Manhattan. ACTA ACUST UNITED AC 2008; 65:1053-61. [PMID: 18695055 DOI: 10.1001/archneur.65.8.1053] [Citation(s) in RCA: 206] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Aging is accompanied by a decrease in brain volume and by an increase in cerebrovascular disease. OBJECTIVE To examine the effects of age, sex, race/ethnicity, and vascular disease history on measures of brain morphology, including relative brain volume, ventricular volume, hippocampus and entorhinal cortex volumes, and white matter hyperintensity (WMH) burden, in a large community-based cohort of racially/ethnically diverse older adults without dementia. DESIGN The associations of age, sex, race/ethnicity, and self-reported vascular disease history with brain morphology were examined in a cross-sectional study using multiple linear regression analyses. Sex x race/ethnicity interactions were also considered. SETTING The Washington Heights-Inwood Columbia Aging Project, a community-based epidemiological study of older adults from 3 racial/ethnic groups (white, Hispanic, and African American) from northern Manhattan. PARTICIPANTS Beginning in 2003, high-resolution quantitative magnetic resonance (MR) images were acquired in 769 participants without dementia. MAIN OUTCOME MEASURES Relative brain volume (total brain volume/intracranial volume), ventricular volume, and hippocampus and entorhinal cortex volumes were derived manually on high-resolution MR images. White matter hyperintensities were quantified semiautomatically on fluid-attenuated inversion recovery-T2-weighted MR images. RESULTS Older age was associated with decreased relative brain volume and with increased ventricular and WMH volumes. Hispanic and African American participants had larger relative brain volumes and more severe WMH burden than white participants, but the associations of these variables with age were similar across racial/ethnic groups. Compared with men, women had larger relative brain volumes. Vascular disease was associated with smaller relative brain volume and with higher WMH burden, particularly among African Americans. CONCLUSIONS Older age and vascular disease, particularly among African Americans, are associated with increased brain atrophy and WMH burden. African American and Hispanic subjects have larger relative brain volumes and more WMH than white subjects. Racial/ethnic group differences in WMH severity seem to be partially attributable to differences in vascular disease. Future work will focus on the determinants and cognitive correlates of these differences.
Collapse
Affiliation(s)
- Adam M Brickman
- Departmentof Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY 10032.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Moretti R, Torre P, Antonello RM, Manganaro D, Vilotti C, Pizzolato G. Risk factors for vascular dementia: hypotension as a key point. Vasc Health Risk Manag 2008; 4:395-402. [PMID: 18561514 PMCID: PMC2496988 DOI: 10.2147/vhrm.s2434] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Physiologically, the cerebral autoregulation system allows maintenance of constant cerebral blood flow over a wide range of blood pressure. In old people, there is a progressive reshape of cerebral autoregulation from a sigmoid curve to a straight line. This implies that any abrupt change in blood pressure will result in a rapid and significant change in cerebral blood flow. Hypertension has often been observed to be a risk factor for vascular dementia (VaD) and sometimes for Alzheimer disease although not always. Indeed, high blood pressure may accelerate cerebral white matter lesions, but white matter lesions have been found to be facilitated by excessive fall in blood pressure, including orthostatic dysregulation and postprandial hypotension. Many recent studies observed among other data, that there was a correlation between systolic pressure reduction and cognitive decline in women, which was not accounted for by other factors. Baseline blood pressure level was not significantly related to cognitive decline with initial good cognition. Some researchers speculate that blood pressure reduction might be an early change of the dementing process. The most confounding factor is that low pressure by itself might be a predictor of death; nevertheless, the effect of low blood pressure on cognition is underestimated because of a survival bias. Another explanation is that clinically unrecognized vascular lesions in the brain or atherosclerosis are responsible for both cognitive decline and blood pressure reduction. We discuss the entire process, and try to define a possible mechanism that is able to explain the dynamic by which hypotension might be related to dementia.
