Prevalence of hippocampal enlarged perivascular spaces in a sample of patients with hypertension and their relation with vascular risk factors and cognitive function

2018 ◽  
Vol 89 (6) ◽  
pp. 651-656 ◽  
Author(s):  
Joan Jiménez-Balado ◽  
Iolanda Riba-Llena ◽  
Edurne Garde ◽  
Marta Valor ◽  
Belen Gutiérrez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Function ◽  
Rating Scale ◽  
Brain Mri ◽  
Treatment Compliance ◽  
Vascular Risk Factors ◽  
Study Cohort ◽  
Perivascular Spaces ◽  
Vascular Risk ◽  
Verbal Reasoning

ObjectivesThe clinical importance of hippocampal enlarged perivascular spaces (H-EPVS) remains uncertain. We aimed to study their association with vascular risk factors, cognitive function and mild cognitive impairment (MCI).MethodsData were obtained from the ISSYS (Investigating Silent Strokes in hYpertensives, a magnetic resonance imaging Study) cohort, which is a prospective study of patients with hypertension aged 50–70 with no prior stroke or dementia. Participants were clinically evaluated and underwent a cognitive screening test, Dementia Rating Scale-2, which includes five cognitive subscales (attention, initiation/perseveration, conceptualisation, construction and memory). Besides, they were diagnosed with MCI or normal ageing following standard criteria. H-EPVS were manually counted on brain MRI according to a previous scale and defined as extensive when H-EPVS count was ≥7 (upper quartile). Multivariate models were created to study the relationship between H-EPVS, vascular risk factors and cognitive function.Results723 patients were included; the median age was 64 (59–67) and 51% were male. Seventy-two patients (10%) were diagnosed with MCI and 612 (84.6%) had at least 1 H-EPVS. Older age (OR per year=1.04, 95% CI 1.01 to 1.08) and poor blood pressure treatment compliance (OR=1.50, 95% CI 1.07 to 2.11) were independently associated with extensive H-EPVS. Regarding cognitive function, H-EPVS were independently and inversely correlated with verbal reasoning (β=−0.021, 95% CI −0.038 to −0.003). No association was found between H-EPVS and MCI.ConclusionsH-EPVS are a frequent finding in patients with hypertension and are associated with ageing and poor hypertension treatment compliance. Besides, H-EPVS are associated with worse verbal reasoning function.

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

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.

Is apathy in late-life depressive illness related to age-at-onset, cognitive function or vascular risk?

2004 ◽  
Vol 16 (4) ◽  
pp. 481-486 ◽  
Author(s):  
Indrag K. Lampe ◽  
Thea J. Heeren
Keyword(s):  
Risk Factors ◽  
Cognitive Function ◽  
Rating Scale ◽  
Late Onset ◽  
Late Life ◽  
Depressive Illness ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Onset Type ◽  
Depressed Patients

Background: Apathy has been shown to be an important feature of degenerative, vascular or traumatic brain disorder. Its presence is associated with high depression scores, higher age, low performance on frontal tasks, and more severe deep white matter hyperintensities. In late-life depression, lack of interest or motivation are often more prominent than depressed mood, especially in the late-onset type. It was hypothesized that in a heterogeneous sample of elderly depressed patients, apathy is associated with late-onset type of depression, cognitive dysfunction or vascular risk factors.Method: The Apathy Evaluation Scale (AES) was administered to twenty-nine elderly (≥60 years) inpatients with a DSM-IV major depression or dysthymic disorder. The severity of the depression was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS) and cognitive function with the Mini-mental State Examination (MMSE). The presence of vascular risk factors was traced in the patient's medical records.Results: Apathy was found in 86% of the patients. The AES-score was correlated with the negative symptom score, but not with total MADRS or MMSE-score. No difference in AES-score between early-onset depressed (n = 16) and late-onset depressed (n = 13) patients was found, and between patients with or without vascular risk.Conclusion: Apathy is a main feature of moderate to severe depressive illness in elderly patients and related to the negative symptoms of the disorder. Further studies should include less severely depressed patients and investigate the relation between depression severity and apathy.

scholarly journals Perivascular spaces on 7 Tesla brain MRI are related to markers of small vessel disease but not to age or cardiovascular risk factors

2016 ◽  
Vol 36 (10) ◽  
pp. 1708-1717 ◽  
Author(s):  
Willem H Bouvy ◽  
Jaco JM Zwanenburg ◽  
Rik Reinink ◽  
Laura EM Wisse ◽  
Peter R Luijten ◽  
...  
Keyword(s):  
Risk Factors ◽  
Basal Ganglia ◽  
Small Vessel Disease ◽  
Brain Mri ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
7 Tesla ◽  
Perivascular Spaces ◽  
Vascular Risk ◽  
Vessel Disease

