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Strand BH, Håberg AK, Eyjólfsdóttir HS, Kok A, Skirbekk V, Huxhold O, Løset GK, Lennartsson C, Schirmer H, Herlofson K, Veenstra M. Spousal bereavement and its effects on later life physical and cognitive capability: the Tromsø study. GeroScience 2024:10.1007/s11357-024-01150-y. [PMID: 38594472 DOI: 10.1007/s11357-024-01150-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/31/2024] [Indexed: 04/11/2024] Open
Abstract
Spousal bereavement is associated with health declines and increased mortality risk, but its specific impact on physical and cognitive capabilities is less studied. A historical cohort study design was applied including married Tromsø study participants (N=5739) aged 50-70 years with baseline self-reported overall health and health-related factors and measured capability (grip strength, finger tapping, digit symbol coding, and short-term recall) at follow-up. Participants had data from Tromsø4 (1994-1995) and Tromsø5 (2001), or Tromsø6 (2007-2008) and Tromsø7 (2015-2016). Propensity score matching, adjusted for baseline confounders (and baseline capability in a subset), was used to investigate whether spousal bereavement was associated with poorer subsequent capability. Spousal bereavement occurred for 6.2% on average 3.7 years (SD 2.0) before the capability assessment. There were no significant bereavement effects on subsequent grip strength, immediate recall, or finger-tapping speed. Without adjustment for baseline digit symbol coding test performance, there was a negative significant effect on the digit symbol coding test (ATT -1.33; 95% confidence interval -2.57, -0.10), but when baseline digit symbol coding test performance was taken into account in a smaller subsample, using the same set of matching confounders, there was no longer any association (in the subsample ATT changed from -1.29 (95% CI -3.38, 0.80) to -0.04 (95% CI -1.83, 1.75). The results in our study suggest that spousal bereavement does not have long-term effects on the intrinsic capacity components physical or cognition capability to a notable degree.
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Affiliation(s)
- Bjørn Heine Strand
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway.
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
| | - Asta K Håberg
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Harpa Sif Eyjólfsdóttir
- Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Stockholm University, Stockholm, Sweden
| | - Almar Kok
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life Programme, Amsterdam, The Netherlands
| | - Vegard Skirbekk
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Gøril Kvamme Løset
- NOVA - Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
| | - Carin Lennartsson
- Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden
- Swedish Institute for Social Research (SOFI), Stockholm University, Stockholm, Sweden
| | - Henrik Schirmer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Cardiology, Akershus, University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Katharina Herlofson
- NOVA - Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
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Anbar R, Sultan SR, Al Saikhan L, Alkharaiji M, Chaturvedi N, Hardy R, Richards M, Hughes A. Is carotid artery atherosclerosis associated with poor cognitive function assessed using the Mini-Mental State Examination? A systematic review and meta-analysis. BMJ Open 2022; 12:e055131. [PMID: 35440451 PMCID: PMC9020283 DOI: 10.1136/bmjopen-2021-055131] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 03/29/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To determine associations between carotid atherosclerosis assessed by ultrasound and the Mini-Mental State Examination (MMSE), a measure of global cognitive function. DESIGN Systematic review and meta-analysis. METHODS MEDLINE and EMBASE databases were searched up to 1 May 2020 to identify studies assessed the associations between asymptomatic carotid atherosclerosis and the MMSE. Studies reporting OR for associations between carotid plaque or intima-media thickness (cIMT) and dichotomised MMSE were meta-analysed. Publication bias of included studies was assessed. RESULTS A total of 31 of 378 reviewed articles met the inclusion criteria; together they included 27 738 participants (age 35-95 years). Fifteen studies reported some evidence of a positive association between measures of atherosclerosis and poorer cognitive performance in either cross-sectional or longitudinal studies. The remaining 16 studies found no evidence of an association. Seven cross-sectional studies provided data suitable for meta-analysis. Meta-analysis of three studies that assessed carotid plaque (n=3549) showed an association between the presence of plaque and impaired MMSE with pooled estimate for the OR (95% CI) being 2.72 (0.85 to 4.59). An association between cIMT and impaired MMSE was reported in six studies (n=4443) with a pooled estimate for the OR (95% CI) being 1.13 (1.04 to 1.22). Heterogeneity across studies was moderate to small (carotid plaque with MMSE, I2=40.9%; cIMT with MMSE, I2=4.9%). There was evidence of publication bias for carotid plaque studies (p=0.02), but not cIMT studies (p=0.2). CONCLUSIONS There is some, limited cross-sectional evidence indicating an association between cIMT and poorer global cognitive function assessed with MMSE. Estimates of the association between plaques and poor cognition are too imprecise to draw firm conclusions and evidence from studies of longitudinal associations between carotid atherosclerosis and MMSE is limited. PROSPERO REGISTRATION NUMBER CRD42021240077.
