Prevalence and risk factors of behavioural changes associated with age-related cognitive impairment in geriatric dogs

The severe depressive disorders of late life are associated with high rates of medical morbidity and mortality, cognitive impairment, suicide, disability, complex treatment regimens, institutionalization and high costs to the community (Murphy, 1983; Murphy et al. 1988; Bruce & Leaf, 1989; NIH Consensus Development Panel, 1992; Alexopoulos et al. 1993a, b; Brodaty et al. 1993; Bruce et al. 1994; Forsell et al. 1994; Hickie et al. 1995; Blazer, 1996). Those disorders that are accompanied by cognitive impairment and/or concurrent medical morbidity have a particularly poor outcome (Bruce & Leaf, 1989; Alexopoulos et al. 1993b; Hickie et al. 1995, 1997a). Although psychosocial models of late-life depression place considerable importance on age-related psychological and social risk factors, those who survive into later life may actually be characterized by psychological resilience (Henderson, 1994; Blazer, 1997).Current aetiological research in late-life depression, therefore, places particular emphasis on the potential role of biological risk factors. The potential importance of vascular risk factors is receiving renewed attention and may provide opportunities for specific prevention and intervention strategies in high-risk populations. This emphasis on possible vascular risk factors, and the wider importance of vascular pathologies in late-life neuropsychiatric disorders, mirrors the emphasis of much earlier clinico-pathological studies (Binswanger, 1894; Alzheimer, 1895). The specific focus on the importance of small progressive changes within the subcortical white matter, as distinct from more discrete cortical infarcts (Olszewski, 1962), is now supported by the emerging neuroimaging literature and theoretical constructs in late-life depression (Krishnan, 1991, 1993; Hickie et al. 1996, 1997b; Krishnan et al. 1997).

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Abstract 151: Enlarged Perivascular Spaces in Lacunar Stroke Patients. The Secondary Prevention of Small Subcortical Stroked (SPS3) trial.

Stroke ◽

10.1161/str.43.suppl_1.a151 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Hideki Ohba ◽

Lesly Pearce ◽

Gillian Potter ◽

Oscar Benavente

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

White Matter ◽

Small Vessel Disease ◽

Large Cohort ◽

Common Finding ◽

Perivascular Spaces ◽

Lacunar Stroke ◽

Stroke Patients ◽

Age Related

Introduction: Enlarge perivascular spaces (EPVS) are a common finding on MRI with little known about their aetiology or clinical significance. Associations of EPVS with white matter hyperintensities (WMH) and cognitive impairment have been reported. We assessed the prevalence of EPVS in the basal ganglia (BG) and centrum semiovale (CS) and associations with vascular risk factors, MRI abnormalities, and cognitive impairment in a large cohort of MRI documented lacunar stroke patients. Methods: All SPS3 participants enrolled in North America (N=1632) were included in the cohort. MRIs were obtained at the time of index stroke. We graded severity of EPVS on T2 in each of the right and left BG and CS as: <10, 11-20, or 20+. We assessed relationships between maximum (max) BG and CS scores and patient demographics, number of subcortical infarcts, WMH, and cognitive impairment using chi-square tests and ANOVA. Logistic regression was used to identify independent associations between max score in the BG or CS (<10 vs. 11+ points) and these factors. Results: Of the 1632 MRIs, 1172 had T2-imaging available. EPVS was symmetrical in right and left sides of BG and of CS so max score in each area were used for analyses. In 42% of BG and 69% of CS, the max number of unilateral EPVS was ≥11. Patients with more EPVS in the BG were older (mean 59 vs. 63 vs. 70 years, p < 0.001), had hypertension (75% vs. 84% vs. 86% p < 0.001), and lower eGFR (mean 83 vs. 80 vs. 74 ml/min/1.73m 2 , p = 0.006). More EPVS in the BG were associated with WMH severity as measured by Age Related White Matter Changes total score (median 3 vs. 6 vs. 8, p < 0.001). Patients with more EPVS in the BG more often had multiple infarcts (11% vs. 19% vs. 29%, p<0.001). All findings were similar in the CS. Age (OR 1.9 per each 10 years, 95% CI 1.7-2.1), history of hypertension (OR 1.7, 95% CI 1.2-2.3) and multiple infarcts (OR 2.4, 95% CI 1.7-3.4) were independently associated with a maximum unilateral EPVS score of 2+ in the BG. Mild cognitive impairment was not associated with EPVS in BG (p=0.3) or CS (p=0.5). Conclusions: In this well-defined large cohort of lacunar stroke patients, BG EPVS were associated with age, hypertension and multiple infarcts. These findings suggest that BG EPVS share similar risk factors with lacunar stroke and may be a marker for small vessel disease. Unexpectedly, EPVS were not associated with cognitive impairment.

