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Grande G, Li Y, Trevisan C, Rizzuto D, Kalpouzos G, Ding M, Laukka EJ, Bellander T, Fratiglioni L, Qiu C. Lung function in relation to brain aging and cognitive transitions in older adults: A population-based cohort study. Alzheimers Dement 2024; 20:5662-5673. [PMID: 38970219 PMCID: PMC11350049 DOI: 10.1002/alz.14079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/27/2024] [Accepted: 05/29/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND We investigated the association of peak expiratory flow (PEF) with dementia; cognitive impairment, no dementia (CIND); and transition from CIND to dementia, and possible underlying neuropathological mechanisms. METHODS A population-based cohort of adults aged 60+ was followed over 15 years to detect dementia (Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria), CIND (assessed through a cognitive battery), and progression from CIND to dementia, in relation to baseline PEF observations. A subsample (n = 462) had 6-year follow-up data on brain magnetic resonance imaging markers of neurodegeneration and small vessel disease. RESULTS In fully adjusted models, poor PEF performance (< 10th vs. ≥ 80th percentile) was associated with increased hazards for dementia (hazard ratio [HR] = 1.89; 95% confidence interval [CI] = 1.23-2.92) and CIND (HR = 1.55; 95% CI = 1.01-2.38) and CIND progression to dementia, although not statistically significantly (HR = 2.44; 95% CI = 0.78-6.88). People with poor PEF also experienced the fastest ventricular enlargement (β coefficient = 0.67 mL/year; 95% CI = 0.13-1.21) and had the highest likelihood of developing lacunes (odds ratio = 5.05; 95% CI = 1.01-25.23). DISCUSSION Poor lung function contributes to cognitive deterioration possibly through accelerated brain atrophy and microvascular damage. HIGHLIGHTS Poor lung function increased the risk of dementia and mild cognitive impairment (MCI). Poor lung function accelerated the progression from MCI to dementia. Poor lung function was linked to brain microvascular damage and global brain atrophy.
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Affiliation(s)
- Giulia Grande
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CentreStockholmSweden
| | - Yuanjing Li
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Caterina Trevisan
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Department of Medical SciencesUniversity of FerraraFerraraItaly
| | - Debora Rizzuto
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CentreStockholmSweden
| | - Grégoria Kalpouzos
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Mozhu Ding
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Erika J Laukka
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CentreStockholmSweden
| | - Tom Bellander
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Laura Fratiglioni
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CentreStockholmSweden
| | - Chengxuan Qiu
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
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Li Y, Dekhtyar S, Grande G, Kalpouzos G, Gregorio C, Laukka EJ, Qiu C. Association of cognitive reserve with transitions across cognitive states and death in older adults: A 15-year follow-up study. Alzheimers Dement 2024; 20:4737-4746. [PMID: 38779828 PMCID: PMC11247709 DOI: 10.1002/alz.13910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION We investigated the association of cognitive reserve (CR) with transitions across cognitive states and death. METHODS This population-based cohort study included 2631 participants (age ≥60 years) who were dementia-free at baseline and regularly examined up to 15 years. Data were analyzed using the Markov multistate models. RESULTS Each 1-point increase in the composite CR score (range: -4.25 to 3.46) was significantly associated with lower risks of transition from normal cognition to cognitive impairment, no dementia (CIND) (multivariable-adjusted hazards ratio = 0.78; 95% confidence interval = 0.72-0.85) and death (0.85; 0.79-0.93), and from CIND to death (0.82; 0.73-0.91), but not from CIND to normal cognition or dementia. A greater composite CR score was associated with a lower risk of transition from CIND to death in people aged 60-72 but not in those aged ≥ 78 years. DISCUSSION CR contributes to cognitive health by delaying cognitive deterioration in the prodromal phase of dementia. HIGHLIGHTS We use Markov multistate model to examine the association between cognitive reserve and transitions across cognitive states and death. A great cognitive reserve contributes to cognitive health by delaying cognitive deterioration in the prodromal phase of dementia. A great cognitive reserve is associated with a lower risk of transition from cognitive impairment, no dementia to death in people at the early stage of old age, but not in those at the late stage of old age.
