Association of trajectories of depressive symptoms with vascular risk factors, cognitive function and adverse brain outcomes: A 28‐year follow‐up

Background and Purpose: The objective of this study were to describe the proportion of patients eligible for the COMPASS trial among stable outpatients with either established atherothrombotic disease or major vascular risk factors, and to analyze 6-month incident stroke risk according vascular risk factors at baseline. Methods: We prospectively recruited 5,101 stable outpatients in 172 sites, within the Mexican INDAGA cohort study. Inclusion criteria were age >18 years and established atherothrombotic disease [history of either acute coronary syndromes (ACS), acute ischemic stroke (AIS)/transient ischemic attack (TIA) or peripheral artery disease (PAD)] or major vascular risk factors (age <55 years plus ≥2 major vascular risk factors, or age ≥55 years plus ≥1 vascular risk factors). Among these patients, we applied the selection criteria of the COMPASS trial for analysis, dividing the population in no COMPASS criteria met and COMPASS criteria met, and this last group subdivided among patients with previous AIS/TIA and without this antecedent, in order to stratify the risk for stroke during 6-month follow-up (incident AIS/TIA). Results: Among 5,101 stable outpatients with either established atherothrombotic disease (n=2,827) or major vascular risk factors (n=2,274), a total of 1,927 (37.8%) met COMPASS trial criteria: 1,054 (54.7%) with established cerebrovascular disease (past history of AIS/TIA) and 873 (45.3%) without. During 6-month follow-up, there were 89 incident AIS/TIA (39 AIS and 54 TIA): 1.7% among the whole population and 2.2% among the COMPASS subgroup. AIS/TIA occurred in a similar frequency among the COMPASS subgroup with established cerebrovascular disease (1.6%) and COMPASS without cerebrovascular disease (0.9%) (P=0.18). After a Cox-proportional hazards model, independent predictors of incident AIS/TIA were age ≥65 years (HR: 1.99, 95% CI: 1.29-3.07) and established cerebrovascular disease at baseline (HR: 1.61, 95% CI: 1.02-2.53). Conclusions: The majority of stable outpatients at vascular risk met COMPASS selection criteria and could be good candidates for low-dose rivaroxaban in addition to aspirin. Short-term predictors of AIS/TIA were old age and history of cerebrovascular disease

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Vascular Risk Factors and Cognitive Function

Brain and Heart Dynamics ◽

10.1007/978-3-030-28008-6_62 ◽

2020 ◽

pp. 953-972

Author(s):

Enrico Mossello ◽

Niccolò Marchionni

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Vascular Risk Factors ◽

Vascular Risk

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Abstract 224: Increased Total Homocysteine Levels Are Associated With the Risk of Dementia Independently of Cerebral Small-vessel Disease

Stroke ◽

10.1161/str.46.suppl_1.224 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Kaori Miwa ◽

Shuhei Okazaki ◽

Yoshiki Yagita ◽

Manabu Sakaguchi ◽

Hideki Mochizuki ◽

...

Keyword(s):

Risk Factors ◽

Small Vessel Disease ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Mri Findings ◽

Vessel Disease ◽

Cerebrovascular Events ◽

Multivariable Analyses ◽

Total Homocysteine

Objectives: Increased serum total homocysteine (tHcy) levels have been associated with not only vascular injury but also dementia. However, given an association between Hcy and vascular injury, such as cerebral small-vessel disease (SVD) or renal impairment, to what extent Hcy would impact future dementia beyond these confouders is unknown. We assessed the predictive value of tHcy levels with the risk of dementia in patients with vascular risk factors, when controlling for the MRI-findings and renal imapirment. Methods: Within a Japanese cohort of partients with vascular risk factors in an observational study from 2001, we evaluated the association between tHcy levels at baseline, defined as a continuous variable (per 1 μmol/L) and as a categorical variable (the tertile of tHcy), the prevalence of MRI-findings, and incident all-cause dementia during follow-up. Baseline brain MRI was used to determine SVD (lacuna, white matter hyperintensities and cerebral microbleeds [CMBs]) and atrophy (medial-temporal lobe atrophy). Cox proportional hazards analyses were performed for predictors of dementia adjusting for age, sex, APOEε4 allele, educational level, cerebrovascular events, estimated glomerular filtration rate (eGFR), vascular risk factors, and MRI-findings. Results: Of the 643 subjects (mean:67.2±8.4years, male:59%, 12.9±2.6years of schooling), in multivariable analyses adjusted for age, sex, hypertension, cerebrovascular events, eGFR, and intima-media thickness, the highest tHcy tertile (vs lowest) were associated with lacuna, CMBs and strictly deep CMBs, respectively. During the mean 7.3-year follow-up (range:3-13), 47 incident dementia patients (Alzheimer’s disease:24; vascular dementia:18; mixed-type:3; other:2) were diagnosed. In multivariable analyses adjusted for age, sex, cerebrovascular events, eGFR, and MRI-findings, tHcy level or the highest tertile of tHcy for all-cause dementia remained significant, respectively (relative risk [RR]1.09: p=0.02, RR;2.59: p=0.021). Conclusions: Our results provide additional evidence of Hcy that leads to increased susceptibility to the risk of dementia, suggesting that this association may be mediated by independent mechanisms.