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The role of social and behavioral risk factors in explaining racial disparities in age-related cognitive impairment: a structured narrative review

Aging Neuropsychology and Cognition ◽

10.1080/13825585.2019.1598539 ◽

2019 ◽

Vol 27 (2) ◽

pp. 173-196 ◽

Cited By ~ 3

Author(s):

Rachel L. Peterson ◽

Mindy J. Fain ◽

Emily A. Butler ◽

John E. Ehiri ◽

Scott C. Carvajal

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Racial Disparities ◽

Narrative Review ◽

Behavioral Risk Factors ◽

Behavioral Risk ◽

Age Related

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Cognitive impairment—risk factors and prevention

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0123 ◽

2017 ◽

pp. 955-962

Author(s):

Francesca Mangialasche ◽

Tiia Ngandu ◽

Miia Kivipelto

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Evidence Based ◽

Preventive Strategies ◽

Related Factors ◽

Life Course Approach ◽

Age Related ◽

Key Aspects ◽

Multicomponent Interventions ◽

Preventive Effects

Cognitive impairment is common in advanced age, with dementia representing the main cause of disability in older adults. Prevention is crucial to halt the pandemic increase of this disorder, and can be achieved by managing several risk factors, including vascular and metabolic disorders, and psychosocial and lifestyle-related factors. While evidence-based approaches still need to be defined, the multifactorial and heterogeneous nature of late-life cognitive impairment suggests that multicomponent interventions targeting several risk factors simultaneously are needed for optimal preventive effects. A life course approach should also be considered to identify strategies that can be efficacious for subjects of different ages and with different risk profiles. This chapter summarizes major findings on risk and protective factors for age-related cognitive impairment, dementia, and Alzheimer’s disease, and reviews key aspects of preventive strategies, focusing on primary and secondary prevention.

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Mixed Brain Pathology Is the Most Common Cause of Cognitive Impairment in the Elderly

Journal of Alzheimer s Disease ◽

10.3233/jad-200925 ◽

2020 ◽

Vol 78 (1) ◽

pp. 453-465

Author(s):

Irina Alafuzoff ◽

Sylwia Libard

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Lewy Bodies ◽

Amyloid Β ◽

The Elderly ◽

Systemic Diseases ◽

Brain Pathology ◽

Cerebrovascular Lesions ◽

Peripheral Organs ◽

Age Related

Background: Systemic diseases, diabetes mellitus (DM), and cardiovascular disease (CaVD) have been suggested being risk factors for cognitive impairment (CI) and/or influence Alzheimer’s disease neuropathologic change (ADNC). Objective: The purpose was to assess the type and the extent of neuropathological alterations in the brain and to assess whether brain pathology was associated with CaVD or DM related alterations in peripheral organs, i.e., vessels, heart, and kidney. Methods: 119 subjects, 15% with DM and 24% with CI, age range 80 to 89 years, were chosen and neuropathological alterations were assessed applying immunohistochemistry. Results: Hyperphosphorylated τ (HPτ) was seen in 99%, amyloid-β (Aβ) in 71%, transactive DNA binding protein 43 (TDP43) in 62%, and α-synuclein (αS) in 21% of the subjects. Primary age related tauopathy was diagnosed in 29% (more common in females), limbic predominant age-related TDP encephalopathy in 4% (14% of subjects with CI), and dementia with Lewy bodies in 3% (14% of subjects with CI) of the subjects. High/intermediate level of ADNC was seen in 47% and the extent of HPτ increased with age. The extent of ADNC was not associated with the extent of pathology observed in peripheral organs, i.e., DM or CaVD. Contrary, brain alterations such as pTDP43 and cerebrovascular lesions (CeVL) were influenced by DM, and CeVL correlated significantly with the extent of vessel pathology. Conclusion: In most (66%) subjects with CI, the cause of impairment was “mixed pathology”, i.e., ADNC combined with TDP43, αS, or vascular brain lesions. Furthermore, our results suggest that systemic diseases, DM and CaVD, are risk factors for CI but not related to ADNC.