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Affiliation(s)
- Yuanjing Li
- Aging Research Center, Department of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
| | - Grégoria Kalpouzos
- Aging Research Center, Department of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
| | - Caterina Gregorio
- Biostatistics Unit, Department of Medical SciencesUniversity of TriesteTrieste TSItaly
- MOX ‐ Modeling and Scientific Computing Laboratory, Department of MathematicsPolitecnico di Milano, Piazza Leonardo da VinciMilanoItaly
| | - Erika J. Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
- Stockholm Gerontology Research CenterStockholmSweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
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Zhao M, Li Y, Han X, Li C, Wang P, Wang J, Hou T, Wang Y, Cong L, Wardlaw JM, Launer LJ, Song L, Du Y, Qiu C. Association of enlarged perivascular spaces with cognitive function in dementia-free older adults: A population-based study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12618. [PMID: 39045142 PMCID: PMC11264110 DOI: 10.1002/dad2.12618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 06/07/2024] [Accepted: 06/13/2024] [Indexed: 07/25/2024]
Abstract
Introduction We sought to characterize cognitive profiles associated with enlarged perivascular spaces (EPVS) among Chinese older adults. Methods This population-based study included 1191 dementia-free participants (age ≥60 years) in the MIND-China MRI Substudy (2018-2020). We visually evaluated EPVS in basal ganglia (BG) and centrum semiovale (CSO), white matter hyperintensities (WMHs), lacunes, cerebral microbleeds (CMBs), and cortical superficial siderosis. We used a neuropsychological test battery to assess cognitive function. Data were analyzed using general linear models. Results Greater BG-EPVS load was associated with lower z-scores in memory, verbal fluency, and global cognition (p < 0.05); these associations became non-significant when controlling for other cerebral small vessel disease (CSVD) markers (e.g., WMHs, lacunes, and mixed CMBs). Overall, CSO-EPVS load was not associated with cognitive z-scores (p > 0.05); among apolipoprotein E (APOE) -ε4 carriers, greater CSO-EPVS load was associated with lower verbal fluency z-score, even when controlling for other CSVD markers (p < 0.05). Discussion The associations of BG-EPVS with poor cognitive function in older adults are largely attributable to other CSVD markers. HIGHLIGHTS The association of enlarged perivascular spaces (EPVS) with cognitive function in older people is poorly defined.The association of basal ganglia (BG)-EPVS with poor cognition is attributed to other cerebral small vessel disease (CSVD) markers.In apolipoprotein E (APOE) ε4 carriers, a higher centrum semiovale (CSO)-EPVS load is associated with poorer verbal fluency.
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Affiliation(s)
- Mingqing Zhao
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongP. R. China
- Department of NeurologyXuanwu Hospital Capital Medical University Jinan BranchJinanShandongP. R. China
| | - Yuanjing Li
- Aging Research CenterDepartment of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
| | - Xiaodong Han
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
| | - Chunyan Li
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongP. R. China
| | - Pin Wang
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
| | - Jiafeng Wang
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
| | - Tingting Hou
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongP. R. China
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
| | - Yongxiang Wang
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongP. R. China
- Aging Research CenterDepartment of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
- Institute of Brain Science and Brain‐Inspired ResearchShandong First Medical University & Shandong Academy of Medical SciencesJinanShandongP. R. China
| | - Lin Cong
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongP. R. China
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
| | - Joanna M. Wardlaw
- Centre for Clinical Brain SciencesUK Dementia Research InstituteUniversity of EdinburghEdinburghUK
| | - Lenore J. Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research ProgramNational Institute on Aging, National Institutes of HealthBaltimoreMarylandUSA
| | - Lin Song
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongP. R. China
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
| | - Yifeng Du
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongP. R. China
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
- Institute of Brain Science and Brain‐Inspired ResearchShandong First Medical University & Shandong Academy of Medical SciencesJinanShandongP. R. China
| | - Chengxuan Qiu
- Department of NeurologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongP. R. China
- Aging Research CenterDepartment of Neurobiology, Care Sciences and SocietyKarolinska Institutet‐Stockholm UniversitySolnaSweden
- Department of NeurologyShandong Provincial HospitalShandong UniversityJinanShandongP. R. China
- Institute of Brain Science and Brain‐Inspired ResearchShandong First Medical University & Shandong Academy of Medical SciencesJinanShandongP. R. China