Cerebral perivascular spaces (PVS) are small physiological structures around blood vessels in the brain. MRI visible PVS are associated with ageing and cerebral small vessel disease (SVD). 7 Tesla (7T) MRI improves PVS detection. We investigated the association of age, vascular risk factors, and imaging markers of SVD with PVS counts on 7 T MRI, in 50 persons aged ≥ 40. The average PVS count ± SD in the right hemisphere was 17 ± 6 in the basal ganglia and 71 ± 28 in the semioval centre. We observed no relation between age or vascular risk factors and PVS counts. The presence of microbleeds was related to more PVS in the basal ganglia (standardized beta 0.32; p = 0.04) and semioval centre (standardized beta 0.39; p = 0.01), and white matter hyperintensity volume to more PVS in the basal ganglia (standardized beta 0.41; p = 0.02). We conclude that PVS counts on 7T MRI are high and are related SVD markers, but not to age and vascular risk factors. This latter finding may indicate that due to the high sensitivity of 7T MRI, the correlation of PVS counts with age or vascular risk factors may be attenuated by the detection of “normal”, non-pathological PVS.

scholarly journals P3-555: AN ONLINE ASSESSMENT OF THE INFLUENCE OF VASCULAR RISK FACTORS ON COGNITIVE FUNCTION IN HEALTHY ADULTS AGED 50 AND ABOVE

2019 ◽  
Vol 15 ◽  
pp. P1187-P1187
Author(s):  
Latha Velayudhan ◽  
Aghaji Ugochukwu ◽  
Keith Wesnes ◽  
Helen Brooker ◽  
Anne Corbett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Function ◽  
Vascular Risk Factors ◽  
Healthy Adults ◽  
Online Assessment ◽  
Vascular Risk

scholarly journals Cognitive Function and Vascular Risk Factors Among Older African American Adults

2017 ◽  
Vol 20 (3) ◽  
pp. 612-618 ◽  
Author(s):  
Ishan C. Williams ◽  
Moon Ho Park ◽  
Siny Tsang ◽  
Scott A. Sperling ◽  
Carol Manning
Keyword(s):  
Risk Factors ◽  
African American ◽  
Cognitive Function ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
African American Adults

scholarly journals Association of trajectories of depressive symptoms with vascular risk factors, cognitive function and adverse brain outcomes: A 28‐year follow‐up

2020 ◽  
Vol 16 (S10) ◽  
Author(s):  
Naiara Demnitz ◽  
Melis Anatürk ◽  
Charlotte L Allan ◽  
Nicola Filippini ◽  
Ludovica Griffanti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
Vascular Risk Factors ◽  
Vascular Risk

P1-269: Vascular risk factors and cognitive function in midlife women: The study of women's health across the nation (SWAN)

2015 ◽  
Vol 11 (7S_Part_10) ◽  
pp. P458-P459
Author(s):  
Carol A. Derby ◽  
Rachel A. Whitmer ◽  
Barbara Sternfeld ◽  
Susan A. Everson-Rose ◽  
Bill Lasley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Function ◽  
Women’S Health ◽  
Women's Health ◽  
Vascular Risk Factors ◽  
Midlife Women ◽  
Vascular Risk

scholarly journals Associations of Vascular Risk Factors and APOE Genotype With Perivascular Spaces Among Community‐Dwelling Older Adults

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Anna Laveskog ◽  
Rui Wang ◽  
Davide L. Vetrano ◽  
Lena Bronge ◽  
Lars‐Olof Wahlund ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
White Matter ◽  
Magnetic Resonance ◽  
Orthostatic Hypotension ◽  
Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Perivascular Spaces ◽  
Vascular Risk ◽  
Vessel Disease

Background Evidence suggests that enlarged perivascular spaces (PVSs) may represent a marker for cerebral small‐vessel disease. We investigated whether vascular risk factors are correlated with visible PVS in older adults. Methods and Results This population‐based study included 530 participants (age ≥60 years) who were free from dementia and functional dependence, derived from the Swedish National study on Aging and Care in Kungsholmen (2001–2003). We collected data on demographics, vascular risk factors, and health conditions through interviews, clinical examinations, laboratory tests, and patient registers. Cerebral PVSs and white matter hyperintensities on magnetic resonance images were visually assessed with semiquantitative visual rating scales. Data were analyzed using the general linear regression models. After controlling for demographics and cardiovascular disease, very high blood pressure (≥160/100 mm Hg) was significantly associated with global PVS score (β‐coefficient, 1.30; 95% CI, 0.06–2.53) and orthostatic hypotension was associated with PVS score in the basal ganglia (β‐coefficient 0.37; 0.03–0.70), but the associations became non‐significant when adjusting for white matter hyperintensity load. Orthostatic hypotension was significantly associated with global and lobar PVS scores in carriers but not in noncarriers of the APOE ε4 allele. Global or regional PVS score was not significantly associated with other traditional vascular risk factors such as smoking, diabetes mellitus, physical inactivity, and overweight or obesity. Conclusions This study provides limited evidence supporting a correlation of magnetic resonance imaging–visible PVS with traditional vascular risk factors in older adults. The association of orthostatic hypotension with lobar PVS among APOE ε4 carriers suggests that lobar PVS may be a marker for amyloid‐associated small‐vessel disease.

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