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Affiliation(s)
- Rayan Anbar
- Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia
- MRC Unit for Lifelong Health and Aging, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Salahaden R Sultan
- Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia
| | - Lamia Al Saikhan
- College of Applied Medial Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Alkharaiji
- Department of Public Health, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Aging, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Rebecca Hardy
- Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Aging, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Alun Hughes
- MRC Unit for Lifelong Health and Aging, UCL Institute of Cardiovascular Science, University College London, London, UK
- Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
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Hakala JO, Pahkala K, Juonala M, Salo P, Kähönen M, Hutri-Kähönen N, Lehtimäki T, Laitinen TP, Jokinen E, Taittonen L, Tossavainen P, Viikari JS, Raitakari OT, Rovio SP. Repeatedly Measured Serum Creatinine and Cognitive Performance in Midlife: The Cardiovascular Risk in Young Finns Study. Neurology 2022; 98:e2268-e2281. [PMID: 35410906 DOI: 10.1212/wnl.0000000000200268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/08/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Serum creatinine is typically used to assess kidney function. Impaired kidney function and thereby high serum creatinine increases risk of poor cognitive performance. However, serum creatinine might have a non-linear association as low serum creatinine has been linked with cardiovascular risk and impaired cognitive performance. We studied the longitudinal association between serum creatinine and cognitive performance in midlife. METHODS Since 2001, participants from the Cardiovascular Risk in Young Finns Study were followed up for 10 years. Serum creatinine was measured repeatedly in 2001, 2007, and 2011. Sex-specific longitudinal trajectories for serum creatinine among participants without kidney disease were identified using latent class growth mixture modeling. Overall cognitive function and four specific domains such as 1) working memory, 2) episodic memory and associative learning, 3) reaction time, and 4) information processing were assessed using a computerized cognitive test. RESULTS Four serum creatinine trajectory groups all with clinically normal serum creatinine were identified for both men (N=973) and women (N=1,204). After 10 years of follow-up, cognitive testing was performed for 2,026 participants aged 34 to 49 years (mean age 41.8 years). In men and women, consistently low serum creatinine was associated with poor childhood school performance, low adulthood education, low adulthood annual income, low physical activity, and smoking. Compared to the men in the low serum creatinine trajectory group, those in the high serum creatinine group had better overall cognitive performance (β=0.353 SD, 95%CI 0.022-0.684) and working memory (β=0.351 SD, 95%CI 0.034-0.668), while those in the moderate (β=0.247 SD, 95%CI 0.026-0.468) or the normal (β=0.244 SD, 95%CI 0.008-0.481) serum creatinine groups had better episodic memory and associative learning. No associations were found for women. DISCUSSION Our results indicate that, in men, compared to low serum creatinine levels consistently high levels may associate with better memory and learning function in midlife.
