scholarly journals Mild cognitive impairment, degenerative and vascular dementia as predictors of intra-hospital, short- and long-term mortality in the oldest old

2011 ◽  
Vol 23 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Dina Zekry ◽  
François R. Herrmann ◽  
Christophe E. Graf ◽  
Sandra Giannelli ◽  
Jean-Pierre Michel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Vascular Dementia ◽  
Oldest Old ◽  
Short And Long Term ◽  
Long Term Mortality

Abstract P53: Long-Term Mortality Among Ischemic Stroke Patients With Pre-Existing Mild Cognitive Impairment or Dementia

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Farhaan S Vahidy ◽  
Thomas Potter ◽  
Jennifer Meeks ◽  
Alan Pan ◽  
Osman Khan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
National Sample ◽  
Healthcare Organizations ◽  
Pooled Data ◽  
Increased Risk ◽  
Icd 10 ◽  
Long Term Mortality

Introduction: The contribution of preexisting mild cognitive impairment (MCI) or dementia (MCID) towards long term mortality in Ischemic Stroke (IS) patients is under studied. Methods: We conducted a propensity score (PS) matched analysis of pooled data from 39 healthcare organizations to evaluate the association between MCID and post stroke mortality (PSM) through a 5-year period. Using ICD-10 codes for MCI, Alzheimer disease, vascular/other dementias, and MCID specific medications; we flagged preexisting MCID diagnoses up till 1 month prior to the index IS event (MCID group). The non-MCID group had no documented MCID diagnoses till after 1 month of the index event. Groups were PS matched on demographic (age, sex, race, ethnicity) and comorbidity variables. Risk Ratios (RR) and 95% confidence intervals (CI) were calculated. Results: Among 544,700 IS patients, 124,892 (22.9%) had preexisting MCID. MCID patients (vs. non-MCID) were older (mean age: 67.8 vs. 64.8 years), had higher proportion (%) of females (52.8 vs. 49.4) and Blacks (21.1 vs. 17.1). A higher proportion (%) of MCID patients had hypertension (77.3 vs. 36.0), diabetes (36.9 vs. 17.4), ischemic heart disease (31.6 vs 13.5), chronic kidney disease (21.4 vs. 7.8) and liver disease (9.5 vs. 3.1). Optimal co-variate balance was achieved post PS match (figure). In the unmatched sample, 8.6% of MCID and 6.0% of non-MCID patients experienced PSM by the 1-year time point; representing 56.2% and 64.2% of the total 5-year PSM, respectively. Matched and unmatched RR (CI) for PSM at 3 month and 1,3,5-year are reported (figure). An increasing risk of PSM was observed across the four time-points which was significantly higher for years 1,3, and 5 in the matched sample. Conclusion: A 24% long term increased risk of PSM was observed in a large national sample of IS patients with preexisting MCID. Majority of PSM burden is experienced by 1 year. MCID screening and exploring mechanisms of MCID-linked PSM is critical among IS patients.

Short and long term effect of cognitive rehabilitation in mild cognitive impairment subtypes in Parkinson's disease

2016 ◽  
Vol 22 ◽  
pp. e74
Author(s):  
Maria Diez-Cirarda ◽  
Natalia Ojeda ◽  
Javier Peña ◽  
Olaia Lucas-Jimenez ◽  
María Ángeles Gómez-Beldarrain ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Rehabilitation ◽  
Term Effect ◽  
Long Term Effect ◽  
Short And Long Term

Exploring the Role of Remote Ischemic Preconditioning In Long Term Cognitive Impairment after Global Ischemia-Reperfusion-Induced Vascular Dementia in Mice

2020 ◽  
Author(s):  
Amteshwar Singh Jaggi
Keyword(s):  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Vascular Dementia ◽  
Ischemic Preconditioning ◽  
Ischemia Reperfusion ◽  
Remote Ischemic Preconditioning ◽  
Global Cerebral Ischemia ◽  
Cerebral Ischemic ◽  
The Brain

Aim: The aim of the present study is to explore the neuroprotective effects of remote ischemic preconditioning in long term cognitive impairment after global cerebral ischemia induced-vascular dementia in mice. Material and methods: The mice were subjected to global cerebral ischemia by occluding the bilateral common carotid arteries for 12 minutes followed by the 24 hours of the reperfusion. The remote ischemic preconditioning stimulus was delivered in the form of 4 cycles of ischemia/reperfusion for 5 minutes each. The cerebral ischemic injury induced-long term cognitive impairment-related learning and memory alterations was assessed using morris water maze, the motor performances of the animals were evaluated using rota-rod test and neurological severity score. The cerebral infract size of the brain were quantified using triphenyltetrazolium chloride staining. Results: Global cerebral ischemia causes long term memory impairment, decreases motor performances and increases the brain infract size in animals. The delivery of remote ischemic preconditioning stimulus significantly abolished the long-term cognitive impairment and ameliorates the motor performances as well as cerebral infract size in brain. Conclusion: The remote ischemic preconditioning mediates neuro protection against global cerebral ischemic injury induced long-term cognitive impairment.

