Analysis of the perioperative change in cognitive function of patients with risk factors for cognitive impairment in cardiovascular surgery

Background/Objective: The association between hypertension, diabetes, and worse cognitive function has been reported to be stronger in groups with low levels of education. Using data from a cross-sectional community survey of Korean elders, we sought to investigate this within a sample with relative cognitive impairment. Methods: The sample consisted of 341 participants with Mini-Mental State Examination (MMSE) (Korean version) scores of 24/30 or below. Previous diagnoses were ascertained and participants were examined for resting blood pressure and nonfasting blood glucose and cholesterol. Results: After adjustment for age, occupation, physical dependence, and cholesterol levels, worse cognitive function (MMSE score < 21) within the sample was associated with raised systolic blood pressure, raised glucose levels, and a previous diagnosis of diabetes. These associations were significant only in participants with no formal education. In this group the adjusted odds ratios for worse cognitive function were 1.18 (95% confidence interval [CI] 1.04-1.34) for each 10 mmHg increase in systolic blood pressure and 3.47 (1.14-10.6) for a previous diagnosis of diabetes. Odds ratios for the group with previous education were 0.99 (0.81-1.21) and 1.82 (0.48-6.92), respectively. Conclusion: The association between risk factors for cerebrovascular disease and cognitive impairment appears to be particularly strong in people with lower educational attainment.

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Impact of Baseline Features and Risk Factor Control on Cognitive Function in the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial

Cerebrovascular Diseases ◽

10.1159/000497245 ◽

2019 ◽

Vol 47 (1-2) ◽

pp. 24-31 ◽

Cited By ~ 1

Author(s):

Tanya N. Turan ◽

Sami Al Kasab ◽

Alison Smock ◽

George Cotsonis ◽

David Bachman ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cognitive Impairment ◽

Cognitive Function ◽

Medical Management ◽

Physical Inactivity ◽

Recurrent Stroke ◽

Older Age ◽

Aggressive Medical Management

Background: Cerebrovascular disease is an important cause of cognitive impairment. The aim of this study is to report the relationship between cognitive function and risk factors at baseline and during follow-up in the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial. Methods: Subjects in the SAMMPRIS trial were included in this study. In order to have an assessment of cognitive function independent of stroke, patients with a stroke as a qualifying event whose deficits included aphasia or neglect were excluded from these analyses as were those with a cerebrovascular event during follow-up. The Montreal Cognitive Assessment (MoCA) score was used to assess cognitive impairment at baseline, 4 months, 12 months and closeout. Cognitive impairment was defined as MoCA < 26. A multivariate analysis was performed to determine what risk factors were independent predictors of cognitive function at baseline, 12 months and closeout. Among patients randomized to aggressive medical management only, the percentage of patients with cognitive impairment was compared between patients in versus out of target for each risk factor at 12 months and closeout. Results: Of the 451 patients in SAMMPRIS, 371 patients met the inclusion criteria. MoCA < 26 was present in 55% at baseline. Older age and physical inactivity were associated with cognitive impairment at baseline. Older age, non-white race, lower baseline body mass index, and baseline cognitive impairment were associated with cognitive impairment at 12 months. In the aggressive medical management group, at 12 months, physical inactivity during follow-up was the strongest risk factor associated with cognitive impairment. Conclusion: Cognitive impairment is common in patients with severe symptomatic intracranial atherosclerosis. Physical inactivity at baseline and during follow-up is a strong predictor of cognitive impairment.

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The Association between Cerebral White Matter Lesions and Plasma Omega-3 to Omega-6 Polyunsaturated Fatty Acids Ratio to Cognitive Impairment Development

BioMed Research International ◽

10.1155/2015/153437 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Michihiro Suwa ◽