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Affiliation(s)
- Juuso O Hakala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Pia Salo
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tomi P Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Eero Jokinen
- Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Leena Taittonen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, University of Oulu, and Oulu University Hospital Oulu, Finland
| | - Päivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, University of Oulu, and Oulu University Hospital Oulu, Finland
| | - Jorma Sa Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Álvarez-Bueno C, Cavero-Redondo I, Bruno RM, Saz-Lara A, Sequí-Dominguez I, Notario-Pacheco B, Martinez-Vizcaino V. Intima Media Thickness and Cognitive Function Among Adults: Meta-Analysis of Observational and Longitudinal Studies. J Am Heart Assoc 2022; 11:e021760. [PMID: 35179392 PMCID: PMC9075078 DOI: 10.1161/jaha.121.021760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Carotid structural changes measured by intima media thickness (IMT) have been related to cognitive complaints during aging. Therefore, the aims of this meta‐analysis were (1) to elucidate the relationship between vascular status, measured as IMT, and cognitive domains distinguishing between global cognition, executive functions, memory and attention; and (2) to explore whether demographic (ie, age and sex), clinical (ie, body mass index and IMT baseline values), and procedure characteristics influence this association. Methods and Results We performed a systematic review of MEDLINE (via PubMed), Scopus, and Web of Science databases from their inception to June 2021. Studies meeting the following inclusion criteria were included: (1) the participants were adults; (2) the exposure was carotid IMT; (3) the outcome was cognitive function, including global cognition, executive function, memory, and attention measured using standardized tests; and (4) the study design was cross‐sectional or longitudinal including unadjusted and adjusted analyses. A total of 19 cross‐sectional and 15 longitudinal studies were included and demographic (age and sex), clinical (body mass index and baseline IMT values), and procedure characteristics were analyzed as potential mediator or moderators of the association. Conclusions Our data support negative associations between IMT and cognitive function in cross‐sectional studies. The association between IMT and cognition lost significance in longitudinal studies and when controlling for covariates in cross‐sectional studies. Finally, the strength of these associations seems not to be modified by age, sex, body mass index, and baseline IMT values. This systematic review and meta‐analysis adds to the evidence supporting the use of IMT as a measure for identifying patients at risk of cognitive decline.
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Affiliation(s)
- Celia Álvarez-Bueno
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Universidad Politécnica y Artística del Paraguay Asunción Paraguay
| | - Iván Cavero-Redondo
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Rehabilitation in Health Research Center (CIRES)Universidad de las Americas Santiago Chile
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine University of Pisa Italy.,INSERM U970 and Université de Paris Paris France
| | - Alicia Saz-Lara
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain
| | | | | | - Vicente Martinez-Vizcaino
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Facultad de Ciencias de la Salud Universidad Autónoma de Chile Talca Chile
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Wang J, Huang R, Tian S, Lin H, Guo D, An K, Wang S. Elevated Plasma Level of D-dimer Predicts the High Risk of Early Cognitive Impairment in Type 2 Diabetic Patients as Carotid Artery Plaques become Vulnerable or Get Aggravated. Curr Alzheimer Res 2020; 16:396-404. [PMID: 30919777 DOI: 10.2174/1567205016666190321164741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/27/2019] [Accepted: 03/15/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVE D-dimer prompts fibrinolysis system, which is involved in Alzheimer's disease and the complications of type 2 diabetic patients, especially among those with carotid artery plaques. Hence, this study aims to investigate the role of D-dimer in early cognitive impairment among type 2 diabetic patients with carotid artery plaques. METHODS A total of 175 Chinese patients with type 2 diabetes were recruited and divided into two groups according to the Montreal Cognitive Assessment score. Demographic data were collected, plasma D-dimer was tested through VIDAS D-dimer New, neuropsychological tests were examined, and carotid artery plaques were detected by ultrasound and further stratified by vulnerability and level. RESULTS A total of 67 types 2 diabetic patients with Mild Cognitive Impairment (MCI) displayed significantly increased plasma D-dimer levels compared with their health-cognition controls (p = 0.011). Plasma D-dimer concentration was negatively related with Digit Span Test scores in diabetic patients with vulnerable plaques (r=-0.471, p=0.023) and Stroop Color Word Test C (number) in diabetic patients with stable plaques (r=-0.482, p<0.001). Multivariable regression analysis further showed that D-dimer concentration was an independent factor of diabetic MCI with carotid artery plaque (p=0.005), and D-dimer concentration especially contributed to the high risk of MCI with vulnerable plaques (p=0.028) or high levels of carotid plaque (p=0.023). CONCLUSION Elevated D-dimer level predicts the high risk of early cognitive impairment in type 2 diabetic patients with carotid artery plaques, especially vulnerable plaques or high levels of carotid plaques.