Cerebrovascular and Neurodegenerative Pathologies in Long-Term Stable Mild Cognitive Impairment

2021 ◽  
pp. 1-15
Author(s):  
Manu J. Sharma ◽  
Brandy L. Callahan
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cerebral Amyloid Angiopathy ◽  
Neurofibrillary Tangles ◽  
Small Vessel Disease ◽  
Significant Proportion ◽  
Amyloid Angiopathy ◽  
Prodromal Phase ◽  
Cerebral Amyloid

Background: Mild cognitive impairment (MCI) is considered by some to be a prodromal phase of a progressive disease (i.e., neurodegeneration) resulting in dementia; however, a substantial portion of individuals (ranging from 5–30%) remain cognitively stable over the long term (sMCI). The etiology of sMCI is unclear but may be linked to cerebrovascular disease (CVD), as evidence from longitudinal studies suggest a significant proportion of individuals with vasculopathy remain stable over time. Objective: To quantify the presence of neurodegenerative and vascular pathologies in individuals with long-term (>5-year) sMCI, in a preliminary test of the hypothesis that CVD may be a contributor to non-degenerative cognitive impairment. We expect frequent vasculopathy at autopsy in sMCI relative to neurodegenerative disease, and relative to individuals who convert to dementia. Methods: In this retrospective study, using data from the National Alzheimer’s Coordinating Center, individuals with sMCI (n = 28) were compared to those with MCI who declined over a 5 to 9-year period (dMCI; n = 139) on measures of neurodegenerative pathology (i.e., Aβ plaques, neurofibrillary tangles, TDP-43, and cerebral amyloid angiopathy) and CVD (infarcts, lacunes, microinfarcts, hemorrhages, and microbleeds). Results: Alzheimer’s disease pathology (Aβ plaques, neurofibrillary tangles, and cerebral amyloid angiopathy) was significantly higher in the dMCI group than the sMCI group. Microinfarcts were the only vasculopathy associated with group membership; these were more frequent in sMCI. Conclusion: The most frequent neuropathology in this sample of long-term sMCI was microinfarcts, tentatively suggesting that silent small vessel disease may characterize non-worsening cognitive impairment.

scholarly journals Five-Year Change in Body Mass Index Predicts Conversion to Mild Cognitive Impairment or Dementia Only in APOE ɛ4 Allele Carriers

2021 ◽  
pp. 1-11
Author(s):  
Kylie R. Kadey ◽  
John L. Woodard ◽  
Allison C. Moll ◽  
Kristy A. Nielson ◽  
J. Carson Smith ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Body Mass ◽  
Carrier Status ◽  
Healthy Older Adults ◽  
E4 Allele ◽  
Lifestyle Risk

Background: Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia. Objective: The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults. Methods: The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer’s Coordinating Center (NACC) database. Results: After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p <  0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96–1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96–1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78–1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53–0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57–0.94). Conclusion: A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.

scholarly journals 332 - Electroconvulsive therapy in older adults with major depression was not associated with cognitive decline during a 15-year follow-up

2020 ◽  
Vol 32 (S1) ◽  
pp. 91-91
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Major Depression ◽  
Cognitive Decline ◽  
Electroconvulsive Therapy ◽  
Antidepressant Treatment ◽  
Community Sample ◽  
Control Group

AUTHORS:Kerstin Johansson, Karolina Thömkvist, Ingmar Skoog and Sacuiu SF* (*presenter)OBJECTIVE:To determine the effects of electroconvulsive therapy (ECT) in major depression in relation to the development of dementia during long-term follow-up.METHOD:In an observational clinical prospective study of consecutive patients 70 years and older diagnosed with major depression at baseline 2000-2004 (n=1090), who were free of dementia and received antidepressant treatment, with or without ECT, we sought to determine if cognitive decline (mild cognitive impairment and dementia) during 15 -year follow-up was associated with receiving ECT at baseline. The control group was selected among the participants in the Gothenburg H70 Birth Cohort Studies matched by age group and sex 1:1.RESULTS:Among patients with affective syndromes 7% received ECT. During follow-up, 157 patients were diagnosed with dementia, equal proportions among those who received ECT (14.5%) and those who did not receive ECT (14.5%). The relation between ECT and cognitive decline remained non-significant irrespective antidepressive medication or presence of mild cognitive impairment at baseline.CONCLUSION:Preliminary results indicate that ECT was not associated with the development of cognitive decline in the long-term in a hospital-based cohort of 70+ year-olds. The results remain to verify against controls from a representative community sample.

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