Shigeru Yamaguchi ◽

Tsuyoshi Komori ◽

Sachiko Kajimoto ◽

Masaya Kino

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Cognitive Function ◽

White Matter ◽

White Matter Lesions ◽

White Matter Hyperintensity ◽

Cerebral White Matter ◽

Omega 3 ◽

Arachidonic Acids ◽

Low Serum

Objective. Cerebral white matter hyperintensity (WMH) with magnetic resonance imaging (MRI) has a potential for predicting cognitive impairment. Serum polyunsaturated fatty acid (PUFA) levels are important for evaluating the extent of atherosclerosis. We investigated whether abnormal PUFA levels affected WMH grading and cognitive function in patients without significant cognitive impairment.Methods. Atherosclerotic risk factors, the internal carotid artery (ICA) plaque, and serum ratios of eicosapentaenoic to arachidonic acids (EPA/AA) and docosahexaenoic to arachidonic acids (DHA/AA) were assessed in 286 patients. The relationship among these risk factors, WMH, and cognitive function was evaluated using WMH grading and the Mini-Mental State Examination (MMSE).Results. The development of WMH was associated with aging, hypertension, ICA plaques, and a low serum EPA/AA ratio (<0.38, obtained as the median value) but was not related to dyslipidemia, diabetes, smoking, and a low serum DHA/AA ratio (<0.84, obtained as the median value). In addition, the MMSE score deteriorated slightly with the progression of WMH (29.7 ± 1.0 compared to 28.4 ± 2.1,P<0.0001).Conclusions. The progression of WMH was associated with a low serum EPA/AA ratio and accompanied minimal deterioration in cognitive function. Sufficient omega-3 PUFA intake may be effective in preventing the development of cognitive impairment.

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Vascular Risk Factors Decrease the Risk of Cognitive Impairment in Amyotrophic Lateral Sclerosis: A Case-Control Study

10.21203/rs.3.rs-552777/v1 ◽

2021 ◽

Author(s):

Tianmi Yang ◽

Qianqian Wei ◽

Chunyu Li ◽

Bei Cao ◽

Ruwei Ou ◽

...

Keyword(s):

Risk Factors ◽

Amyotrophic Lateral Sclerosis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Rating Scale ◽

Case Control ◽

Vascular Risk Factors ◽

Sensitivity Analyses ◽

Vascular Risk ◽

Lateral Sclerosis

Abstract Background The disease-modifying effects of diabetes mellitus (DM), hyperlipidemia, and overweight on risk and prognosis of amyotrophic lateral sclerosis (ALS) have gained significant attention in recent years. However, whether these well-known vascular risk factors increase the cognitive burden in patients with ALS remains unclear. We aim to evaluate the association between vascular risk factors (including hypertension, DM, hyperlipidemia, overweight and smoking) and cognitive function in patients with ALS. Methods Patients with ALS were consecutively recruited between June 2012 and November 2019 from a tertiary referral center for ALS at the West China Hospital. Vascular risk factors were confirmed based on clinical data, while cognitive function was evaluated by the Chinese version of the Addenbrooke’s Cognitive Examination-revised. Case-control design to investigate the association between vascular risk factors and cognitive impairment in ALS. With careful confounder adjustment, multivariable logistic regression analysis was performed separately (for each factor) and accumulatively (based on the sum of factors) to determine the association between cognitive impairment and vascular risk factors in ALS. Results Of 870 patients, 561 (64.5%) were men, the mean age at registeration was 54.1 (11.3) years and 266 had cognitive impairment. No cognitive burden from vascular risk factors was found in patients with ALS. On the contrary, we first observed that DM (odds ratio [OR], 0.50; 95% confidence interval [CI], 0.25–0.98; P = 0.04) and hyperlipidemia (OR, 0.50; 95% CI, 0.26–0.97; P = 0.04) showed protective effects against cognitive decline in ALS, adjusted for age, sex, educational level, site of onset, Revised-ALS Functional Rating Scale score, predominant upper motor neuron phenotype, family history of ALS, and the remaining vascular risk factors. Furthermore, patients with > 2 vascular risk factors showed a significantly lower risk of cognitive impairment (OR, 0.18; 95% CI, 0.07–0.48; P = 0.001). Sensitivity analyses of sex did not substantially reverse the risk estimates. Conclusions DM and hyperlipidemia decrease the risk of cognitive impairment in patients with ALS. The fitness hypothesis in ALS has been tested and expanded in our work.

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Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16162847 ◽

2019 ◽

Vol 16 (16) ◽

pp. 2847 ◽

Cited By ~ 9

Author(s):

Qilin Zhang ◽

Yanli Wu ◽

Tiankuo Han ◽

Erpeng Liu

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Logistic Regression Analysis ◽

Binary Logistic Regression ◽

The Elderly ◽

Binary Logistic Regression Analysis ◽

Chinese Elderly

Background: The cognitive function of the elderly has become a focus of public health research. Little is known about the changes of cognitive function and the risk factors for cognitive impairment in the Chinese elderly; thus, the purposes of this study are as follows: (1) to describe changes in cognitive function in the Chinese elderly from 2005–2014 and (2) to explore risk factors for cognitive impairment of the Chinese elderly. Design and setting: A total of 2603 participants aged 64 years and above participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and were followed up from 2005 to 2014. Cognitive function and cognitive impairment were assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Binary logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) of cognitive impairment. Results: Results revealed that the cognitive function of the Chinese elderly shows diversified changes: deterioration (55.09%), unchanged (17.21%) and improvement (27.70%). In addition, there are significant demographic differences in gender, age, education, marriage and other aspects when it comes to the changes of cognitive function in Chinese elderly. In the binary logistic regression analysis, female, increased age, lower education level, no spouse, less income, worse PWB (psychological well-being), less fresh fruit and vegetable intake, more activities of daily living (ADL) limitations, lower social engagement were significantly associated with higher odds for cognitive impairment. Conclusions: Various interventions should be implemented to maintain cognitive function in Chinese elderly.