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Sugai Y, Hiraka T, Shibata A, Taketa A, Tanae T, Moriya Y, Komatsu M, Iseki C, Ohta Y, Kanoto M. The time-course augmentation of perivascular space enlargement in the basal ganglia among a community-dwelling elder population. Jpn J Radiol 2024:10.1007/s11604-024-01595-3. [PMID: 38896331 DOI: 10.1007/s11604-024-01595-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE We examined whether time-course augmentation of perivascular space enlargement in the basal ganglia (BG-PVS) reflected cerebral small vessel disease (CSVD) severity by considering white matter hyperintensity lesion (WMHL) as an indicator for CSVD. MATERIALS AND METHODS This study population included 416 older participants from a community-based cohort. They participated in magnetic resonance imaging (MRI) studies more than once during the study period. The grades for BG-PVS and WMHL were evaluated by visual rating scales; BG-PVS time-course augmentation in 4-9 years was also evaluated. At baseline, the participants were asked about their smoking and drinking history, and medical history. They also underwent a blood examination and their office blood pressure (BP) examination. In addition, 24-h ambulatory BP monitoring was also performed within the study period. RESULTS Of the 416 participants, 48 participants (11.5%) had BG-PVS time-course augmentation. The participants with BG-PVS augmentation had significantly lower LDL levels, hyper-nighttime BP, and lower nighttime BP fall in univariate analysis (p = 0.03, p = 0.03, p = 0.003, respectively). In multivariate analysis, lower nighttime BP fall and male sex showed significance (p = 0.02, 0.03, respectively). Additionally, BG-PVS time-course augmentation was significantly associated with subsequent WMHL severity in univariate analysis (p < 0.001), which remained significant in multivariate analysis adjusted by imaging and demographic factors (p = 0.03). In multivariate analysis, additionally adjusted by the clinical factors, the significance disappeared (p = 0.07). CONCLUSION This study revealed that the lower nighttime BP fall in ambulatory blood pressure monitoring was a factor significantly associated with BG-PVS augmentation. Moreover, the BG-PVS time-course augmentation would be a notable finding that was associated with the subsequent WMHL.
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Affiliation(s)
- Yasuhiro Sugai
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Toshitada Hiraka
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Akiko Shibata
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Ayato Taketa
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Taiyo Tanae
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Yosuke Moriya
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Masanori Komatsu
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Chifumi Iseki
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yasuyuki Ohta
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Masafumi Kanoto
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
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Rowsthorn E, Pham W, Nazem-Zadeh MR, Law M, Pase MP, Harding IH. Imaging the neurovascular unit in health and neurodegeneration: a scoping review of interdependencies between MRI measures. Fluids Barriers CNS 2023; 20:97. [PMID: 38129925 PMCID: PMC10734164 DOI: 10.1186/s12987-023-00499-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
The neurovascular unit (NVU) is a complex structure that facilitates nutrient delivery and metabolic waste clearance, forms the blood-brain barrier (BBB), and supports fluid homeostasis in the brain. The integrity of NVU subcomponents can be measured in vivo using magnetic resonance imaging (MRI), including quantification of enlarged perivascular spaces (ePVS), BBB permeability, cerebral perfusion and extracellular free water. The breakdown of NVU subparts is individually associated with aging, pathology, and cognition. However, how these subcomponents interact as a system, and how interdependencies are impacted by pathology remains unclear. This systematic scoping review identified 26 studies that investigated the inter-relationships between multiple subcomponents of the NVU in nonclinical and neurodegenerative populations using MRI. A further 112 studies investigated associations between the NVU and white matter hyperintensities (WMH). We identify two putative clusters of NVU interdependencies: a 'vascular' cluster comprising BBB permeability, perfusion and basal ganglia ePVS; and a 'fluid' cluster comprising ePVS, free water and WMH. Emerging evidence suggests that subcomponent coupling within these clusters may be differentially related to aging, neurovascular injury or neurodegenerative pathology.
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Affiliation(s)
- Ella Rowsthorn
- Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Turner Institute for Brain and Mental Health & School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton, VIC, 3168, Australia
| | - William Pham
- Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Mohammad-Reza Nazem-Zadeh
- Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Department of Radiology, Alfred Health, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Department of Electrical and Computer Systems Engineering, Monash University, 14 Alliance Lane, Clayton, VIC, 3168, Australia
| | - Matthew P Pase
- Turner Institute for Brain and Mental Health & School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton, VIC, 3168, Australia
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Ian H Harding
- Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
- Monash Biomedical Imaging, Monash University, 762-772 Blackburn Road, Clayton, VIC, 3168, Australia.