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P3-555: AN ONLINE ASSESSMENT OF THE INFLUENCE OF VASCULAR RISK FACTORS ON COGNITIVE FUNCTION IN HEALTHY ADULTS AGED 50 AND ABOVE

Alzheimer s & Dementia ◽

10.1016/j.jalz.2019.06.3592 ◽

2019 ◽

Vol 15 ◽

pp. P1187-P1187

Author(s):

Latha Velayudhan ◽

Aghaji Ugochukwu ◽

Keith Wesnes ◽

Helen Brooker ◽

Anne Corbett ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Vascular Risk Factors ◽

Healthy Adults ◽

Online Assessment ◽

Vascular Risk

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Cognitive Function and Vascular Risk Factors Among Older African American Adults

Journal of Immigrant and Minority Health ◽

10.1007/s10903-017-0583-7 ◽

2017 ◽

Vol 20 (3) ◽

pp. 612-618 ◽

Cited By ~ 1

Author(s):

Ishan C. Williams ◽

Moon Ho Park ◽

Siny Tsang ◽

Scott A. Sperling ◽

Carol Manning

Keyword(s):

Risk Factors ◽

African American ◽

Cognitive Function ◽

Vascular Risk Factors ◽

Vascular Risk ◽

African American Adults

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The influence of vascular risk factors on cognitive function in early Parkinson's disease

International Journal of Geriatric Psychiatry ◽

10.1002/gps.4735 ◽

2017 ◽

Vol 33 (2) ◽

pp. 288-297 ◽

Cited By ~ 8

Author(s):

Maxime Doiron ◽

Mélanie Langlois ◽

Nicolas Dupré ◽

Martine Simard

Keyword(s):

Risk Factors ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Function ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Early Parkinson’S Disease

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Prevalence of hippocampal enlarged perivascular spaces in a sample of patients with hypertension and their relation with vascular risk factors and cognitive function

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2017-316724 ◽

2018 ◽

Vol 89 (6) ◽

pp. 651-656 ◽

Cited By ~ 8

Author(s):

Joan Jiménez-Balado ◽

Iolanda Riba-Llena ◽

Edurne Garde ◽

Marta Valor ◽

Belen Gutiérrez ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Rating Scale ◽

Brain Mri ◽

Treatment Compliance ◽

Vascular Risk Factors ◽

Study Cohort ◽

Perivascular Spaces ◽

Vascular Risk ◽

Verbal Reasoning

ObjectivesThe clinical importance of hippocampal enlarged perivascular spaces (H-EPVS) remains uncertain. We aimed to study their association with vascular risk factors, cognitive function and mild cognitive impairment (MCI).MethodsData were obtained from the ISSYS (Investigating Silent Strokes in hYpertensives, a magnetic resonance imaging Study) cohort, which is a prospective study of patients with hypertension aged 50–70 with no prior stroke or dementia. Participants were clinically evaluated and underwent a cognitive screening test, Dementia Rating Scale-2, which includes five cognitive subscales (attention, initiation/perseveration, conceptualisation, construction and memory). Besides, they were diagnosed with MCI or normal ageing following standard criteria. H-EPVS were manually counted on brain MRI according to a previous scale and defined as extensive when H-EPVS count was ≥7 (upper quartile). Multivariate models were created to study the relationship between H-EPVS, vascular risk factors and cognitive function.Results723 patients were included; the median age was 64 (59–67) and 51% were male. Seventy-two patients (10%) were diagnosed with MCI and 612 (84.6%) had at least 1 H-EPVS. Older age (OR per year=1.04, 95% CI 1.01 to 1.08) and poor blood pressure treatment compliance (OR=1.50, 95% CI 1.07 to 2.11) were independently associated with extensive H-EPVS. Regarding cognitive function, H-EPVS were independently and inversely correlated with verbal reasoning (β=−0.021, 95% CI −0.038 to −0.003). No association was found between H-EPVS and MCI.ConclusionsH-EPVS are a frequent finding in patients with hypertension and are associated with ageing and poor hypertension treatment compliance. Besides, H-EPVS are associated with worse verbal reasoning function.

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