Association between cerebral small vessel diseases and mild parkinsonian signs in the elderly with vascular risk factors

Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascular risk factor acquisition. In sub-Saharan Africa, the effect sizes of vascular risk factors for stroke occurrence by age is unknown. Objective: To quantify the magnitude and direction of the effect sizes of key modifiable risk factors of stroke according to three age groups: <50years(young), 50-65 years(middle age) and >65 years(elderly) in West Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular, lifestyle, stroke severity and outcomes were performed. We used conditional logistic regression to estimate adjusted odds ratios (aOR) of vascular risk factors of stroke. Results: Among 3,553 stroke cases, 813(22.9%) were young, 1441(40.6%) were middle-aged and 1299(36.6%) were elderly. Five modifiable risk factors were consistently associated with stroke occurrence regardless of age namely hypertension, dyslipidemia, diabetes mellitus, regular meat consumption and non-consumption of green vegetables. Among the 5 co-shared risk factors, the effect size, aOR(95%CI) of dyslipidemia, 4.13(2.64-6.46), was highest among the young age group, hypertension, 28.93(15.10-55.44) and non-consumption of vegetables 2.34(1.70-3.23) was highest among the middle-age group while diabetes, aOR of 3.50(2.48-4.95) and meat consumption, 2.40(1.76-3.26) were highest among the elderly age group. Additionally, among the young age group cigarette smoking and cardiac disease were associated with stroke. Furthermore, physical inactivity and salt intake were associated with stroke in the middle-age group while cardiac disease was associated with stroke in the elderly age group. Conclusions: Age has a profound influence on the profile, magnitude and direction of effect sizes of vascular risk factors for stroke occurrence among West Africans. Population-level prevention of stroke must target both co-shared dominant risk factors as well as factors that are unique to specific age bands in Africa.

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Differing Pattern of Ambulatory Blood Pressure in Very Elderly Men Expresses Dynamics in Atherosclerotic Load in the Senescence

International Journal of Hypertension ◽

10.1155/2012/417291 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Arkadiusz Siennicki-Lantz ◽

Sölve Elmståhl

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Blood Pressure Measurement ◽

Ankle Brachial Index ◽

The Elderly ◽

Population Based ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Pressure Development

To assess an impact of vascular risk factors on ambulatory blood pressure measurement (ABPM) in the elderly, we followed up a population-based cohort of men from 68 until 82 years, when 104 survivors underwent ABPM.Results. At age 68, hypertension and high clinic blood pressure (CBP) did not predict ABPM level. Smoking and low ankle-brachial index (ABI) predicted higher ABPM variability and pulse pressure (PP), but not absolute ABPM values. At age 82, hypertension, high or increasing CBP, strongly positively correlated with all variables of ABPM. Carotid stenosis, low or declining ABI during followup, correlated with higher nocturnal ABPM and PP.Concluding. Hypertension and vascular risk factors in a cohort of 68-year-old men do not result in higher ABPM at age 82, possibly due to inflection point in their pressure development. Higher ABPM reflects instead an increasing CBP and aggravating atherosclerosis during the preceding decade in that part of the cohort with previously favorable risk factor status.

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Study of the positivity of spontaneous and directed diagnosis of leukoaraiosis in the elderly by cranial computerized tomography, and its correlation with cognitive defi cit and cardiovascular risk factors

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000700008 ◽

2007 ◽

Vol 65 (4b) ◽

pp. 1134-1138

Author(s):

Mauricio de Miranda Ventura ◽

Antonio Carlos de Paiva Melo ◽

Henrique Carrete Jr ◽

Ricardo Vieira Botelho

Keyword(s):

Risk Factors ◽

Cognitive Performance ◽

Computerized Tomography ◽

Positive Association ◽

The Elderly ◽

Vascular Risk Factors ◽

Cognitive Tests ◽

Vascular Risk ◽

Significant Difference ◽

Cranial Computerized Tomography

OBJECTIVE: To evaluate the prevalence of leukoaraiosis (LA) and its correlation with vascular risk factors and the cognitive performance of elderly patients. METHOD: 78 patients were randomly selected and submitted to clinic-laboratorial evaluation for vascular risk factors. Two cognitive tests were performed. All patients were submitted to cranial computerized tomography (CT), which was analyzed in two situations: the spontaneous and the directed way. RESULTS: There was no statistically significant difference between the prevalence of spontaneous and the directed diagnoses of LA (20.5 and 18%, respectively). The presence of LA was not significantly correlated with cognitive impairment. Only age was positively associated with LA. CONCLUSION: Cranial CT is a trustworthy method for the diagnosis of LA. Only age showed a positive association. No clinical implications were found, concerning the cognitive performance of the patients.

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Leuko-Araiosis, Vascular Risk Factors, and Cognitive Function in the Elderly

Ewha Medical Journal ◽

10.12771/emj.1999.22.4.253 ◽

1999 ◽

Vol 22 (4) ◽

pp. 253

Author(s):

Yong-Jae Kim

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

The Elderly ◽

Vascular Risk Factors ◽

Vascular Risk

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Abstract W MP58: The Relationship Between Carotid Stiffness, Diastolic Diameter, and White Matter Hyperintensity Volume: The Northern Manhattan Study

Stroke ◽

10.1161/str.45.suppl_1.wmp58 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Matthew S Markert ◽

Chuanhui Dong ◽

David Della-Morte ◽

Eugene Roberts ◽

Susanne Bartels ◽

...