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Backhouse EV, Bauermeister S, Wardlaw JM. Lifetime influences on imaging markers of adverse brain health and vascular disease. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 6:100194. [PMID: 38292018 PMCID: PMC10827485 DOI: 10.1016/j.cccb.2023.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/13/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024]
Abstract
Cerebral small vessel disease (cSVD) is highly prevalent in the general population, increases with age and vascular risk factor exposure, and is a common cause of stroke and dementia. There is great variation in cSVD burden experienced in older age, and maintaining brain health across the life course requires looking beyond an individual's current clinical status and traditional vascular risk factors. Of particular importance are social determinants of health which can be more important than healthcare or lifestyle choices in influencing later life health outcomes, including brain health. In this paper we discuss the social determinants of cerebrovascular disease, focusing on the impact of socioeconomic status on markers of cSVD. We outline the potential mechanisms behind these associations, including early life exposures, health behaviours and brain reserve and maintenance, and we highlight the importance of public health interventions to address the key determinants and risk factors for cSVD from early life stages.
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Affiliation(s)
- Ellen V Backhouse
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK
- MRC UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Sarah Bauermeister
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- MRC UK Dementia Research Institute, University of Oxford, Oxford OX3 7JX, UK
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK
- MRC UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, UK
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Li Y, Kalpouzos G, Bäckman L, Qiu C, Laukka EJ. Association of white matter hyperintensity accumulation with domain-specific cognitive decline: a population-based cohort study. Neurobiol Aging 2023; 132:100-108. [PMID: 37776581 DOI: 10.1016/j.neurobiolaging.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 10/02/2023]
Abstract
We investigated the association of load and accumulation of white matter hyperintensities (WMHs) with rate of cognitive decline. This population-based study included 510 dementia-free people (age ≥60 years) who had repeated measures of global and regional (lobar, deep, periventricular) WMHs up to 6 years (from 2001-2003 to 2007-2010) and repeated measures of cognitive function (episodic memory, semantic memory, category fluency, letter fluency, executive function, perceptual speed) up to 15 years (from 2001-2004 to 2016-2019). We found that greater baseline loads of global and regional WMHs were associated with faster decline in letter fluency, perceptual speed, and global cognition. Furthermore, faster accumulation of global, deep, and periventricular WMHs was related to accelerated cognitive decline, primarily in perceptual speed. These data show that WMHs are associated with decline in perceptual speed rather than episodic or semantic memory and that cognitive change is more vulnerable to WMH accumulations in deep and periventricular regions.
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Affiliation(s)
- Yuanjing Li
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Grégoria Kalpouzos
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
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Johansson J, Karalija N, Salami A. Cerebrovascular integrity affects gradients of aging-related dopamine D1 differences in the striatum. AGING BRAIN 2023; 4:100094. [PMID: 37645244 PMCID: PMC10460986 DOI: 10.1016/j.nbas.2023.100094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/31/2023] Open
Abstract
Extant research suggest aging-related losses of different dopaminergic markers, including presynaptic dopamine transporters as well as post-synaptic DA receptors. Given the central role of DA in neurocognitive functions, maintenance of a healthy DA system may be a key to mitigate age-related cognitive decline. Mechanisms behind DA losses in aging are however largely uncharted. Past research documented an association between dopaminergic integrity and cerebrovascular health (via white matter lesion volumes). However, it remains unclear whether proximity to lesions affected the spatial patterns of age-related D1DR differences within the striatum, and whether such differences are related to mnemonic function. Here, a large cohort of middle-aged to older healthy participants (age = 40-80 years, n = 119, 50 % women) was assessed for D1-receptor (D1DR) availability with positron emission tomography using [11C]SCH23390, and for white matter lesions using FLAIR-MRI. We found evidence for variations in degree of age-related differences along the ventro-dorsal axis, with more pronounced differences in the dorsal caudate. Further analyses revealed an association between distance to lesions and extent of D1DR losses in the caudate. Furthermore, D1DR differences in dorsal caudate (proximal to lesions) was more strongly associated with memory performance. In conclusion, the present findings suggest that maintenance of cerebrovascular health may be a key factor in promoting successful dopaminergic and memory aging.