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Cognitive Impairment in Older Adults With Concurrent Hearing and Vision Impairment: A Systematic Scoping Review Protocol

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.661560 ◽

2021 ◽

Vol 12 ◽

Author(s):

Atul Jaiswal ◽

Natalina Martiniello ◽

Peter Holzhey ◽

Gabrielle Aubin ◽

Shirley Dumassais ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Impairment ◽

Scoping Review ◽

Vision Impairment ◽

Assessment Tools ◽

Future Research ◽

Sensory Impairment ◽

Services Delivery ◽

Age Related

Introduction: As the prevalence of age-related sensory impairment increases, more evidence emerges on the association between uni-sensory and cognitive impairment (CI) in older adults. However, the link between CI and concurrent hearing and vision impairment (referred to as dual sensory impairment/DSI) is not well-understood, and this combined effect may be additive or multiplicative. Moreover, the existing evidence on CI in older adults with DSI is scattered and limited. Through this systematic scoping review, we aim to map existing evidence on CI in older adults with DSI, and to summarize what is known about the prevalence, incidence and risk factors of CI, and tools used to screen or assess CI in older adults with DSI.Methods and Analysis: We will use the Joanna Briggs Institute framework to perform the review. Eleven databases [MEDLINE, CINAHL/EBSCO, EMBASE, Mednar, WorldWideScience, PsycEXTRA, OAIster, OpenGrey (SIGLE), Global Health, PsycINFO, and Web of Science] and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) will be searched. Study selection will be completed using Covidence, and data will be extracted using an a priori data extraction tool. To be included, studies had to be peer-reviewed, had older adults with DSI as the focal population, and are related to CI. Data will be presented using a narrative summary with emphasis on implications for future research and practice.Discussion: Reliable cognitive screening is of the utmost importance for prevention and treatment of CI within DSI population. The study findings will have significant implications for health services delivery and policy research. The summarized findings on the prevalence, incidence, associated risk factors, and CI screening and assessment tools will inform geriatric care. The review will also document knowledge gaps on CI in the DSI population and identify areas of interest for future studies.Ethics and Dissemination: The scoping study, being a review of existing documents, does not require ethics approval. The findings will be disseminated with relevant stakeholders using knowledge translation activities such as scientific presentations and publications. We intend to use the findings to conduct a Delphi study to evaluate which CI tools are suitable for older population with DSI.

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Hypertension and Age-Related Cognitive Impairment: Common Risk Factors and a Role for Precision Aging

Current Hypertension Reports ◽

10.1007/s11906-020-01090-w ◽

2020 ◽

Vol 22 (10) ◽

Author(s):

Meredith Hay ◽

Carol Barnes ◽

Matt Huentelman ◽

Roberta Brinton ◽

Lee Ryan

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Age Related ◽

Common Risk Factors

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Association of plaque echostructure and cardiovascular risk factors with symptomatic carotid artery disease

VASA ◽

10.1024/0301-1526.38.4.357 ◽

2009 ◽

Vol 38 (4) ◽

pp. 357-364 ◽

Cited By ~ 5

Author(s):

Giannoukas ◽

Sfyroeras ◽

Griffin ◽

Saleptsis ◽

Antoniou ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Carotid Artery ◽

Cardiovascular Risk Factors ◽

Carotid Plaque ◽

Young Patients ◽

Symptomatic Disease ◽

Age Related ◽

Ica Stenosis

Background: Severity of stenosis remains the main factor for assessing risk of stroke in patients with internal carotid artery (ICA) disease. This study was conducted to investigate the association of plaque echostructure and other established and emerging cardiovascular risk factors with symptomatic ICA disease. Design: Cross-sectional study of consecutive patients with significant (> 50 %) ICA stenosis. Patients and methods: Carotid plaque echostructure, smoking, hypertension, diabetes mellitus, serum lipoprotein (a), homocysteine, vitamin B12, folate, cholesterol to high-density lipoprotein ratio, triglycerides, C-reactive protein, and the Framingham risk score were assessed in 124 consecutive patients (70 asymptomatic; 54 symptomatic) with significant (> 50 %) ICA stenosis. Results: The asymptomatic and symptomatic groups did not differ in terms of gender distribution (p = 0.76) and severity of stenosis (p = 0.62). Echolucent plaques (type 1 and 2) were more predominant in patients with symptomatic disease (p = 0.004, OR = 2.13, 95 % CI = 1.26-3.6). Patients with plaques type 1 were relatively younger than those with type 4 (p = 0.02). None of the other factors assessed had any significant association with symptomatic disease and any type of carotid plaque. Conclusions: Besides the severity of carotid stenosis, the presence of an echolucent plaque appears as an important factor associated with symptomatic ICA disease. Also, young patients are more likely to have an echolucent plaque suggesting an age-related association with plaque maturation.

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