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Kraft JN, Matijevic S, Hoagey DA, Kennedy KM, Rodrigue KM. Differential Effects of Aging on Regional Corpus Callosum Microstructure and the Modifying Influence of Pulse Pressure. eNeuro 2024; 11:ENEURO.0449-23.2024. [PMID: 38719452 PMCID: PMC11106647 DOI: 10.1523/eneuro.0449-23.2024] [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: 10/31/2023] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 05/18/2024] Open
Abstract
The corpus callosum is composed of several subregions, distinct in cellular and functional organization. This organization scheme may render these subregions differentially vulnerable to the aging process. Callosal integrity may be further compromised by cardiovascular risk factors, which negatively influence white matter health. Here, we test for heterochronicity of aging, hypothesizing an anteroposterior gradient of vulnerability to aging that may be altered by the effects of cardiovascular health. In 174 healthy adults across the adult lifespan (mean age = 53.56 ± 18.90; range, 20-94 years old, 58.62% women), pulse pressure (calculated as participant's systolic minus diastolic blood pressure) was assessed to determine cardiovascular risk. A deterministic tractography approach via diffusion-weighted imaging was utilized to extract fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) from each of five callosal subregions, serving as estimates of microstructural health. General linear models tested the effects of age, hypertension, and pulse pressure on these cross-sectional metrics. We observed no significant effect of hypertensive diagnosis on callosal microstructure. We found a significant main effect of age and an age-pulse pressure interaction whereby older age and elevated pulse pressure were associated with poorer FA, AD, and RD. Age effects revealed nonlinear components and occurred along an anteroposterior gradient of severity in the callosum. This gradient disappeared when pulse pressure was considered. These results indicate that age-related deterioration across the callosum is regionally variable and that pulse pressure, a proxy of arterial stiffness, exacerbates this aging pattern in a large lifespan cohort.
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Affiliation(s)
- Jessica N Kraft
- Center for Vital Longevity, Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas 75235
| | - Stephanie Matijevic
- Center for Vital Longevity, Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas 75235
- Department of Psychology, University of Arizona, Tucson, Arizona 85721
| | - David A Hoagey
- Center for Vital Longevity, Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas 75235
| | - Kristen M Kennedy
- Center for Vital Longevity, Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas 75235
| | - Karen M Rodrigue
- Center for Vital Longevity, Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas 75235
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Tian J, Zhang K, Cui J, Qin J, Wang B, Zhou L, Li T, Bu K, Li Z, Liu L, Wang Q, Yuan S, Ma L, Wang Y, Wang R, Meng C, Zhou B, Guo L, Liu X. Brain frailty associated with stroke events in anterior circulation large artery occlusion. BMC Neurol 2024; 24:97. [PMID: 38494491 PMCID: PMC10946158 DOI: 10.1186/s12883-024-03566-7] [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: 02/13/2023] [Accepted: 02/12/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE To investigate the factors associated with brain frailty and the effect of brain frailty in patients with anterior circulation large artery occlusion (AC-LAO). METHODS 1100 patients with AC-LVO consecutively admitted to the Second Hospital of Hebei Medical University, North China between June 2016 and April 2018 were retrospectively analyzed. The variables associated with brain frailty and stroke outcome were analyzed by ANOVA analysis, the Mann-Whitney U test and multiple linear regression. Based on previous research. Brain frailty score comprises 1 point each for white matter hyperintensity (WMH), old infarction lesions, and cerebral atrophy among 983 participants with baseline brain magnetic resonance imaging or computed tomography. RESULTS Among AC-LAO participants, baseline brain frailty score ≥ 1 was common (750/983, 76.3%). Duration of hypertension > 5 years (mean difference [MD] 0.236, 95% CI 0.077, 0.395, p = 0.004), multiple vessel occlusion (MD 0.339, 95% CI 0.068, 0.611, p = 0.014) and basal ganglia infarction (MD -0.308, 95% CI -0.456, -0.160, p < 0.001) were independently associated with brain frailty score. Brain frailty score was independently associated with stroke events, and higher brain frailty scores were associated with higher rates of stroke events (p < 0.001). However, brain frailty has no independent effect on short-term outcome of ACI in AC-LAO patients. CONCLUSIONS In AC-LAO patients, older age, duration of hypertension > 5 years, and multiple vessel occlusion influenced the brain frailty score. Brain frailty score was independently associated with the occurrence of stroke events in AC-LAO patients.
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Affiliation(s)
- Jing Tian
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Kun Zhang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Junzhao Cui
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Jin Qin
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Binbin Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lixia Zhou
- Department of Radiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tong Li
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Kailin Bu
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Zhongzhong Li
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Lin Liu
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Qisong Wang
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Si Yuan
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Lina Ma
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Ye Wang
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Rui Wang
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Chaoyue Meng
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Biyi Zhou
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Li Guo
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China
| | - Xiaoyun Liu
- Department of Neurology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, Hebei, 050000, China.
- Neuroscience Research Center, Medicine and Health Institute, Hebei Medical University, Shijiazhuang, China.
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China.
