Contribution of vascular risk factors to the relationship between ADHD symptoms and cognition in adults and seniors

AbstractSymptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood have been found to be predictive of compromised cognitive function, and possibly even dementia, in later adulthood. This study aimed to test vascular risk as a hypothesized moderator or mediator of this association, because individuals with elevated ADHD symptoms frequently have comorbid vascular disease or risk factors which are recognized to contribute to later-life cognitive decline. Data from 1,092 adults aged 18–85 were drawn from the Enhanced Nathan Kline Institute Rockland Sample. Childhood ADHD symptoms (assessed using the Adult ADHD Clinical Diagnostic Scale) were assessed as predictors of cognitive functioning in adulthood (assessed using subtests from the University of Pennsylvania Computerized Neurocognitive Battery, the Delis-Kaplan Executive Functioning System, and the Wechsler Memory Scale). Vascular risk factors (including diabetes, tobacco use, obesity, hypertension, and hypercholesterolemia) were tested as both a moderator and mediator of this relationship. Childhood ADHD symptoms and vascular risk factors were both independently associated with later-life cognition, but vascular risk was not a significant moderator or mediator of relationships between ADHD symptoms and cognition in statistical models. Results from this large community sample suggest that the relationship between ADHD symptoms and cognition is not accounted for by vascular risk. This question should also be investigated in clinical samples.

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Assessment of the relationship between platelet reactivity, vascular risk factors and gender in cerebral ischaemia patients

Neurologia i Neurochirurgia Polska ◽

10.5603/pjnns.a2019.0028 ◽

2019 ◽

Vol 53 (4) ◽

pp. 258-264 ◽

Cited By ~ 5

Author(s):

Adam Wiśniewski ◽

Joanna Sikora ◽

Karolina Filipska ◽

Grzegorz Kozera

Keyword(s):

Risk Factors ◽

Cerebral Ischaemia ◽

Platelet Reactivity ◽

Vascular Risk Factors ◽

Vascular Risk ◽

And Gender ◽

The Relationship

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The relationship between Alzheimer's disease and vascular risk factors

The FASEB Journal ◽

10.1096/fasebj.2020.34.s1.02068 ◽

2020 ◽

Vol 34 (S1) ◽

pp. 1-1

Author(s):

Xianghui Chen ◽

Weidong Zhang ◽

Xiaohong Qiao ◽

Youliang Li ◽

Hubin Duan ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Vascular Risk Factors ◽

Vascular Risk ◽

The Relationship

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Vascular Risk Factors and Depression in Later Life: A Systematic Review and Meta-Analysis

Biological Psychiatry ◽

10.1016/j.biopsych.2012.10.028 ◽

2013 ◽

Vol 73 (5) ◽

pp. 406-413 ◽

Cited By ~ 90

Author(s):

Vyara Valkanova ◽

Klaus P. Ebmeier

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Later Life ◽

Vascular Risk Factors ◽

Vascular Risk

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Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study

BMJ ◽

10.1136/bmj.322.7300.1447 ◽

2001 ◽

Vol 322 (7300) ◽

pp. 1447-1451 ◽

Cited By ~ 889

Author(s):

M. Kivipelto

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Later Life ◽

Population Based ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Population Based Study

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[P2-551]: THE RELATIONSHIP OF HYPERTENSION, DIABETES AND OTHER VASCULAR RISK FACTORS WITH POSTSTROKE COGNITIVE FUNCTION: THE STROKOG (STROKE AND COGNITION) CONSORTIUM

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.06.1209 ◽

2017 ◽

Vol 13 (7S_Part_17) ◽

pp. P855-P856

Author(s):

Jessica W. Lo ◽

John D. Crawford ◽

David W. Desmond ◽

Rufus O. Akinyemi ◽

Hee-Joon Bae ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Relationship Of ◽

The Relationship

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Abstract TP165: Associations Between Parkinson Disease and Stroke

Stroke ◽

10.1161/str.48.suppl_1.tp165 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Benjamin R Kummer ◽

Ashley E Aaroe ◽

Hooman Kamel ◽

Costantino Iadecola ◽

Babak B Navi

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Parkinson Disease ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Vascular Risk Factors ◽