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Reshaping the path of vascular cognitive impairment with resistance training: a study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-021-05156-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Teresa Liu-Ambrose ◽

Elizabeth Dao ◽

Rachel A. Crockett ◽

Cindy K. Barha ◽

Ryan S. Falck ◽

...

Keyword(s):

Risk Factors ◽

Randomized Controlled Trial ◽

Cognitive Impairment ◽

Cognitive Function ◽

Resistance Training ◽

Controlled Trial ◽

Vascular Cognitive Impairment ◽

Progressive Resistance Training ◽

Randomized Controlled ◽

Progressive Resistance

Abstract Background Subcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment in older adults, due to its modifiable risk factors such as hypertension, diabetes mellitus, and hypercholesterolemia. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities (WMHs), research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, the primary aim of this proof-of-concept randomized controlled trial is to investigate the efficacy of a 12-month, twice-weekly progressive resistance training program on cognitive function and WMH progression in adults with SIVCI. We will also assess the efficiency of the intervention. Methods Eighty-eight community-dwelling adults, aged > 55 years, with SIVCI from metropolitan Vancouver will be recruited to participate in this study. SIVCI will be determined by the presence of cognitive impairment (Montreal Cognitive Assessment < 26) and cerebral small vessel disease using computed tomography or magnetic resonance imaging. Participants will be randomly allocated to a twice-weekly exercise program of (1) progressive resistance training or (2) balance and tone training (i.e., active control). The primary outcomes are cognitive function measured by the Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-13 with additional cognitive tests) and WMH progression. Discussion The burden of SIVCI is immense, and to our knowledge, this will be the first study to quantify the effect of progressive resistance training on cognitive function and WMH progression among adults with SIVCI. Slowing the rate of cognitive decline and WMH progression could preserve functional independence and quality of life. This could lead to reduced health care costs and avoidance of early institutional care. Trial registration ClinicalTrials.gov NCT02669394. Registered on February 1, 2016

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CHANGES OF COGNITIVE FUNCTION IN PATIENTS WITH HYPERTENSION WITH CONCOMITANT DIABETES MELLITUS TYPE 2

Medical Science of Ukraine (MSU) ◽

10.32345/2664-4738.2.2020.2 ◽

2020 ◽

Vol 16 (2) ◽

pp. 9-15

Author(s):

V.Z. Netiazhenko ◽

T.I. Malchevska ◽

O.N. Plenova ◽

V.S. Potaskalova ◽

V.V. Taranchuk

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Blood Pressure ◽

Cognitive Impairment ◽

Cognitive Function ◽

Mental State ◽

Group I ◽

Moderate Cognitive Impairment ◽

The Relationship

Relevance. Till now there is no clear clinical trial understanding of the relationship between hypertension (AH) and the patient's cognitive function. Objective: the investigation of changes in cognitive function in patients with hypertension with concomitant type 2 diabetes mellitus (DM2). Materials and methods. 215 people were examined: Group I (n = 131) – stage II hypertensive disease (HD); Group II (n = 46) – HD, combined with diabetes mellitus2; Group III, control (n = 38) – without a diagnosis of HD and diabetes mellitus2. All examined blood pressure (BP), echocardiogram. Clinical complaints, anamnestic data, and neuropsychiatric testing data were used to diagnose moderate cognitive impairment (MCI). Used modified diagnostic criteria J. Touchon, R. Petersen. To assess cognitive function used: Short scale of assessment of mental state (Mini-Mental State Examination - MMSE); Frontal Assessment Battery (FAB); clock drawing test; test for literal and categorical associations; Schulte tables; the Global Deterioration Scale (GDS) and the Clinical Dementia Rating (CDR). Result. In patients with HD, the most significant risk factors for moderate cognitive impairment are hypercholesterolemia and overweight (with OR 1.8), obesity (OR 1.6), the presence of concomitant diabetes mellitus2, which, especially in overweight, significantly impairs cognitive function ( OR 2.56). Deterioration of cognitive function correlates with the duration of HD, cholesterol levels. Concomitant diabetes mellitus2 in patients with HD creates a statistically significant additional negative effect on the results of cognitive function. In patients with HD with a distorted daily blood pressure profile, the neurodynamic component of cognitive function is first of all affected - conceptualization, repetition, the reaction of choice. The relationship between cognitive function and daily monitoring of blood pressure often have a U-shaped relationship, where the maximum indicators of cognitive function are at the level of the optimal recommended blood pressure figures (130-139 mm Hg for SBP, and 75-85 mm Hg for DBP, and the daily index within 10%). Conclusions. There is a dependence on changes in cognitive function on the presence of risk factors and signs of subclinical damage to target organs. The nonlinear U-shaped character of the relationship between the average daily, average night, and average daily blood pressure and the results of screening tests and scales for assessing cognitive function are shown.