Collapse
Affiliation(s)
- Rita Moretti
- Department of Internal Medicine and Clinical Neurology, University of Trieste, Italy.
| | | | | | | | | | | |
Collapse
|
48
|
Gazdzinski S, Kornak J, Weiner MW, Meyerhoff DJ. Body mass index and magnetic resonance markers of brain integrity in adults. Ann Neurol 2008; 63:652-7. [PMID: 18409192 DOI: 10.1002/ana.21377] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Obesity and being overweight during adulthood have been consistently linked to increased risk for development of dementia later in life, especially Alzheimer's disease. They have also been associated with cognitive dysfunction and brain structural alterations in otherwise healthy adults. Although proton magnetic resonance spectroscopy may distinguish between neuronal and glial components of the brain and may point to neurobiological mechanisms underlying brain atrophy and cognitive changes, no spectroscopic studies have yet assessed the relationships between adiposity and brain metabolites. METHODS We have utilized magnetic resonance imaging and proton magnetic resonance spectroscopic imaging data from 50 healthy middle-aged participants (mean age, 41.7 +/- 8.5 years; 17 women), who were scanned as control subjects for another study. RESULTS After adjustment for age and sex, greater body mass indices (BMIs) correlated with: (1) lower concentrations of N-acetylaspartate (spectroscopic marker of neuronal viability) in frontal (p = 0.001), parietal (p = 0.006), and temporal (p = 0.008) white matter; (2) lower N-acetylaspartate in frontal gray matter (p = 0.01); and (3) lower concentrations of choline-containing metabolites (associated with membrane metabolism) in frontal white matter (p = 0.05). INTERPRETATION These results suggest that increased BMI at midlife is associated with neuronal and/or myelin abnormalities, primarily in the frontal lobe. Because white matter in the frontal lobes is more prone to the effects of aging than in other lobes, our results may reflect accelerated aging in individuals with high levels of adiposity. Thus, greater BMI may increase the odds of developing an age-related disease, such as Alzheimer's disease.
Collapse
Affiliation(s)
- Stefan Gazdzinski
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical Center, University of California San Francisco, San Francisco, CA 94121, USA.
| | | | | | | |
Collapse
|
49
|
Mills S, Cain J, Purandare N, Jackson A. Biomarkers of cerebrovascular disease in dementia. Br J Radiol 2008; 80 Spec No 2:S128-45. [PMID: 18445743 DOI: 10.1259/bjr/79217686] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
There is increasing recognition that cerebrovascular disease contributes significantly to the development and progression of patients with dementia. The concepts of pure vascular and pure degenerative dementia have been replaced with a recognition that, in many patients, there is a spectrum of neurodegenerative and vascular processes. This is supported by preliminary studies showing response to vascular therapeutics and ventriculo-peritoneal shunting in patients with Alzheimer's disease. This article examines the imaging biomarkers that are available for the characterization of microvascular abnormality in the ageing brain, with particular reference to microvascular angiopathy, cerebral embolic disease, orthostatic hypotension and abnormalities of Monro-Kellie homeostasis.
Collapse
Affiliation(s)
- S Mills
- Division of Imaging Science, University of Manchester, Wolfson Molecular Imaging Centre, 27 Palatine Rd, Withington, Manchester, UK
| | | | | | | |
Collapse
|
50
|
Carlson EB, Lauderdale S, Hawkins J, Sheikh JI. Posttraumatic stress and aggression among veterans in long-term care. J Geriatr Psychiatry Neurol 2008; 21:61-71. [PMID: 18287172 DOI: 10.1177/0891988707311557] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Because stresses associated with long-term care settings may exacerbate distress and aggression related to past trauma, we investigated self-report and staff reports of posttraumatic stress disorder symptoms and staff observations of verbal and physical aggression in 32 elderly males who were patients in a long-term care unit for veterans. Feelings of anger and irritability were reported by 47% of patients; levels of anger and irritability were significantly correlated with observed aggressive behaviors (r = 0.43, P < .02); and observed aggressive behaviors were significantly more frequent among those reporting past traumatic stressors (t = 2.84, P < .008). Patient-reported posttraumatic stress disorder symptoms were significantly correlated with the frequency of past traumatic stressors (r = 0.48, P < .006). Observer-reported posttraumatic stress disorder symptoms and patient reports of anger were strongly correlated (r = 0.73, P < .001). No patient or staff reports were related to level of cognitive function. These findings are consistent with the hypothesis that posttraumatic symptoms can contribute to aggressive behaviors in elderly, medically ill, and cognitively impaired patients.
Collapse
Affiliation(s)
- Eve B Carlson
- National Center for Posttraumatic Stress Disorder, Department of Veterans Affairs, Menlo Park, California 94025, USA.
| | | | | | | |
Collapse
|