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Affiliation(s)
- Jiaqi Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, China.,Medical School of Southeast University, Nanjing 210009, China
| | - Rong Huang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, China.,Medical School of Southeast University, Nanjing 210009, China
| | - Sai Tian
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, China.,Medical School of Southeast University, Nanjing 210009, China
| | - Hongyan Lin
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, China.,Medical School of Southeast University, Nanjing 210009, China
| | - Dan Guo
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, China.,Medical School of Southeast University, Nanjing 210009, China
| | - Ke An
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, China.,Medical School of Southeast University, Nanjing 210009, China
| | - Shaohua Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing 210009, China
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Hestad K, Engedal K, Schirmer H, Strand BH. The Effect of Blood Pressure on Cognitive Performance. An 8-Year Follow-Up of the Tromsø Study, Comprising People Aged 45-74 Years. Front Psychol 2020; 11:607. [PMID: 32373010 PMCID: PMC7186429 DOI: 10.3389/fpsyg.2020.00607] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/13/2020] [Indexed: 12/04/2022] Open
Abstract
Background The relationship between blood pressure (BP) and cognition is complex were age appears to be an intervening variable. High and low BP have been associated with cognitive deficits as part of the aging process, but more studies are needed, especially in more recent birth cohorts. Methods The study sample comprised 4,465 participants, with BP measured at baseline in the Tromsø Study, Wave 6 in 2007–2008 (T0), and cognition assessed at follow-up 8 years later, in 2015–2016 in Tromsø Study 7 (T1). Age at T0 was 45–74 years, and at T1 it was 53–82 years. Cognition was assessed with three tests: The Mini Mental State Examination (MMSE), the Digit Symbol Test, and the Twelve-word Test. The associations between BP and cognition were examined specifically for age and sex using linear regression analysis adjusted for baseline BP medication use, education and body mass index (kg/m2). Results BP was associated with cognition at the 8-year follow-up, but the association differed according to age and sex. In men, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) at a young age (45–55 years of age) was associated with poorer cognition; the association was reversed at older ages, especially for those above 65 years of age. In women, the associations were generally weaker than for men, and sometimes in the opposite direction: For women, a higher SBP was associated with better cognition at a younger age and higher SBP poorer cognition at older ages – perhaps due to an age delay in women compared to men. Digit Symbol Test results correlated best with BP in a three-way interaction: BP by age by sex was significant for both SBP (p = 0.005) and DBP (p = 0.005). Conclusion Increased SBP and DBP at the younger age was clearly associated with poorer cognitive function in men 8 years later; in women the associations were weaker and sometimes in the opposite direction. Our findings clearly indicate that interactions between age and sex related to BP can predict cognitive performance over time. Men and women have different age trajectories regarding the influence of BP on cognition.