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Cognitive Impairment At 3, 6 and 12 Month After the First-Ever Stroke Among Lebanese Survivors: Incidence and Risk Factors

10.21203/rs.3.rs-147073/v1 ◽

2021 ◽

Author(s):

Celina Boutros ◽

Walaa Khazaal ◽

Maram Taliani ◽

Pascale Salameh ◽

Hassan Hosseini ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Cognitive Function ◽

Length Of Hospital Stay ◽

Epileptic Seizures ◽

Protective Role ◽

P Value ◽

Post Stroke ◽

Physical Disorders ◽

History Of

Abstract Cognitive impairment is a prevalent outcome of stroke, affecting the quality of life and increasing the disability. Its risk factors are unknown in Lebanon. Therefore, the aims of this study were to evaluate the cognitive impairment incidence among Lebanese stroke survivors at 3, 6 and 12 month post stroke, and to identify the associated factors. A multicenter longitudinal prospective study was conducted in 10 hospitals of Beirut and Mount Lebanon among 150 subjects aged ≥ 18 years old between February 2018 until May 2019. The Mini-Mental State Examination assessed the cognitive function. Univariate and Multivariable analyses were performed to identify the predictors of the post stroke cognitive impairment. A p-value <0.05 was considered statistically significant. At 3 month post stroke, 74.8% were cognitively impaired versus 46.7% and 37.6% at 6 and 12 month post stroke respectively. Older age, past smoking, presence of a caregiver, sedentary ≥ 12 hours, aphasia at the time of stroke occurrence, the length of hospital stay, severe stroke, high disability degree, post stroke anxiety and depression, epileptic seizures and physical disorders were the risk factors inducing cognitive decline. Whereas, the high education level, the employment and the history of diabetes mellitus played a protective role for the cognitive function. Findings reveal levels of cognitive impairment post-stroke that are concerning. Thus, primary and secondary prevention is essential to reduce its incidence and to cope with its burden.

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Impact of transcranial direct current stimulation on cognitive function, brain functional segregation, and integration in patients with mild cognitive impairment according to amyloid-beta deposition and APOE ε4-allele

10.21203/rs.3.rs-360532/v1 ◽

2021 ◽

Author(s):

Dong Woo Kang ◽

Sheng-Min Wang ◽

TaeYeong Kim ◽

Donghyeon Kim ◽

Hae-Ran Na ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

High Risk ◽

Direct Current ◽

Resting State ◽

Anodal Tdcs ◽

High Risk Factors ◽

Ε4 Allele

Abstract Background: Anodal transcranial direct current stimulation (anodal-tDCS) is known to improve cognition and normalise abnormal network configuration during resting-state functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI). We evaluated the impact of sequential anodal-tDCS on cognitive functions, functional segregation, and integration parameters in patients with MCI, according to high-risk factors for Alzheimer’s disease (AD): amyloid-beta (Aβ) deposition and APOE ε4-allele status. Methods: In 32 patients with MCI ([18F] flutemetamol-: n = 10, [18F] flutemetamol+: n = 22; APOE ε4-: n = 13, APOE ε4+: n = 19), we delivered anodal-tDCS (2 mA/day, five times/week, for 2 weeks) over the left dorsolateral prefrontal cortex and assessed the neuropsychological test battery and resting-state fMRI measurements before and after 2 weeks’ stimulation.Results: We observed a trend for impact of an anodal-tDCS-by-Aβ retention interaction on MMSE score changes. Baseline Aβ accumulation tended to be negatively associated with word list recognition score changes. We found a significant effect of tDCS-by-APOE ε4-allele interaction on changes in the functional segregation parameter of the temporal pole. Baseline Aβ deposition associated negatively with change in global functional integrity of hippocampal formation. There was a significant difference in brain functional segregation and integration parameters between MCI patients with and without high-risk factors of AD.Conclusions: Thus, anodal-tDCS could help to improve cognitive function and enhance restorative and compensatory intrinsic functional changes in MCI patients, modulated by the presence of Aβ retention and the APOE ε4-allele. Trial registration: This study is registered with the Clinical Research Information Service of Korea Disease Control and Prevention Agency (KCT0006020). Registered on 24 March 2021—retrospectively registered.

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