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Affiliation(s)
- Jarkko Johansson
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, S-90187 Umeå, Sweden
- Umeå Ceer for Functional Brain Imaging (UFBI), Umeå University, S-90187 Umeå, Sweden
- Wallenberg Center for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Nina Karalija
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, S-90187 Umeå, Sweden
- Department of Integrative Medical Biology, Umeå University, S-90187 Umeå, Sweden
| | - Alireza Salami
- Umeå Ceer for Functional Brain Imaging (UFBI), Umeå University, S-90187 Umeå, Sweden
- Wallenberg Center for Molecular Medicine, Umeå University, Umeå, Sweden
- Department of Integrative Medical Biology, Umeå University, S-90187 Umeå, Sweden
- Aging Research Center, Karolinska Institutet & Stockholm University, S-17165 Stockholm, Sweden
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Progress on Prevention and Treatment of Cerebral Small Vascular Disease Using Integrative Medicine. Chin J Integr Med 2023; 29:186-191. [PMID: 36527536 DOI: 10.1007/s11655-022-3622-8] [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] [Accepted: 07/01/2022] [Indexed: 12/23/2022]
Abstract
Cerebral small vessel disease (CSVD) is a senile brain lesion caused by the abnormal structure and function of arterioles, venules and capillaries in the aging brain. The etiology of CSVD is complex, and disease is often asymptomatic in its early stages. However, as CSVD develops, brain disorders may occur, such as stroke, cognitive dysfunction, dyskinesia and mood disorders, and heart, kidney, eye and systemic disorders. As the population continues to age, the burden of CSVD is increasing. Moreover, there is an urgent need for better screening methods and diagnostic markers for CSVD, in addition to preventive and asymptomatic- and mild-stage treatments. Integrative medicine (IM), which combines the holistic concepts and syndrome differentiations of Chinese medicine with modern medical perspectives, has unique advantages for the prevention and treatment of CSVD. In this review, we summarize the biological markers, ultrasound and imaging features, disease-related genes and risk factors relevant to CSVD diagnosis and screening. Furthermore, we discuss IM-based CSVD prevention and treatment strategies to stimulate further research in this field.
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Li Y, Laukka EJ, Dekhtyar S, Papenberg G, Speh A, Fratiglioni L, Kalpouzos G, Qiu C. Association Between Behavioral, Biological, and Genetic Markers of Cardiovascular Health and MRI Markers of Brain Aging: A Cohort Study. Neurology 2023; 100:e38-e48. [PMID: 36319110 PMCID: PMC9827130 DOI: 10.1212/wnl.0000000000201346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/19/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The life's simple 7 approach was proposed to define cardiovascular health (CVH) metrics. We sought to investigate the associations between behavioral, biological, and genetic markers for CVH and vascular brain aging in older adults. METHODS This population-based cohort study included participants who had repeated brain MRI measures from 2001 to 2003 to 2007-2010 (i.e., count of perivascular spaces, volumes of white matter hyperintensity [WMH] and gray matter, and lacunes). At baseline, global, behavioral, and biological CVH metrics were defined and scored following the life's simple 7 approach and categorized into unfavorable, intermediate, and favorable profiles according to tertiles. The metabolic genetic risk score was calculated by counting 15 risk alleles associated with hypertension, diabetes, or dyslipidemia. Data were analyzed using linear mixed-effects and Cox proportional hazards models, adjusting for age, sex, and education. RESULTS The study sample consisted of 317 participants (age 60 years or older; 61.8% women). Favorable and intermediate (vs unfavorable) global CVH profiles were related to slower WMH progression, with β-coefficients (95% CI) being -0.019(-0.035-0.002) and -0.018(-0.034-0.001), respectively. Favorable and intermediate (vs unfavorable) biological CVH profiles were significantly related to slower WMH increase only in people aged 60-72 years. CVH profiles were not related to progression of other brain measures. Furthermore, a higher metabolic genetic risk score (range: 6-21) was associated with faster WMH increase (β-coefficient = 0.005; 95% CI: 0.003-0.008). There were statistical interactions of metabolic genetic risk score with global and behavioral CVH profiles on WMH accumulation. A higher metabolic genetic risk score was related to faster WMH accumulation, with β-coefficients being 0.015(0.007-0.023), 0.005(0.001-0.009), and 0.003(-0.001 to 0.006) among people with unfavorable, intermediate, and favorable global CVH profiles, respectively; the corresponding β-coefficients were 0.013(0.006-0.020), 0.006(0.003-0.009), and 0.002(-0.002 to 0.006) among people with unfavorable, intermediate, and favorable behavioral CVH profiles. DISCUSSION Intermediate to favorable global CVH profiles in older adults are associated with slower vascular brain aging. The association of metabolic genetic risk load with accelerated vascular brain aging was evident among people with unfavorable to intermediate, but not favorable, CVH profiles. These findings highlight the importance of adhering to favorable CVH profiles, especially healthy behaviors, in vascular brain health.