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Affiliation(s)
- Knut Hestad
- Department of Health Studies, Inland Norway University of Applied Sciences, Elverum, Norway.,Department of Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold County Hospital Trust, Tønsberg, Norway
| | - Henrik Schirmer
- Department of Cardiology, Akerhus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Bjørn Heine Strand
- Norwegian National Advisory Unit on Ageing and Health, Vestfold County Hospital Trust, Tønsberg, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
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Småbrekke S, Schirmer H, Melsom T, Solbu MD, Eriksen BO. Low-grade impairments in cognitive and kidney function in a healthy middle-aged general population: a cross-sectional study. BMC Nephrol 2019; 20:166. [PMID: 31088493 PMCID: PMC6518698 DOI: 10.1186/s12882-019-1356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 04/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Although the relationship between manifest chronic kidney disease and reduced cognitive function is well established, limited data exists on GFR and cognitive function in the general population. Both the brain and kidneys have low-impedance vascular beds, rendering them susceptible to damage from pulsatile blood flow. An association between mildly reduced GFR and cognitive function in the healthy general population may reveal early disease mechanisms underlying low-grade impairment of both organs as well as the possibility for intervention. Our aim was to identify an early stage of low-grade impairments in both the brain and the kidneys in the general population. Methods This investigation was a population-based cross-sectional study that included 1627 participants aged 50–62 years who were representative of the general population in the municipality of Tromsø, Norway. The associations between GFR, measured as iohexol clearance, the urinary albumin-creatinine ratio and performance on five tests of cognitive function—the Digit Symbol Substitution Test, the finger tapping test, the Mini-Mental State Examination and the 12-word test parts 1 and 2 – were examined. The data were adjusted for factors known to be associated with both GFR and cognitive function, including cardiovascular risk factors, medications and education level. Results In multivariate adjusted linear regression analyses, we did not observe associations of the measured GFR or albumin-creatinine ratio with performance on any of the five cognitive tests. In an analysis without adjustment for the education level, an association of worse performance on the Digit Symbol Substitution Test with higher measured GFR (p = 0.03) was observed. An exploratory analysis revealed an inverse relationship between mGFR and a higher education level that remained significant after adjusting for factors known to influence mGFR. Conclusions We did not find evidence of an association between low-grade impairments in either the kidneys or the brain in the middle-aged general population. A possible association between a high GFR and reduced cognitive function should be investigated in future studies. Electronic supplementary material The online version of this article (10.1186/s12882-019-1356-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Silje Småbrekke
- Metabolic and Renal Research Group, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway. .,Department of Clinical Medicine, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway.
| | - Henrik Schirmer
- Department of Clinical Medicine, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway.,Clinical Cardiovacular Research Group, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway
| | - Toralf Melsom
- Metabolic and Renal Research Group, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway.,Department of Clinical Medicine, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway.,Section of Nephrology, University Hospital of North Norway, Sykehusvegen 38, N-9019, Tromsø, Norway
| | - Marit Dahl Solbu
- Metabolic and Renal Research Group, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway.,Department of Clinical Medicine, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway.,Section of Nephrology, University Hospital of North Norway, Sykehusvegen 38, N-9019, Tromsø, Norway
| | - Bjørn Odvar Eriksen
- Metabolic and Renal Research Group, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway.,Department of Clinical Medicine, University in Tromsø (UiT) The Arctic University of Norway, Hansine Hansens veg 18, N-9019, Tromsø, Norway.,Section of Nephrology, University Hospital of North Norway, Sykehusvegen 38, N-9019, Tromsø, Norway
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8
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Ekblad LL, Toppala S, Johansson JK, Koskinen S, Sundvall J, Rinne JO, Puukka P, Viitanen M, Jula A. Albuminuria and Microalbuminuria as Predictors of Cognitive Performance in a General Population: An 11-Year Follow-Up Study. J Alzheimers Dis 2019; 62:635-648. [PMID: 29480195 DOI: 10.3233/jad-170972] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Microalbuminuria, defined as urine albumin-to-creatinine ratio (UACR)>3.0 mg/mmol and ≤ 30 mg/mmol, is an early marker of endothelial damage of the renal glomeruli. Recent research suggests an association among microalbuminuria, albuminuria (UACR > 3.0 mg/mmol), and cognitive impairment. Previous studies on microalbuminuria, albuminuria, and cognition in the middle-aged have not provided repeated cognitive testing at different time-points. We hypothesized that albuminuria (micro- plus macroalbuminuria) and microalbuminuria would predict cognitive decline independently of previously reported risk factors for cognitive decline, including cardiovascular risk factors. In addition, we hypothesized that UACR levels even below the cut-off for microalbuminuria might be associated with cognitive functioning. These hypotheses were tested in the Finnish nationwide, population-based Health 2000 Survey (n = 5,921, mean age 52.6, 55.0% women), and its follow-up, Health 2011 (n = 3,687, mean age at baseline 49.3, 55.6% women). Linear regression analysis was used to determine the associations between measures of albuminuria and cognitive performance. Cognitive functions were assessed with verbal fluency, word-list learning, word-list delayed recall (at baseline and at follow-up), and with simple and visual choice reaction time tests (at baseline only). Here, we show that micro- plus macroalbuminuria associated with poorer word-list learning and a slower reaction time at baseline, with poorer word-list learning at follow-up, and with a steeper decline in word-list learning during 11 years after multivariate adjustments. Also, higher continuous UACR consistently associated with poorer verbal fluency at levels below microalbuminuria. These results suggest that UACR might have value in evaluating the risk for cognitive decline.