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3
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Aparicio HJ. Healthy Lifestyle for Healthier Arteries in People With Type 2 Diabetes. J Am Heart Assoc 2023; 12:e030594. [PMID: 37609983 PMCID: PMC10547331 DOI: 10.1161/jaha.123.030594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Hugo J. Aparicio
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Stroke and Cerebrovascular CenterBoston Medical CenterBostonMAUSA
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Sedaghat S, Ji Y, Empana JP, Hughes TM, Mosley TH, Gottesman RF, Griswold M, Jack CR, Lutsey PL, van Sloten TT. Changes in Cardiovascular Health Across Midlife and Late-Life and Magnetic Resonance Imaging Markers of Cerebral Vascular Disease in Late-Life. Stroke 2023; 54:1280-1288. [PMID: 36951053 PMCID: PMC10133201 DOI: 10.1161/strokeaha.122.041374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/17/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Cardiovascular health may be used for prevention of cerebral vascular disease; however, data on the association of cardiovascular health across midlife and late-life with late-life cerebral vascular disease are lacking. Our aim was to examine whether midlife or late-life cardiovascular health as well as changes of cardiovascular health within midlife and between midlife and late-life were associated with prevalence of magnetic resonance imaging markers of cerebral vascular disease at late-life. METHODS Prospective cohort study including 1638 participants from the Atherosclerosis Risk in Communities Study who took part in 2 visits at midlife (mean ages, 53 and 59 years), and a late-life visit (mean age, 76 years). A cardiovascular health Life's Simple 7 score (range, 0-12/0-14, depending on diet availability) including 6 out of 7 items was calculated at each visit, with weight assigned to each item as poor (0), intermediate (1), or ideal (2). Participants underwent 3T brain magnetic resonance imaging scans in late-life visit. Outcomes were white matter hyperintensity volume, microbleeds, and lacunar, subcortical, and cortical infarcts at late-life. Linear and logistic regression models were used to assess the associations of cardiovascular health in midlife and late-life, and improvement of cardiovascular health within midlife, and from midlife to late-life with magnetic resonance imaging markers of cerebral vascular disease, adjusting for potential confounders. RESULTS A higher cardiovascular health in midlife, improvement of cardiovascular health within midlife, higher cardiovascular health at late-life, and improvement of cardiovascular health from midlife to late-life were associated with a lower prevalence of cerebral vascular disease markers. For example, improvement in cardiovascular health (per point) from midlife to late-life was associated with smaller white matter hyperintensity volume (β, -0.07 [95% CI, -0.10 to -0.04]) and lower odds of microbleeds (odds ratio, 0.93 [0.90-0.97]), lacunar (odds ratio, 0.93 [0.89-0.97]), subcortical (odds ratio, 0.93 [0.89-0.97]), and cortical infarcts (odds ratio, 0.92 [0.87-0.97]). CONCLUSIONS Improving cardiovascular health within midlife and from midlife to late-life may prevent development of cerebral vascular disease.
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Affiliation(s)
- Sanaz Sedaghat
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Yuekai Ji
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Jean-Philippe Empana
- Université de Paris, INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | | | - Thomas H Mosley
- Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, MS, USA
| | - Rebecca F Gottesman
- Stroke Branch, Intramural Research Program, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Michael Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - Thomas T van Sloten
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
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Fu Y, Sun Y, Wang ZB, Zhang DD, Tan L, Feng JF, Cheng W, Yu JT. Associations of Life's Simple 7 with cerebral white matter hyperintensities and microstructural integrity: UK Biobank cohort study. Eur J Neurol 2023; 30:1200-1208. [PMID: 36794682 DOI: 10.1111/ene.15750] [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: 12/21/2022] [Revised: 01/26/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND PURPOSE The American Heart Association Life's Simple 7 (LS7) metric was used to define optimal cardiovascular and brain health, but the associations with macrostructural hyperintensities and microstructural white matter damage are unclear. The objective was to determine the association of LS7 ideal cardiovascular health factors with macrostructural and microstructural integrity. METHOD A total of 37,140 participants with available LS7 and imaging data from UK Biobank were included in this study. Linear associations were implemented to examine the associations of LS7 score and subscores with white matter hyperintensity load (WMH) (WMH volume normalized by total white matter volume and logit-transformed) and diffusion imaging indices (fractional anisotropy [FA], mean diffusivity, orientation dispersion index [OD], intracellular volume fraction, isotropic volume fraction [ISOVF]). RESULTS In individuals (mean age 54.76 years; 19,697 females, 52.4%), higher LS7 score and subscores were strongly associated with lower WMH and microstructural white matter injury, including OD, ISOVF, FA. Both interaction analyses and stratified analyses of LS7 score and subscores with age and sex showed a strong association with microstructural damage markers, with remarkable age and sex differences. The association of OD was pronounced in females and populations younger than 50 years and FA, mean diffusivity and ISOVF were pronounced in males and populations older than 50 years. CONCLUSION These findings suggest that healthier LS7 profiles are associated with better profiles of both macrostructural and microstructural markers of brain health, and indicate that ideal cardiovascular health is associated with improved brain health.
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Affiliation(s)
- Yan Fu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan Sun
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Zhi-Bo Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Dan-Dan Zhang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), China.,Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.,MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.,Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), China.,Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.,Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
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6
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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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Zhao YL, Ou YN, Ma YH, Huang YY, Bi YL, Tan L, Yu JT. Association between Life’s Simple 7 and cerebrospinal fluid biomarkers of Alzheimer’s disease pathology in cognitively intact adults: the CABLE study. Alzheimers Res Ther 2022; 14:74. [PMID: 35619174 PMCID: PMC9134665 DOI: 10.1186/s13195-022-01019-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/16/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Introduction
This study sought to explore the association between Life’s Simple 7 (LS7) and cerebrospinal fluid (CSF) Alzheimer’s disease (AD) pathological biomarkers in the cognitively normal northern Chinese population.
Methods
From the Chinese Alzheimer’s Biomarker and LifestylE (CABLE) study, 1106 cognitively normal participants were enrolled. The mean age was 62.34 years, and 39.6% were female. LS7 scores were summed with each metric assigned 0, 1, or 2 scores. The multiple linear regression models were used to investigate the association between LS7 scores and CSF AD biomarkers.
Results
We found that LS7 scores were significantly associated with CSF AD pathologies, including Aβ42/40 (β = 0.034, P = .041), p-tau181 (β = − 0.043, P = .006), and t-tau (β = − 0.044, P = .003). In subscales, the biological metrics (blood pressure, cholesterol, glucose) were significantly related to CSF tau-related biomarkers. These associations were observed in the APOE ε4 allele non-carriers, yet not in carriers. The relationship of behavior metrics was found in the middle age and males.
Conclusion
Improving LS7 scores might do a favor to alleviate the pathology of AD in the preclinical stage, especially among the APOE ε4 allele non-carriers.