Annual Incidence ◽

Vascular Risk ◽

Medicare Beneficiaries ◽

The Relationship

Introduction: Cerebral ischemia and vascular risk factors are associated with the development of Alzheimer disease (AD). While Parkinson disease (PD) is also a common neurodegenerative condition, the relationship between ischemic stroke and PD remains unclear. Some evidence suggests a shared pathogenic pathway between both diseases. Methods: We used inpatient and outpatient claims data from 2008-2014 in a 5% sample of Medicare beneficiaries ≥66 years of age. Our variables of interest were: 1) a hospital-based diagnosis of ischemic stroke and 2) an outpatient or hospital-based diagnosis of idiopathic PD. Previously validated ICD-9-CM code algorithms were used to identify all diagnoses. We used Cox proportional hazards modeling to characterize the relationship between ischemic stroke and PD, while adjusting for demographics and vascular risk factors. We assessed both the association between PD and subsequent stroke, as well as stroke and subsequent PD. In a separate but identically designed set of analyses, we characterized the relationship between ischemic stroke and AD as a point of comparison. Results: Our analysis encompassed nearly 1.6 million patients with a mean age of 73(+/- 8) years, of whom 57% were female. The annual incidence of ischemic stroke was 1.75% (95% confidence interval [CI], 1.67-1.85%) after a diagnosis of PD versus 0.96% (95% CI, 0.96-0.97%) in those without PD (adjusted hazard ratio [aHR], 1.25; 95% CI, 1.19-1.32). In contrast, the annual incidence of ischemic stroke was 1.96% (95% CI, 1.89-2.03%) after a diagnosis of AD versus 0.96% (95% CI, 0.96-0.97%) in those without AD (aHR, 0.98; 95% CI, 0.95-1.02). The annual incidence of PD was 0.97% (95% CI, 0.92-1.03%) after ischemic stroke versus 0.39% (95% CI, 0.38-0.39%) in those without ischemic stroke (aHR, 1.62; 95% CI, 1.53-1.72). In contrast, the annual incidence of AD was 3.66% (95% CI, 3.56-3.78%) after a diagnosis of ischemic stroke versus 1.17% (95% CI, 1.16-1.17%) in those without ischemic stroke (aHR, 1.67; 95% CI, 1.61-1.72). Conclusions: Among Medicare beneficiaries, the relationships between stroke and PD were similar to those between stroke and AD. As in AD, a link may exist between cerebrovascular disease and PD.

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Network Efficiency Mediates the Relationship Between Vascular Burden and Cognitive Impairment

Stroke ◽

10.1161/strokeaha.119.028587 ◽

2020 ◽

Vol 51 (6) ◽

pp. 1682-1689 ◽

Cited By ~ 1

Author(s):

Jun Shen ◽

Daniel J. Tozer ◽

Hugh S. Markus ◽

Jonathan Tay

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

White Matter ◽

White Matter Hyperintensities ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Network Efficiency ◽

Global Efficiency ◽

Vascular Burden ◽

The Relationship

Background and Purpose— Cerebrovascular disease contributes to age-related cognitive decline, but the mechanisms underlying this phenomenon remain incompletely understood. We hypothesized that vascular risk factors would lead to cognitive impairment through the disruption of brain white matter network efficiency. Methods— Participants were 19 346 neurologically healthy individuals from UK Biobank that underwent diffusion MRI and cognitive testing (mean age=62.6). Global efficiency, a measure of network integration, was calculated from white matter networks constructed using deterministic diffusion tractography. First, we determined whether demographics (age, sex, ethnicity, socioeconomic status, and education), vascular risk factors (hypertension, hypercholesterolemia, diabetes mellitus, smoking, body mass index), and white matter hyperintensities were related to global efficiency using multivariate linear regression. Next, we used structural equation modeling to model a multiple regression. The dependent variable was a latent cognition variable using all cognitive data, while independent variables were a latent factor including all vascular risk factors (vascular burden), demographic variables, white matter hyperintensities, and global efficiency. Finally, we used mediation analysis to determine whether global efficiency explained the relationship between vascular burden and cognition. Results— Hypertension and diabetes mellitus were consistently associated with reduced global efficiency even after controlling for white matter hyperintensities. Structural equation models revealed that vascular burden was associated with cognition ( P =0.023), but not after adding global efficiency to the model ( P =0.09), suggesting a mediation effect. Mediation analysis revealed a significant indirect effect of global efficiency on cognition through vascular burden ( P <0.001), suggesting a partial mediation effect. Conclusions— Vascular burden is associated with reduced global efficiency and cognitive impairment in the general population. Network efficiency partially mediates the relationship between vascular burden and cognition. This suggests that treating specific risk factors may prevent reductions in brain network efficiency and preserve cognitive functioning in the aging population.

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