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Affiliation(s)
- Laura L Ekblad
- Turku PET Centre, University of Turku, c/o Turku University Hospital, Turku, Finland
| | - Sini Toppala
- Turku PET Centre, University of Turku, c/o Turku University Hospital, Turku, Finland.,Turku City Hospital, University of Turku, Turku, Finland
| | - Jouni K Johansson
- National Institute for Health and Welfare, Turku, Finland.,Welfare Division of Turku City, Turku, Finland
| | - Seppo Koskinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Jouko Sundvall
- National Institute for Health and Welfare, Helsinki, Finland
| | - Juha O Rinne
- Turku PET Centre, University of Turku, c/o Turku University Hospital, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | - Pauli Puukka
- National Institute for Health and Welfare, Turku, Finland
| | - Matti Viitanen
- Turku City Hospital, University of Turku, Turku, Finland.,Clinical Geriatrics, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
| | - Antti Jula
- National Institute for Health and Welfare, Turku, Finland
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9
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Rouch L, Cestac P, Sallerin B, Andrieu S, Bailly H, Beunardeau M, Cohen A, Dubail D, Hernandorena I, Seux ML, Vidal JS, Hanon O. Pulse Wave Velocity Is Associated With Greater Risk of Dementia in Mild Cognitive Impairment Patients. Hypertension 2018; 72:1109-1116. [DOI: 10.1161/hypertensionaha.118.11443] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Laure Rouch
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Philippe Cestac
- Unité INSERM 1027, Toulouse, France (P.C., S.A.)
- University Paul Sabatier Toulouse III, France (P.C., B.S., S.A.)
- Pôle Pharmacie, Centre Hospitalier Universitaire de Toulouse, France (P.C., B.S.)
| | - Brigitte Sallerin
- University Paul Sabatier Toulouse III, France (P.C., B.S., S.A.)
- Pôle Pharmacie, Centre Hospitalier Universitaire de Toulouse, France (P.C., B.S.)
- Unité INSERM 1048, Toulouse, France (B.S.)
| | - Sandrine Andrieu
- Unité INSERM 1027, Toulouse, France (P.C., S.A.)
- University Paul Sabatier Toulouse III, France (P.C., B.S., S.A.)
- Unité INSERM 1048, Toulouse, France (B.S.)
- Pôle Epidémiologie et Santé Publique, Centre Hospitalier Universitaire de Toulouse, France (S.A.)
| | - Henri Bailly
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Maëlle Beunardeau
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Adrien Cohen
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Delphine Dubail
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Intza Hernandorena
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Marie-Laure Seux
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Jean-Sébastien Vidal
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Olivier Hanon
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
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10
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Masi S, Georgiopoulos G, Khan T, Johnson W, Wong A, Charakida M, Whincup P, Hughes AD, Richards M, Hardy R, Deanfield J. Patterns of adiposity, vascular phenotypes and cognitive function in the 1946 British Birth Cohort. BMC Med 2018; 16:75. [PMID: 29804545 PMCID: PMC5971427 DOI: 10.1186/s12916-018-1059-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/23/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The relationship between long-term exposure to whole body or central obesity and cognitive function, as well as its potential determinants, remain controversial. In this study, we assessed (1) the potential impact of 30 years exposure to different patterns of whole body and central adiposity on cognitive function at 60-64 years, (2) whether trajectories of central adiposity can provide additional information on later cognitive function compared to trajectories of whole body adiposity, and (3) the influence of vascular phenotypes on these associations. METHODS The study included 1249 participants from the prospective cohort MRC National Survey of Health and Development. Body mass index (BMI), waist circumference (WC), and vascular (carotid intima-media thickness, carotid-femoral pulse wave velocity) and cognitive function (memory, processing speed, reaction time) data, at 60-64 years, were used to assess the associations between different patterns of adult WC or BMI (from 36 years of age) and late midlife cognitive performance, as well as the proportion of this association explained by cardiovascular phenotypes. RESULTS Longer exposure to elevated WC was related to lower memory performance (p < 0.001 for both) and longer choice reaction time (p = 0.003). A faster gain of WC between 36 and 43 years of age was associated with the largest change in reaction time and memory test (P < 0.05 for all). Similar associations were observed when patterns