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Tao W, Kwapong WR, Xie J, Wang Z, Guo X, Liu J, Ye C, Wu B, Zhao Y, Liu M. Retinal microvasculature and imaging markers of brain frailty in normal aging adults. Front Aging Neurosci 2022; 14:945964. [PMID: 36072485 PMCID: PMC9441884 DOI: 10.3389/fnagi.2022.945964] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe retina and brain share a similar embryologic origin, blood barriers, and microvasculature features. Thus, retinal imaging has been of interest in the aging population to help in the early detection of brain disorders. Imaging evaluation of brain frailty, including brain atrophy and markers of cerebral small vessel disease (CSVD), could reflect brain health in normal aging, but is costly and time-consuming. In this study, we aimed to evaluate the retinal microvasculature and its association with radiological indicators of brain frailty in normal aging adults.MethodsSwept-source optical coherence tomography angiography (SS-OCTA) and 3T-MRI brain scanning were performed on normal aging adults (aged ≥ 50 years). Using a deep learning algorithm, microvascular tortuosity (VT) and fractal dimension parameter (Dbox) were used to evaluate the superficial vascular complex (SVC) and deep vascular complex (DVC) of the retina. MRI markers of brain frailty include brain volumetric measures and CSVD markers that were assessed.ResultsOf the 139 normal aging individuals included, the mean age was 59.43 ± 7.31 years, and 64.0% (n = 89) of the participants were females. After adjustment of age, sex, and vascular risk factors, Dbox in the DVC showed a significant association with the presence of lacunes (β = 0.58, p = 0.007), while VT in the SVC significantly correlated with the score of cerebral deep white matter hyperintensity (β = 0.31, p = 0.027). No correlations were found between brain volumes and retinal microvasculature changes (P > 0.05).ConclusionOur report suggests that imaging of the retinal microvasculature may give clues to brain frailty in the aging population.
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Affiliation(s)
- Wendan Tao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Jianyang Xie
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Zetao Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaonan Guo
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Junfeng Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Chen Ye
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yitian Zhao
- The Affiliated People’s Hospital of Ningbo University, Ningbo, China
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
- Yitian Zhao,
| | - Ming Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Ming Liu,
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Acosta JN, Both CP, Rivier C, Szejko N, Leasure AC, Gill TM, Payabvash S, Sheth KN, Falcone GJ. Analysis of Clinical Traits Associated With Cardiovascular Health, Genomic Profiles, and Neuroimaging Markers of Brain Health in Adults Without Stroke or Dementia. JAMA Netw Open 2022; 5:e2215328. [PMID: 35622359 PMCID: PMC9142873 DOI: 10.1001/jamanetworkopen.2022.15328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE The American Heart Association (AHA) Life's Simple 7 (LS7) score captures 7 biological and lifestyle factors associated with promoting cardiovascular health. OBJECTIVES To test whether healthier LS7 profiles are associated with significant brain health benefits in persons without stroke or dementia, and to evaluate whether genomic information can recapitulate the observed LS7. DESIGN, SETTING, AND PARTICIPANTS This genetic association study was a nested neuroimaging study within the UK Biobank, a large population-based cohort study in the United Kingdom. Between March 2006 and October 2010, the UK Biobank enrolled 502 480 community-dwelling persons aged 40 to 69 years at recruitment. This study focused on a subset of 35 914 participants without stroke or dementia who completed research brain magnetic resonance imaging (MRI) and had available genome-wide data. All analyses were conducted between March 2021 and March 2022. EXPOSURES The LS7 (blood pressure, low-density lipoprotein cholesterol, hemoglobin A1c, smoking, exercise, diet, and body mass index) profiles were ascertained clinically and genomically. Independent genetic variants known to influence each of the traits included in the LS7 were assessed. The total LS7 score ranges from 0 (worst) to 14 (best) and was categorized as poor (≤4), average (>4 to 9) and optimal (>9). MAIN OUTCOMES AND MEASURES The outcomes of interest were 2 neuroimaging markers of brain health: white matter hyperintensity (WMH) volume and brain volume (BV). RESULTS The final analytical sample included 35 914 participants (mean [SD] age 64.1 [7.6] years; 18 830 [52.4%] women). For WMH, compared with persons with poor observed LS7 profiles, those with average profiles had 16% (β = -0.18; SE, 0.03; P < .001) lower mean volume and those with optimal profiles had 39% (β = -0.39; SE, 0.03; P < .001) lower mean volume. Similar results were obtained using the genomic LS7 for WMH (average LS7 profile: β = -0.06; SE, 0.014; P < .001; optimal LS7 profile: β = -0.08; SE, 0.018; P < .001). For BV, compared with persons with poor observed LS7 profiles, those with average LS7 profiles had 0.55% (β = 0.09; SE, 0.02; P < .001) higher volume, and those with optimal LS7 profiles had 1.9% (β = 0.14; SE, 0.02; P < .001) higher volume. The genomic LS7 profiles were not associated with BV. CONCLUSIONS AND RELEVANCE These findings suggest that healthier LS7 profiles were associated with better profiles of 2 neuroimaging markers of brain health in persons without stroke or dementia, indicating that cardiovascular health optimization was associated with improved brain health in asymptomatic persons. Genomic information appropriately recapitulated 1 of these associations, confirming the feasibility of modeling the LS7 genomically and pointing to an important role of genetic predisposition in the observed association among cardiometabolic and lifestyle factors and brain health.