Keyword(s):

Risk Factors ◽

White Matter ◽

Small Vessel Disease ◽

Vascular Risk Factors ◽

Small Vessel ◽

White Matter Hyperintensity ◽

Large Artery ◽

Vascular Risk ◽

Vessel Disease ◽

Carotid Stiffness

Background: Changes in the extracranial vasculature may be associated with small vessel disease in the brain. We sought to examine the association of carotid stiffness and carotid diastolic diameter with white matter hyperintensity volume (WMHV), a magnetic resonance imaging (MRI) measure for cerebral small vessel disease, in a multi-ethnic community-based cohort. Methods: We evaluated 1140 stroke-free participants in the Northern Manhattan study who underwent brain MRIs and high-resolution carotid ultrasounds. We used linear regression to examine carotid stiffness and diastolic diameter with WMHV after adjusting for sociodemographics, lifestyle behaviors, and traditional vascular risk factors. Results: Among 1140 participants (mean age: 70.6±9.0 years; 61% women; 15% White, 16% Black, 59% Hispanics), the mean carotid stiffness was 8.19 ± 5.39, mean carotid diastolic diameter was 6.16 ± 0.93 mm, and mean WMHV 0.68 ± 0.84. In a fully adjusted model, diastolic diameter was associated with log-WMHV (β=0.10, p=0.001). In a stratified multivariable linear model, greater carotid arterial stiffness and diastolic diameter were associated with log-WMHV among Hispanics (β=0.15, p=0.005 and β=0.13, p<0.001, respectively), but not among blacks or whites. Conclusion: Greater carotid stiffness and diastolic diameter were associated with greater WMHV independent of demographics and traditional vascular risk factors, especially among Hispanics. Further studies are needed to understand how these large artery characteristics relate to WMH formation and lesion load. Carotid ultrasound may be a useful tool to assess the risk of increased brain white matter disease in a pre-clinical stage.

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Psychosocial and Vascular Risk Factors for Depression in the Elderly

American Journal of Geriatric Psychiatry ◽

10.1097/01.jgp.0000192504.48810.cb ◽

2006 ◽

Vol 14 (1) ◽

pp. 84-90 ◽

Cited By ~ 31

Author(s):

Caitlin Holley ◽

Stanley A. Murrell ◽

Benjamin T. Mast

Keyword(s):

Risk Factors ◽

The Elderly ◽

Vascular Risk Factors ◽

Vascular Risk

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Vascular risk factors as independent predictors of neurocognitive impairments in patients with late-onset epilepsy who have small-vessel disease

Epilepsy & Behavior ◽

10.1016/j.yebeh.2019.106443 ◽

2020 ◽

Vol 104 ◽

pp. 106443 ◽

Cited By ~ 1

Author(s):

Marc Turon ◽

Laura Abraira ◽

Sonia Cazorla ◽

Elena Fonseca ◽

Manuel Quintana ◽

...

Keyword(s):

Risk Factors ◽

Small Vessel Disease ◽

Late Onset ◽

Vascular Risk Factors ◽

Small Vessel ◽

Vascular Risk ◽

Vessel Disease ◽

Neurocognitive Impairments

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Characterization of Lenticulostriate Arteries and Its Associations With Vascular Risk Factors in Community-Dwelling Elderly

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.685571 ◽

2021 ◽

Vol 13 ◽

Author(s):

Xiaopei Xu ◽

Xiao Wu ◽

Chengcheng Zhu ◽

Ruiting Zhang ◽

Yeerfan Jiaerken ◽

...

Keyword(s):

Risk Factors ◽

Cerebral Artery ◽

Vascular Risk Factors ◽

Community Dwelling ◽

Small Vessel ◽

Imaging Biomarkers ◽

Elderly Subjects ◽

Vascular Risk ◽

Lenticulostriate Arteries ◽

Vessel Tortuosity

Lenticulostriate arteries (LSAs) supply blood to important subcortical areas and are, therefore, essential for maintaining the optimal functioning of the brain’s most metabolically active nuclei. Past studies have demonstrated the potential for quantifying the morphology of LSAs as biomarkers of vascular fragility or underlying arteriopathies. Thus, the current study aims to evaluate the morphological features of LSAs, their potential value in cerebrovascular risk stratification, and their concordance with other vascular risk factors in community-dwelling elderly people. A total of 125 community-dwelling elderly subjects who underwent a brain MRI scan were selected from our prospectively collected imaging database. The morphological measures of LSAs were calculated on the vascular skeletons obtained by manual tracing, and the number of LSAs was counted. Additionally, imaging biomarkers of small vessel disease were evaluated, and the diameters of major cerebral arteries were measured. The effects of vascular risk factors on LSA morphometry, as well as the relationship between LSA measures and other imaging biomarkers, were investigated. We found that smokers had shorter (p = 0.04) and straighter LSAs (p < 0.01) compared to nonsmokers, and the presence of hypertension is associated with less tortuous LSAs (p = 0.03) in community-dwelling elderly. Moreover, the middle cerebral artery diameter was positively correlated with LSA count (r = 0.278, p = 0.025) and vessel tortuosity (r = 0.257, p = 0.04). The posterior cerebral artery diameter was positively correlated with vessel tortuosity and vessel length. Considering the scarcity of noninvasive methods for measuring small artery abnormalities in the brain, the LSA morphological measures may provide valuable information to better understand cerebral small vessel degeneration during aging.

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