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Affiliation(s)
- Yuanjing Li
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Erika J Laukka
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Serhiy Dekhtyar
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Goran Papenberg
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Andreja Speh
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Laura Fratiglioni
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Grégoria Kalpouzos
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Chengxuan Qiu
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia.
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11
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Li Y, Wang M, Cong L, Hou T, Song L, Wang X, Shi L, Dekhtyar S, Wang Y, Du Y, Qiu C. Lifelong Cognitive Reserve, Imaging Markers of Brain Aging, and Cognitive Function in Dementia-Free Rural Older Adults: A Population-Based Study. J Alzheimers Dis 2023; 92:261-272. [PMID: 36710675 PMCID: PMC10041437 DOI: 10.3233/jad-220864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Cognitive reserve (CR) partly explains cognitive variability in the presence of pathological brain aging. OBJECTIVE We investigated the interplay of lifelong CR with age, sex, and brain aging markers in cognitive phenotypes among older adults with very limited education. METHODS This population-based cross-sectional study included 179 dementia-free participants (age ≥65 years; 39.7% women; 67.0% had no or elementary education) examined in 2014-2016. We assessed lacunes and volumes of hippocampus, ventricles, grey matter, white matter (WM), and white matter hyperintensities. Lifelong CR score was generated from six lifespan intellectual factors (e.g., education and social support). We used Mini-Mental State Examination (MMSE) score to assess cognition and Petersen's criteria to define mild cognitive impairment (MCI). Data were analyzed using general linear and logistic models. RESULTS The association of higher lifelong CR score (range: -4.0-5.0) with higher MMSE score was stronger in women (multivariable-adjusted β-coefficient and 95% CI: 1.75;0.99-2.51) than in men (0.68;0.33-1.03) (pinteraction = 0.006). The association of higher CR with MCI (multivariable-adjusted odds ratio and 95% CI: 0.77;0.60-0.99) did not vary by age or sex. Among participants with low CR (<1.4[median]), greater hippocampal and WM volumes were related to higher MMSE scores with multivariable-adjusted β-coefficients being 1.77(0.41-3.13) and 0.44(0.15-0.74); the corresponding figures in those with high CR were 0.15(-0.76-1.07) and -0.17(-0.41-0.07) (pinteraction <0.01). There was no statistical interaction of CR with MRI markers on MCI. CONCLUSION Greater lifelong CR capacity is associated with better late-life cognition among people with limited education, possibly by compensating for impact of neurodegeneration.
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Affiliation(s)
- Yuanjing Li
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Mingqi Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, P.R. China
| | - Serhiy Dekhtyar
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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12
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Han X, Song L, Li Y, Dong Y, Liu R, Han Q, Wang X, Mao M, Cong L, Tang S, Hou T, Zhang Q, Liu C, Han X, Shi L, Nyberg L, Launer LJ, Wang Y, Du Y, Qiu C. Accelerometer-Measured Sedentary Behavior Patterns, Brain Structure, and Cognitive Function in Dementia-Free Older Adults: A Population-Based Study. J Alzheimers Dis 2023; 96:657-668. [PMID: 37840495 PMCID: PMC10657675 DOI: 10.3233/jad-230575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Sedentary behavior is associated with cognitive impairment, but the neuropathological mechanisms underlying their associations are poorly understood. OBJECTIVE To investigate the associations of accelerometer-measured sedentary behavior patterns with brain structure and cognition, and further to explore the potential mechanisms. METHODS This community-based study included 2,019 older adults (age≥60 years, 59% women) without dementia derived from participants in the baseline examination of MIND-China (2018-2020). We assessed sedentary parameters using an accelerometer and cognitive function using a neuropsychological test battery. Structural brain markers were assessed on the structural brain MRI scans in a subsample (n = 1,009). Data were analyzed using the general linear, isotemporal substitution, and mediation models. RESULTS In the total sample (n = 2,019), adjusting for multiple covariates and moderate-to-vigorous-intensity physical activity, longer mean sedentary bout duration was linearly related with lower z-scores of global cognition, verbal fluency, and memory (ptrend < 0.05), whereas greater total sedentary time was linearly associated with lower z-scores of global cognition, verbal fluency, and memory only among individuals with long sedentary time (>10 h/day) (ptrend < 0.05); Breaking up sedentary time with same amount of light-intensity physical activity was significantly associated with higher verbal fluency and memory z-scores (p < 0.05). In the MRI subsample (n = 1,009), separately entering structural brain MRI markers into the mediation models substantially attenuated the associations of mean sedentary bout duration with global cognition, verbal fluency, and memory z-scores. CONCLUSION Prolonged uninterrupted sedentary time is associated with poor global cognition, memory, and verbal fluency among rural older adults, and structural brain markers could partially mediate the association.