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Affiliation(s)
- Julián N. Acosta
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Cameron P. Both
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Cyprien Rivier
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Natalia Szejko
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Audrey C. Leasure
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Thomas M. Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | | | - Kevin N. Sheth
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Guido J. Falcone
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
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10
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Erickson KI, Donofry SD, Sewell KR, Brown BM, Stillman CM. Cognitive Aging and the Promise of Physical Activity. Annu Rev Clin Psychol 2022; 18:417-442. [PMID: 35044793 DOI: 10.1146/annurev-clinpsy-072720-014213] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Is the field of cognitive aging irretrievably concerned with decline and deficits, or is it shifting to emphasize the hope of preservation and enhancement of cognitive function in late life? A fragment of an answer comes from research attempting to understand the reasons for individual variability in the extent and rate of cognitive decline. This body of work has created a sense of optimism based on evidence that there are some health behaviors that amplify cognitive performance or mitigate the rate of age-related cognitive decline. In this context, we discuss the role of physical activity on neurocognitive function in late adulthood and summarize how it can be conceptualized as a constructive approach both for the maintenance of cognitive function and as a therapeutic for enhancing or optimizing cognitive function in late life. In this way, physical activity research can be used to shape perceptions of cognitive aging. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Kirk I Erickson
- Department of Psychology and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; .,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Western Australia, Australia.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Shannon D Donofry
- Department of Psychology and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; .,Psychiatry and Behavioral Health Institute, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Kelsey R Sewell
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Western Australia, Australia
| | - Belinda M Brown
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Western Australia, Australia
| | - Chelsea M Stillman
- Department of Psychology and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA;
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11
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Jochems ACC, Muñoz Maniega S, Del C Valdés Hernández M, Barclay G, Anblagan D, Ballerini L, Meijboom R, Wiseman S, Taylor AM, Corley J, Chappell FM, Backhouse EV, Stringer MS, Dickie DA, Bastin ME, Deary IJ, Cox SR, Wardlaw JM. Contribution of white matter hyperintensities to ventricular enlargement in older adults. Neuroimage Clin 2022; 34:103019. [PMID: 35490587 PMCID: PMC9062739 DOI: 10.1016/j.nicl.2022.103019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/24/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
Abstract
Lateral ventricles might increase due to generalized tissue loss related to brain atrophy. Alternatively, they may expand into areas of tissue loss related to white matter hyperintensities (WMH). We assessed longitudinal associations between lateral ventricle and WMH volumes, accounting for total brain volume, blood pressure, history of stroke, cardiovascular disease, diabetes and smoking at ages 73, 76 and 79, in participants from the Lothian Birth Cohort 1936, including MRI data from all available time points. Lateral ventricle volume increased steadily with age, WMH volume change was more variable. WMH volume decreased in 20% and increased in remaining subjects. Over 6 years, lateral ventricle volume increased by 3% per year of age, 0.1% per mm Hg increase in blood pressure, 3.2% per 1% decrease of total brain volume, and 4.5% per 1% increase of WMH volume. Over time, lateral ventricle volumes were 19% smaller in women than men. Ventricular and WMH volume changes are modestly associated and independent of general brain atrophy, suggesting that their underlying processes do not fully overlap.
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Affiliation(s)
- Angela C C Jochems
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Susana Muñoz Maniega
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Maria Del C Valdés Hernández
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Gayle Barclay
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Devasuda Anblagan
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Lucia Ballerini
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Rozanna Meijboom
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Stewart Wiseman
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Adele M Taylor
- Lothian Birth Cohorts Group, The University of Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Janie Corley
- Lothian Birth Cohorts Group, The University of Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Francesca M Chappell
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ellen V Backhouse
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Michael S Stringer
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - David Alexander Dickie
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary & Life Sciences, Queen Elizabeth University Hospital, University of Glasgow, Glasgow, UK
| | - Mark E Bastin
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Ian J Deary
- Lothian Birth Cohorts Group, The University of Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts Group, The University of Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK.
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12
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Body fat, cardiovascular risk factors and brain structure in school-age children. Int J Obes (Lond) 2021; 45:2425-2431. [PMID: 34267324 DOI: 10.1038/s41366-021-00913-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/17/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND In adults, cardiovascular risk factors are known to be associated with brain health. We hypothesized that these associations are already present at school-age. We examined the associations of adverse body fat measures and cardiovascular risk factors with brain structure, including volumetric measures and white matter microstructure, in 10-year-old children. METHODS We performed a cross-sectional analysis in a population-based prospective cohort study in Rotterdam, the Netherlands. Analyses were based on 3098 children aged 10 years with neuroimaging data and at least one measurement of body fat and cardiovascular risk factors. Body fat measures included body mass index (BMI), fat mass index and android fat mass percentage obtained by Dual-energy X-ray absorptiometry. Cardiovascular risk factors included blood pressure, and serum glucose, insulin and lipids blood concentrations. Structural neuroimaging, including global and regional brain volumes, was quantified by magnetic resonance imaging. DTI was used to assess white matter microstructure, including global fractional anisotropy (FA) and mean diffusivity (MD). RESULTS As compared to children with a normal weight, those with underweight had a smaller total brain and white matter volumes (differences -18.10 (95% Confidence Interval (CI) -30.97,-5.22) cm3, -10.64 (95% CI -16.82,-4.47) cm3, respectively). In contrast, one SDS (Standard Deviation Score) increase in fat mass index was associated with a smaller gray matter volume (differences -3.48 (95% CI -16.82, -4.47) cm3). Also, one SDS increase in android fat mass percentage was associated with lower white matter diffusivity (difference -0.06 (95% CI -0.10, -0.02) SDS). None of the other cardiovascular risk factors were associated with any of the brain outcomes. CONCLUSIONS Body fat measures, but not other cardiovascular risk factors, were associated with structural neuroimaging outcomes in school-aged children. Prospective studies are needed to assess causality, direction and long-term consequences of the associations.