of WC were substituted with patterns of BMI, but when WC and BMI were included in the same model, only patterns of WC remained significantly associated with cognitive function. Participants who dropped one BMI category and maintained a lower BMI had similar memory performance to those of normal weight during the whole follow-up. Conversely, those who dropped and subsequently regained one BMI category had a memory function similar to those with 30 years exposure to elevated BMI. Adjustment for vascular phenotypes, levels of cardiovascular risk factors, physical activity, education, childhood cognition and socioeconomic position did not affect these associations. CONCLUSIONS Longer exposure to elevated WC or BMI and faster WC or BMI gains between 36 and 43 years are related to lower cognitive function at 60-64 years. Patterns of WC in adulthood could provide additional information in predicting late midlife cognitive function than patterns of BMI. The acquisition of an adverse cardiovascular phenotype associated with adiposity is unlikely to account for these relationships.
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Affiliation(s)
- Stefano Masi
- National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, University College London, 1 St Martin le Grande, London, EC1A 4NP, UK. .,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Georgios Georgiopoulos
- First Department of Cardiology
- , Hippokration Hospital, University of Athens, Athens, Greece
| | - Tauseef Khan
- National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, University College London, 1 St Martin le Grande, London, EC1A 4NP, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Epidemiology and Health Care, UCL, London, UK
| | - Marietta Charakida
- National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, University College London, 1 St Martin le Grande, London, EC1A 4NP, UK
| | - Peter Whincup
- Division of Population Health Sciences and Education, St George's University of London, London, UK
| | - Alun D Hughes
- Cardiometabolic Phenotyping Group, Institute of Cardiovascular Science, UCL, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Epidemiology and Health Care, UCL, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Epidemiology and Health Care, UCL, London, UK
| | - John Deanfield
- National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, University College London, 1 St Martin le Grande, London, EC1A 4NP, UK
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11
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Wang J, Yuan Y, Cai R, Huang R, Tian S, Lin H, Guo D, Wang S. Association between Plasma Levels of PAI-1, tPA/PAI-1 Molar Ratio, and Mild Cognitive Impairment in Chinese Patients with Type 2 Diabetes Mellitus. J Alzheimers Dis 2018; 63:835-845. [PMID: 29689724 DOI: 10.3233/jad-171038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Jiaqi Wang
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Yang Yuan
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
| | - Rongrong Cai
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Rong Huang
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Sai Tian
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Hongyan Lin
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Dan Guo
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Shaohua Wang
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
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12
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Georgakis MK, Dimitriou NG, Karalexi MA, Mihas C, Nasothimiou EG, Tousoulis D, Tsivgoulis G, Petridou ET. Albuminuria in Association with Cognitive Function and Dementia: A Systematic Review and Meta-Analysis. J Am Geriatr Soc 2017; 65:1190-1198. [PMID: 28152169 DOI: 10.1111/jgs.14750] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Cerebral microvascular disease is considered to contribute to cognitive dysfunction. We opted to explore whether albuminuria, a marker of systemic microangiopathy, is associated with cognitive impairment, dementia, and cognitive function. DESIGN Systematic review; independent reviewers screened 2359 articles, derived through the search strategy, for identification of observational studies quantifying an association of albuminuria with the outcomes of interest, abstracted data on study characteristics and results and evaluated studies on quality using the Newcastle-Ottawa scale. SETTING Community. PARTICIPANTS Adults. MESUREMENTS Cognitive impairment and dementia, defined by validated neuropsychological tests or clinical guidelines, respectively, and cognitive function, assessed by validated instruments. RESULTS Thirty-two eligible studies were identified. Albuminuria was associated with cognitive impairment (Odds Ratio (OR): 1.35, 95% Confidence Interval (CI): 1.19-1.53; 7,852 cases), dementia (OR: 1.35, 95% CI: 1.10-1.65; 5,758 cases), clinical Alzheimer's disease (OR: 1.37, 95% CI: 1.11-1.69; 629 cases) and vascular dementia (OR: 1.96, 95% CI: 1.16-3.31; 186 cases); the effect remained significant among longitudinal, population-based and high quality studies. Time-to-event analysis on prospective studies of non-demented at baseline individuals also showed a significant association with incident dementia (Risk Ratio: 1.52, 95% CI: 1.16-1.99; 971 cases). Worse global cognitive performance (Hedge's g: -0.13, 95% CI: -0.18, -0.09; 68,348 subjects) and accelerated cognitive decline (g: -0.20, 95% CI: -0.34, -0.07; 31,792 subjects) were noted among subjects with albuminuria, who also scored lower in executive function, processing speed, verbal fluency, and verbal memory. CONCLUSIONS Albuminuria was independently associated with cognitive impairment, dementia and cognitive decline. The stronger effects for vascular dementia and cognitive performance in domains primarily affected by microvascular disease support that the association could be mediated by shared microvascular pathology in the kidney and the brain.
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Affiliation(s)
- Marios K Georgakis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos G Dimitriou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos Mihas
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Internal Medicine Department, General Hospital of Kimi, Kimi, Greece
| | - Efthimia G Nasothimiou
- Hypertension Unit and Cardiovascular Research Laboratory, First Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, School of Medicine, Hippokrateion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Neurology, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.,International Clinical Research Center, St. Anne's University Hospital in Brno, Brno, Czech Republic
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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13
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Rogne S, Vangberg T, Eldevik P, Wikran G, Mathiesen EB, Schirmer H. Magnetic Resonance Volumetry: Prediction of Subjective Memory Complaints and Mild Cognitive Impairment, and Associations with Genetic and Cardiovascular Risk Factors. Dement Geriatr Cogn Dis Extra 2016; 6:529-540. [PMID: 28101099 PMCID: PMC5216191 DOI: 10.1159/000450885] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/18/2016] [Indexed: 12/18/2022] Open
Abstract
Background/Aims Subjective memory complaints (SMC) are strong predictors of mild cognitive impairment (MCI) and subsequent Alzheimer's disease. Our aims were to see if fully automated cerebral MR volume measurements could distinguish subjects with SMC and MCI from controls, and if probable parental late-onset Alzheimer's disease (LOAD), apolipoprotein E ε4 genotype, total plasma homocysteine, and cardiovascular risk factors were associated with MR volumetric findings. Methods 198 stroke-free subjects comprised the control (n = 58), the SMC (n = 25) and the MCI (n = 115) groups. Analysis of covariance and receiver operating characteristic curve was used to see if MR volumetry distinguished subjects with SMC and MCI from controls. Results Subjects with SMC and MCI had significantly larger lateral ventricles and smaller hippocampal volumes than controls. The area under the curve in subjects with SMC and MCI compared to that of controls was less than 0.68 for all volumes of intracranial structures. There was an interaction between sex and probable parental LOAD for hippocampal volume, with a significant association between probable parental LOAD and hippocampal volume in women. Conclusions Fully automated MR volumetry can distinguish subjects with SMC and MCI from controls in a general population, but insufficiently to assume a clear clinical role. Research on sporadic LOAD might benefit from a sex-specific search for genetic risk factors.
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Affiliation(s)
- Sigbjørn Rogne
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Torgil Vangberg
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Petter Eldevik
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Gry Wikran
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Cardiology, Division of Cardiothoracic and Respiratory Disease, University Hospital of North Norway, Tromsø, Norway
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14
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Njølstad I, Mathiesen EB, Schirmer H, Thelle DS. The Tromsø study 1974–2016: 40 years of cardiovascular research. SCAND CARDIOVASC J 2016; 50:276-281. [DOI: 10.1080/14017431.2016.1239837] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
| | - Dag Steinar Thelle
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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