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Affiliation(s)
- Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Yuanjing Li
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Rui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Qi Han
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Xiaojie Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Ming Mao
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Qinghua Zhang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Cuicui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Xiaodong Han
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Lin Shi
- BrainNow Research Institute, Shenzhen, Guangdong, China
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lars Nyberg
- Department of Radiation Sciences, Radiology, Umeå University, Umeå, Sweden
| | - Lenore J. Launer
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Institute of Brain Science and Brain-inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Institute of Brain Science and Brain-inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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13
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Del Brutto OH, Mera RM, Costa AF, Rumbea DA, Recalde BY, Del Brutto VJ. Patterns of progression of cerebral small vessel disease markers in older adults of Amerindian ancestry: a population-based, longitudinal prospective cohort study. Aging Clin Exp Res 2022; 34:2751-2759. [PMID: 35999426 PMCID: PMC9398047 DOI: 10.1007/s40520-022-02223-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/07/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Progression of cerebral small vessel disease (cSVD) markers has been studied in different races/ethnic groups. However, information from individuals of Amerindian ancestry is lacking. We sought to evaluate progression patterns of cSVD markers in community-dwelling older adults of Amerindian ancestry. METHODS Following a longitudinal prospective study design, participants of the Atahualpa Project Cohort aged ≥ 60 years received a baseline brain MRI and clinical interviews. Those who also received a brain MRI at the end of the study were included. Poisson regression models were fitted to assess cSVD markers progression according to their baseline load after a median follow-up of 6.5 ± 1.4 years. Logistic regression models were fitted to assess interrelations in the progression of the different cSVD markers at the end of the study. RESULTS The study included 263 individuals (mean age: 65.7 ± 6.2 years). Progression of white matter hyperintensities (WMH) was noticed in 103 (39%) subjects, cerebral microbleeds in 25 (12%), lacunes in 12 (5%), and enlarged basal ganglia-perivascular spaces (BG-PVS) in 56 (21%). Bivariate Poisson regression models showed significant associations between WMH severity at baseline and progression of WMH and enlarged BG-PVS. These associations became non-significant in multivariate models adjusted for clinical covariates. Logistic regression models showed interrelated progressions of WMH, cerebral microbleeds and enlarged BG-PVS. The progression of lacunes was independent. CONCLUSIONS Patterns of cSVD marker progression in this population of Amerindians are different than those reported in other races/ethnic groups. The independent progression of lacunes suggests different pathogenic mechanisms with other cSVD markers.
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Affiliation(s)
- Oscar H. Del Brutto
- School of Medicine and Research Center, Universidad Espíritu Santo–Ecuador, Urbanización Toscana, Apt 3H, Km 4.5 vía Puntilla-Samborondón, 092301 Samborondón, Ecuador
| | - Robertino M. Mera
- Biostatistics/Epidemiology, Freenome, Inc., South San Francisco, CA USA
| | - Aldo F. Costa
- Department of Neurology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Denisse A. Rumbea
- School of Medicine and Research Center, Universidad Espíritu Santo–Ecuador, Urbanización Toscana, Apt 3H, Km 4.5 vía Puntilla-Samborondón, 092301 Samborondón, Ecuador
| | - Bettsy Y. Recalde
- School of Medicine and Research Center, Universidad Espíritu Santo–Ecuador, Urbanización Toscana, Apt 3H, Km 4.5 vía Puntilla-Samborondón, 092301 Samborondón, Ecuador
| | - Victor J. Del Brutto
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
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