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13
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Suzuki H, Davis-Plourde K, Beiser A, Kunimura A, Miura K, DeCarli C, Maillard P, Mitchell GF, Vasan RS, Seshadri S, Fujiyoshi A. Coronary Artery Calcium Assessed Years Before Was Positively Associated With Subtle White Matter Injury of the Brain in Asymptomatic Middle-Aged Men: The Framingham Heart Study. Circ Cardiovasc Imaging 2021; 14:e011753. [PMID: 34256573 PMCID: PMC8323993 DOI: 10.1161/circimaging.120.011753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Using magnetic resonance diffusion tensor imaging, we previously showed a cross-sectional association between carotid-femoral pulse wave velocity, a measure of aortic stiffness, and subtle white matter injury in clinically asymptomatic middle-age adults. While coronary artery calcium (CAC) is a robust measure of atherosclerosis, and a predictor of stroke and dementia, whether it predicts diffusion tensor imaging-based subtle white matter injury in the brain remains unknown. METHODS In FHS (Framingham Heart Study), an observational study, third-generation participants were assessed for CAC (2002-2005) and brain magnetic resonance imaging (2009-2014). Outcomes were diffusion tensor imaging-based measures; free water, fractional anisotropy, and peak width of mean diffusivity. After excluding the participants with neurological conditions and missing covariates, we categorized participants into 3 groups according to CAC score (0, 0 < to 100, and >100) and calculated a linear trend across the CAC groups. In secondary analyses treating CAC score as continuous, we computed slope of the outcomes per 20 to 80th percentiles higher log-transformed CAC score using linear regression. RESULTS In a total of 1052 individuals analyzed (mean age 45.4 years, 45.4% women), 71.6%, 22.4%, and 6.0% had CAC score of 0, 0 < to 100, and >100, respectively. We observed a significant linear trend of fractional anisotropy, but not other measures, across the CAC groups after multivariable adjustment. In the secondary analyses, CAC was associated with lower fractional anisotropy in men but not in women. CONCLUSIONS CAC may be a promising tool to predict prevalent subtle white matter injury of the brain in asymptomatic middle-aged men.
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Affiliation(s)
- Harumitsu Suzuki
- Department of Hygiene, Wakayama Medical University, Wakayama, Japan
| | - Kendra Davis-Plourde
- The Framingham Heart Study, Framingham, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Massachusetts
| | - Alexa Beiser
- The Framingham Heart Study, Framingham, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | | | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- NCD Epidemiology Research Center, Shiga, Japan
| | - Charles DeCarli
- Department of Neurology and Center for Neuroscience, University of California Davis, Davis, California
| | - Pauline Maillard
- Department of Neurology and Center for Neuroscience, University of California Davis, Davis, California
| | | | - Ramachandran S. Vasan
- The Framingham Heart Study, Framingham, Massachusetts
- Section of Cardiovascular Medicine, Boston University School of Medicine, Massachusetts
- Sections of Preventive Medicine and Epidemiology, Boston University School of Medicine, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Massachusetts
| | - Sudha Seshadri
- The Framingham Heart Study, Framingham, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio
| | - Akira Fujiyoshi
- Department of Hygiene, Wakayama Medical University, Wakayama, Japan
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14
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Rundek T, Gardener H, Dias Saporta AS, Loewenstein DA, Duara R, Wright CB, Dong C, Levin B, Elkind MSV, Sacco RL. Global Vascular Risk Score and CAIDE Dementia Risk Score Predict Cognitive Function in the Northern Manhattan Study. J Alzheimers Dis 2021; 73:1221-1231. [PMID: 31884476 DOI: 10.3233/jad-190925] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Modifiable vascular risk factors (VRF) have been implicated in cognitive impairment. OBJECTIVE We compared the prediction of cognitive performance between the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score, a validated tool to estimate dementia risk using VRF, and the Northern Manhattan Study (NOMAS) global vascular risk score (GVRS), created to predict vascular events. METHODS The CAIDE and GVRS scores were calculated based on baseline VRF among 1,290 stroke-free participants in the prospective population-based NOMAS MRI cohort (mean age 64±8 years, 60% women; 66% Hispanic, 17% Black, 15% White; 46% completed high school). Domain-specific Z-scores were derived for episodic and semantic memory, executive function, and processing speed, and averaged to calculate global cognition. RESULTS The CAIDE score was associated with worse global cognition at initial assessment (Beta per SD = -0.347, p < 0.0001), and with greater decline over time (Beta per SD = -0.033, p = 0.02). These associations were largely due to age and education, and the association with cognitive decline was not significant after adjusting for age, sex, and education. The GVRS was inversely associated with global cognition at initial testing (Beta per SD = -0.247, p < 0.0001) and greater decline over time (Beta per SD = -0.127, p < 0.0001), which persisted after adjusting for sociodemographics. The associations for both scores with initial cognitive performance were driven by executive function and processing speed, and the GVRS was associated with decline in episodic memory and processing speed. CONCLUSIONS The GVRS was a stronger predictor of cognitive decline than the CAIDE in a multi-ethnic urban cohort. The inclusion of glucose and smoking in the GVRS, which are absent in CAIDE, likely explains the better performance of the GVRS.
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Affiliation(s)
- Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hannah Gardener
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Anita Seixas Dias Saporta
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David A Loewenstein
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Chuanhui Dong
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bonnie Levin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mitchell S V Elkind
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ralph L Sacco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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15
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Bu N, Khlif MS, Lemmens R, Wouters A, Fiebach JB, Chamorro A, Ringelstein EB, Norrving B, Laage R, Grond M, Wilms G, Brodtmann A, Thijs V. Imaging Markers of Brain Frailty and Outcome in Patients With Acute Ischemic Stroke. Stroke 2021; 52:1004-1011. [PMID: 33504185 DOI: 10.1161/strokeaha.120.029841] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Functional outcome after stroke may be related to preexisting brain health. Several imaging markers of brain frailty have been described including brain atrophy and markers of small vessel disease. We investigated the association of these imaging markers with functional outcome after acute ischemic stroke. METHODS We retrospectively studied patients with acute ischemic stroke enrolled in the AXIS-2 trial (AX200 in Ischemic Stroke Trial), a randomized controlled clinical trial of granulocyte colony-stimulating factor versus placebo. We assessed the ratio of brain parenchymal volume to total intracerebral volumes (ie, the brain parenchymal fraction) and total brain volumes from routine baseline magnetic resonance imaging data obtained within 9 hours of symptom onset using the unified segmentation algorithm in SPM12. Enlarged perivascular spaces, white matter hyperintensities, lacunes, as well as a small vessel disease burden, were rated visually. Functional outcomes (modified Rankin Scale score) at day 90 were determined. Logistic regression was used to test associations between brain imaging features and functional outcomes. RESULTS We enrolled 259 patients with a mean age of 69±12 years and 46 % were female. Increased brain parenchymal fraction was associated with higher odds of excellent outcome (odds ratio per percent increase, 1.078 [95% CI, 1.008-1.153]). Total brain volumes and small vessel disease burden were not associated with functional outcome. An interaction between brain parenchymal fraction and large vessel occlusion on excellent outcome was not observed. CONCLUSIONS Global brain health, as assessed by brain parenchymal fraction on magnetic resonance imaging, is associated with excellent functional outcome after ischemic stroke. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT00927836.
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Affiliation(s)
- Ning Bu
- Department of Neurology, the Second Affiliated Hospital of Xi'an Jiaotong University (N.B.)
| | - Mohamed Salah Khlif
- Dementia Theme (M.S.K., A.B.), The Florey Institute of Neuroscience and Mental Health
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Belgium (R. Lemmens, A.W.).,Laboratory of Neurobiology, VIB, Center for Brain & Disease Research, Leuven, Belgium (R. Lemmens, A.W.).,Department of Neurology (R. Lemmens, A.W.), University Hospitals Leuven, Belgium
| | - Anke Wouters
- Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Belgium (R. Lemmens, A.W.).,Laboratory of Neurobiology, VIB, Center for Brain & Disease Research, Leuven, Belgium (R. Lemmens, A.W.).,Department of Neurology (R. Lemmens, A.W.), University Hospitals Leuven, Belgium
| | | | - Angel Chamorro
- Department of Neurology, University of Barcelona, Spain (A.C.)
| | | | - Bo Norrving
- Department of Clinical Sciences, Section of Neurology, Lund University, Sweden (B.N.)
| | - Rico Laage
- Clinical Research Department, GUIDED Development GmbH, Heidelberg, Germany (R. Laage)
| | - Martin Grond
- Department of Neurology, Kreisklinikum Siegen, and University of Marburg Germany (M.G.)
| | - Guido Wilms
- Department of Radiology (G.W.), University Hospitals Leuven, Belgium
| | - Amy Brodtmann
- Dementia Theme (M.S.K., A.B.), The Florey Institute of Neuroscience and Mental Health
| | - Vincent Thijs
- Stroke Division (V.T.), The Florey Institute of Neuroscience and Mental Health
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16
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Wright CB, DeRosa JT, Moon MP, Strobino K, DeCarli C, Cheung YK, Assuras S, Levin B, Stern Y, Sun X, Rundek T, Elkind MS, Sacco RL. Race/Ethnic Disparities in Mild Cognitive Impairment and Dementia: The Northern Manhattan Study. J Alzheimers Dis 2021; 80:1129-1138. [PMID: 33646162 PMCID: PMC8150441 DOI: 10.3233/jad-201370] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Variability in dementia rates across racial and ethnic groups has been estimated at 60%. Studies suggest disparities in Caribbean Hispanic and Black populations, but community-based data are limited. OBJECTIVE Estimate the prevalence of mild cognitive impairment (MCI) and dementia in the racially and ethnically diverse community-based Northern Manhattan Study cohort and examine sociodemographic, vascular risk factor, and brain imaging correlates. METHODS Cases of MCI and dementia were adjudicated by a team of neuropsychologists and neurologists and prevalence was estimated across race/ethnic groups. Ordinal proportional odds models were used to estimate race/ethnic differences in the prevalence of MCI or dementia adjusting for sociodemographic variables (model 1), model 1 plus potentially modifiable vascular risk factors (model 2), and model 1 plus structural imaging markers of brain integrity (model 3). RESULTS There were 989 participants with cognitive outcome determinations (mean age 69±9 years; 68% Hispanic, 16% Black, 14% White; 62% women; mean (±SD) follow-up five (±0.6) years). Hispanic and Black participants had greater likelihood of MCI (20%) and dementia (5%) than White participants accounting for age and education differences. Hispanic participants had greater odds of MCI or dementia than both White and Black participants adjusting for sociodemographic variables, vascular risk factors, and brain imaging factors. White matter hyperintensity burden was significantly associated with greater odds of MCI or dementia (OR = 1.3, 1.1 to 1.6), but there was no significant interaction by race/ethnicity. CONCLUSION In this diverse community-based cohort, cross-sectional data revealed significant race/ethnic disparities in the prevalence of MCI and dementia. Longer follow-up and incidence data are needed to further clarify these relationships.
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Affiliation(s)
- Clinton B. Wright
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Janet T. DeRosa
- Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Michelle P. Moon
- Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Kevin Strobino
- Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Davis, CA, USA
| | - Ying Kuen Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Stephanie Assuras
- Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Bonnie Levin
- Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yaakov Stern
- Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Xiaoyan Sun
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tatjana Rundek
- Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mitchell S.V. Elkind
- Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Ralph L. Sacco
- Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
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Liang Y, Ngandu T, Laatikainen T, Soininen H, Tuomilehto J, Kivipelto M, Qiu C. Cardiovascular health metrics from mid- to late-life and risk of dementia: A population-based cohort study in Finland. PLoS Med 2020; 17:e1003474. [PMID: 33320852 PMCID: PMC7737898 DOI: 10.1371/journal.pmed.1003474] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Very few studies have explored the patterns of cardiovascular health (CVH) metrics in midlife and late life in relation to risk of dementia. We examined the associations of composite CVH metrics from midlife to late life with risk of incident dementia. METHODS AND FINDINGS This cohort study included 1,449 participants from the Finnish Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study, who were followed from midlife (baseline from1972 to 1987; mean age 50.4 years; 62.1% female) to late life (1998), and then 744 dementia-free survivors were followed further into late life (2005 to 2008). We defined and scored global CVH metrics based on 6 of the 7 components (i.e., smoking, physical activity, and body mass index [BMI] as behavioral CVH metrics; fasting plasma glucose, total cholesterol, and blood pressure as biological CVH metrics) following the modified American Heart Association (AHA)'s recommendations. Then, the composite global, behavioral, and biological CVH metrics were categorized into poor, intermediate, and ideal levels. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Data were analyzed with Cox proportional hazards and the Fine and Gray competing risk regression models. During the follow-up examinations, dementia was diagnosed in 61 persons in 1998 and additional 47 persons in 2005 to 2008. The fully adjusted hazard ratio (HR) of dementia was 0.71 (95% confidence interval [CI]: 0.43, 1.16; p = 0.174) and 0.52 (0.29, 0.93; p = 0.027) for midlife intermediate and ideal levels (versus poor level) of global CVH metrics, respectively; the corresponding figures for late-life global CVH metrics were 0.60 (0.22, 1.69; p = 0.338) and 0.91 (0.34, 2.41; p = 0.850). Compared with poor global CVH metrics in both midlife and late life, the fully adjusted HR of dementia was 0.25 (95% CI: 0.08, 0.86; p = 0.028) for people with intermediate global CVH metrics in both midlife and late life and 0.14 (0.02, 0.76; p = 0.024) for those with midlife ideal and late-life intermediate global CVH metrics. Having an intermediate or ideal level of behavioral CVH in both midlife and late life (versus poor level in both midlife and late life) was significantly associated with a lower dementia risk (HR range: 0.03 to 0.26; p < 0.05), whereas people with midlife intermediate and late-life ideal biological CVH metrics had a significantly increased risk of dementia (p = 0.031). Major limitations of this study include the lack of data on diet and midlife plasma glucose, high rate of attrition, as well as the limited power for certain subgroup analyses. CONCLUSIONS In this study, we observed that having the ideal CVH metrics, and ideal behavioral CVH metrics in particular, from midlife onwards is associated with a reduced risk of dementia as compared with people having poor CVH metrics. Maintaining life-long health behaviors may be crucial to reduce late-life risk of dementia.
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Affiliation(s)
- Yajun Liang
- Aging Research Center & Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Tiia Ngandu
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics & Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Tiina Laatikainen
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland
| | - Hilkka Soininen
- Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia and Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Miia Kivipelto
- Division of Clinical Geriatrics & Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
- Stockholms Sjukhem, Research and Development Unit, Stockholm, Sweden
- * E-mail: (MK); (CQ)
| | - Chengxuan Qiu
- Aging Research Center & Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden
- * E-mail: (MK); (CQ)
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18
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Han TW, Liu YQ, Dong W, Bai XJ, Liu YY, Su X, Li YM, Qian JY, Xiang MX, Cai L, Lin Q, Hou JB, Yang J, Li DD, Yang HW, Zhou SS, Wang J, Tian F, Zhao XQ, Chen YD. Poor cardiovascular health status among Chinese women. BMC Cardiovasc Disord 2020; 20:497. [PMID: 33238890 PMCID: PMC7687850 DOI: 10.1186/s12872-020-01748-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022] Open
Abstract
Background Systematic investigation and analysis of cardiovascular health status (CVHS) of Chinese women is rare. This study aimed to assess CVHS and atherosclerotic cardiovascular disease (ASCVD) burden in the Chinese women physicians (CWP) and community-based non-physician cohort (NPC). Methods In this prospective, multicenter, observational study, CVHS using the American Heart Association (AHA) defined 7 metrics (such as smoking and fasting glucose) and ASCVD risk factors including hypertension, hyperlipidemia and type-2 diabetes were evaluated in CWP compared with NPC. Results Of 5832 CWP with a mean age of 44 ± 7 years, only 1.2% achieved the ideal CVHS and 90.1% showed at least 1 of the 7 AHA CVHS metrics at a poor level. Total CVHS score was significantly decreased and ASCVD risk burden was increased in postmenopausal subjects in CWP although ideal CVHS was not significantly influenced by menopause. Compared to 2596 NPC, fewer CWP had ≥ 2 risk factors (8% vs. 27%, P < 0.001); CWP scored significantly higher on healthy factors, a composite of total cholesterol, blood pressure, fasting glucose (P < 0.001), but, poorly on healthy behaviors (P < 0.001), specifically in the physical activity component; CWP also showed significantly higher levels of awareness and rates of treatment for hypertension and hyperlipidemia, but, not for type-2 diabetes. Conclusion Chinese women’s cardiovascular health is far from ideal and risk intervention is sub-optimal. Women physicians had lower ASCVD burden, scored higher in healthy factors, but, took part in less physical activity than the non-physician cohort. These results call for population-specific early and improved risk intervention.
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Affiliation(s)
- Tian-Wen Han
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Yu-Qi Liu
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Wei Dong
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Xiao-Juan Bai
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Yu-Yang Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Xi Su
- Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, 430000, China
| | - Yu-Ming Li
- Department of Cardiology, Logistics University of Chinese People's Armed Police Forces, Tianjin, 300162, China
| | - Ju-Ying Qian
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Mei-Xiang Xiang
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
| | - Lin Cai
- Department of Cardiology, The Third People's Hospital of Chengdu, Chengdu, 610031, China
| | - Qian Lin
- Department of Cardiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Jing-Bo Hou
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Jie Yang
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Dan-Dan Li
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Huan-Wan Yang
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Shan-Shan Zhou
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Jing Wang
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Feng Tian
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China
| | - Xue-Qiao Zhao
- Department of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359720, Seattle, WA, GEC-3798104, USA.
| | - Yun-Dai Chen
- Department of Cardiology, Chinese PLA General Hospital, Haidian District, No. 28, Fuxing Road, Beijing, 100853, China.
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19
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Wang D, Zhang Q, Wang A, Wu S, Zhao X. Ideal Cardiovascular Health Metrics on the New Occurrence of Peripheral Artery Disease: A Prospective Cohort Study in Northern China. Sci Rep 2020; 10:9660. [PMID: 32541812 PMCID: PMC7296034 DOI: 10.1038/s41598-020-66578-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/24/2020] [Indexed: 12/20/2022] Open
Abstract
Peripheral artery disease (PAD) is a common atherosclerotic disease which could lead to severe cardiovascular and cerebrovascular events. Previous studies have indicated the ideal cardiovascular health (ICVH) was associated with many atherosclerotic diseases and cardiovascular events. This study aimed to find out the relationship between ICVH metrics and the new occurrence of PAD. We collected information of baseline from 2010 on the seven ICVH metrics (including smoking, body mass index, dietary intake, physical activity, blood pressure, total cholesterol and fasting blood glucose); and assessed PAD by ankle brachial index among the enrolled participants. The relationship between the ICVH metrics and new occurrence of PAD was analyzed using the multivariate logistic regression in 2018. There were 214 participants were diagnosed with the new occurrence of PAD during the follow-up visit. Participants with PAD tend to be older, with a lower level of education and a higher morbidity of hypertension. Among the seven ICVH metrics, BMI seems to be the most sensitive metric to the occurrence of PAD after adjusting the other risk factors (HR (95% CI) = 0.704 (0.529-0.937), P = 0.0163). We further found out as the number of ICVH metric increased, the morbidity of PAD decreased gradually (HR (95% CI) = 0.888 (0.801-0.984), P for trend= 0.0240). There is no difference between different age and gender groups. The ICVH metrics affect the new occurrence of PAD in a Chinese population. It enhances the importance of ideal health behaviors and factors in the prevention of PAD.
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Affiliation(s)
- Dandan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Qian Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China.
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. .,China National Clinical Research Center for Neurological Diseases, Beijing, China. .,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China. .,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
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20
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Nam KW, Kwon HM, Jeong HY, Park JH, Kwon H, Jeong SM. Pooled cohort risk equation and subclinical cerebrovascular diseases. Eur J Neurol 2020; 27:793-799. [PMID: 31994781 DOI: 10.1111/ene.14155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/09/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE In 2013, the American College of Cardiology/American Heart Association (ACC/AHA) introduced a novel pooled cohort risk (PCR) model for atherosclerotic cardiovascular disease. In this study, we evaluated the relationship between the PCR score and cerebral large- and small-vessel diseases (cLVD and cSVD) in a healthy population, METHODS: We assessed consecutive health check-up volunteers from 2006 to 2013. We calculated the estimated 10-year atherosclerotic cardiovascular disease risk as the PCR score based on the 2013 ACC/AHA guidelines. We evaluated both cSVD/cLVD, including the prevalence of cLVD, lacunes and cerebral microbleed (CMB), and the volume of white matter hyperintensity (WMH). In addition to PCR score, the risk factors that were associated with outcome variables at P < 0.10 in univariate analysis were included for further multivariable linear or regression analyses. RESULTS A total of 2720 participants were evaluated (mean age, 57 years, male sex, 54%). In multivariable analysis, PCR score was associated with WMH volume [β = 0.361; 95% confidence interval (CI), 0.320-0.402, P < 0.001], cLVD [adjusted odds ratio (aOR), 1.66; 95% CI, 1.29-2.16, P < 0.001], lacunes (aOR, 1.80; 95% CI, 1.52-2.14, P < 0.001) and CMBs (aOR, 1.75; 95% CI, 1.40-2.19, P < 0.001). Furthermore, PCR score also showed dose-response tendencies according to the burden of cLVD, WMH, lacunes and CMB. CONCLUSIONS A higher PCR score based on the ACC/AHA guidelines is closely associated with a higher prevalence and burden of cLVD and cSVD.
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Affiliation(s)
- K-W Nam
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - H-M Kwon
- Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - H-Y Jeong
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - J-H Park
- Department of Family Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - H Kwon
- Department of Family Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S-M Jeong
- Department of Family Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
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21
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Sabia S, Fayosse A, Dumurgier J, Schnitzler A, Empana JP, Ebmeier KP, Dugravot A, Kivimäki M, Singh-Manoux A. Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study. BMJ 2019; 366:l4414. [PMID: 31391187 PMCID: PMC6664261 DOI: 10.1136/bmj.l4414] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To examine the association between the Life Simple 7 cardiovascular health score at age 50 and incidence of dementia. DESIGN Prospective cohort study. SETTING Civil service departments in London (Whitehall II study; study inception 1985-88). PARTICIPANTS 7899 participants with data on the cardiovascular health score at age 50. EXPOSURES The cardiovascular health score included four behavioural (smoking, diet, physical activity, body mass index) and three biological (fasting glucose, blood cholesterol, blood pressure) metrics, coded on a three point scale (0, 1, 2). The cardiovascular health score was the sum of seven metrics (score range 0-14) and was categorised into poor (scores 0-6), intermediate (7-11), and optimal (12-14) cardiovascular health. MAIN OUTCOME MEASURE Incident dementia, identified through linkage to hospital, mental health services, and mortality registers until 2017. RESULTS 347 incident cases of dementia were recorded over a median follow-up of 24.7 years. Compared with an incidence rate of dementia of 3.2 (95% confidence interval 2.5 to 4.0) per 1000 person years among the group with poor cardiovascular health, the absolute rate differences per 1000 person years were -1.5 (95% confidence interval -2.3 to -0.7) for the group with intermediate cardiovascular health and -1.9 (-2.8 to -1.1) for the group with optimal cardiovascular health. Higher cardiovascular health score was associated with a lower risk of dementia (hazard ratio 0.89 (0.85 to 0.95) per 1 point increment in the cardiovascular health score). Similar associations with dementia were observed for the behavioural and biological subscales (hazard ratios per 1 point increment in the subscores 0.87 (0.81 to 0.93) and 0.91 (0.83 to 1.00), respectively). The association between cardiovascular health at age 50 and dementia was also seen in people who remained free of cardiovascular disease over the follow-up (hazard ratio 0.89 (0.84 to 0.95) per 1 point increment in the cardiovascular health score). CONCLUSION Adherence to the Life Simple 7 ideal cardiovascular health recommendations in midlife was associated with a lower risk of dementia later in life.
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Affiliation(s)
- Séverine Sabia
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, 75010 Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Aurore Fayosse
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, 75010 Paris, France
| | - Julien Dumurgier
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, 75010 Paris, France
- Cognitive Neurology Center, Lariboisière - Fernand Widal Hospital, AP-HP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Alexis Schnitzler
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, 75010 Paris, France
| | - Jean-Philippe Empana
- Inserm, U970, Integrative Epidemiology of Cardiovascular Disease, Paris Descartes University, Paris, France
| | | | - Aline Dugravot
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, 75010 Paris, France
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
- Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, Finland
| | - Archana Singh-Manoux
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, 75010 Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
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