Cognitive Patterns in Relation to Biomarkers of Cerebrovascular Disease and Vascular Risk Factors

Throughout the lifespan, common variations in systemic health and illness contribute to alterations in vasculature structure and function throughout the body, significantly increasing risk for cardiovascular and cerebrovascular disease (CVD). CVD is a prevalent cause of mortality in late life; it also promotes brain alterations, contributing to cognitive decline and, when severe, vascular dementia. Even prior to diseased states, individual variation in CVD risk is associated with structural and functional brain alterations. Yet, how cumulative asymptomatic alterations in vessel structure and function contribute to more subtle changes in brain tissue integrity and function that emerge in late life is unclear. Finally, vascular risk factors are associated with the clinical progression of neurodegenerative diseases such as Alzheimer’s disease (AD); however, recent theory posits that vascular degeneration may serve a contributory role in these conditions. This chapter reviews how lifespan changes in vascular health contribute to degenerative changes in neural tissue and the subsequent development of cognitive impairment and/or vascular dementia. It first discusses associations between vascular risk factors and cognition and also how declining vascular health may lead to cognitive impairment and dementia. Next, it identifies basic aspects of cerebrovascular anatomy and physiology sustaining tissue health and discusses how vulnerabilities of this system contribute to neurodegenerative changes. Finally, it reviews evidence of vascular contributions to AD and presents ideas for future research to better understand the full spectrum of cerebrovascular contributions to brain aging, cognitive decline, and dementia.

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Abstract WP244: Applicability of the Compass Trial Criteria Among Stable Outpatients With Established Atherothrombotic Disease or Major Risk Factors

Stroke ◽

10.1161/str.51.suppl_1.wp244 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Carlos Cantu-Brito ◽

Erwin Chiquete ◽

Jose L Ruiz-Sandoval ◽

Fernando Flores-Silva

Keyword(s):

Risk Factors ◽

Cerebrovascular Disease ◽

Selection Criteria ◽

Vascular Risk Factors ◽

Cox Proportional Hazards Model ◽

Vascular Risk ◽

Similar Frequency ◽

History Of ◽

Atherothrombotic Disease

Background and Purpose: The objective of this study were to describe the proportion of patients eligible for the COMPASS trial among stable outpatients with either established atherothrombotic disease or major vascular risk factors, and to analyze 6-month incident stroke risk according vascular risk factors at baseline. Methods: We prospectively recruited 5,101 stable outpatients in 172 sites, within the Mexican INDAGA cohort study. Inclusion criteria were age >18 years and established atherothrombotic disease [history of either acute coronary syndromes (ACS), acute ischemic stroke (AIS)/transient ischemic attack (TIA) or peripheral artery disease (PAD)] or major vascular risk factors (age <55 years plus ≥2 major vascular risk factors, or age ≥55 years plus ≥1 vascular risk factors). Among these patients, we applied the selection criteria of the COMPASS trial for analysis, dividing the population in no COMPASS criteria met and COMPASS criteria met, and this last group subdivided among patients with previous AIS/TIA and without this antecedent, in order to stratify the risk for stroke during 6-month follow-up (incident AIS/TIA). Results: Among 5,101 stable outpatients with either established atherothrombotic disease (n=2,827) or major vascular risk factors (n=2,274), a total of 1,927 (37.8%) met COMPASS trial criteria: 1,054 (54.7%) with established cerebrovascular disease (past history of AIS/TIA) and 873 (45.3%) without. During 6-month follow-up, there were 89 incident AIS/TIA (39 AIS and 54 TIA): 1.7% among the whole population and 2.2% among the COMPASS subgroup. AIS/TIA occurred in a similar frequency among the COMPASS subgroup with established cerebrovascular disease (1.6%) and COMPASS without cerebrovascular disease (0.9%) (P=0.18). After a Cox-proportional hazards model, independent predictors of incident AIS/TIA were age ≥65 years (HR: 1.99, 95% CI: 1.29-3.07) and established cerebrovascular disease at baseline (HR: 1.61, 95% CI: 1.02-2.53). Conclusions: The majority of stable outpatients at vascular risk met COMPASS selection criteria and could be good candidates for low-dose rivaroxaban in addition to aspirin. Short-term predictors of AIS/TIA were old age and history of cerebrovascular disease

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Mixed cerebrovascular disease in an elderly patient with mixed vascular risk factors: a case report

BMC Neurology ◽

10.1186/s12883-019-1248-z ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Dian He ◽

YunLi Yu ◽

Shan Wu ◽

ShuFen Tian ◽

Hui Yu ◽

...

Keyword(s):

Risk Factors ◽

Elderly Patient ◽

Case Report ◽

Cerebrovascular Disease ◽

Vascular Risk Factors ◽

Vascular Risk

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Intracranial Internal Carotid Artery Calcifications: Association with Vascular Risk Factors and Ischemic Cerebrovascular Disease

Yearbook of Diagnostic Radiology ◽

10.1016/s0098-1672(09)79331-2 ◽

2009 ◽

Vol 2009 ◽

pp. 300-301

Author(s):

A.G. Osborn

Keyword(s):

Risk Factors ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Cerebrovascular Disease ◽

Internal Carotid ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Ischemic Cerebrovascular Disease

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VASCULAR RISK FACTORS AND COGNITIVE FUNCTIONS IN THE PATIENTS WITH CEREBROVASCULAR DISEASE

Wiadomości Lekarskie ◽

10.36740/wlek202010128 ◽

2020 ◽

Vol 73 (10) ◽

pp. 2250-2254

Author(s):

Oksana O. Kopchak ◽

Natalia Yu. Bachinskaya ◽

Oleksandr R. Pulyk

Keyword(s):

Risk Factors ◽

Cerebrovascular Disease ◽

Cognitive Decline ◽

Mmse Score ◽

Significant Negative Correlation ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test

The aim: To assess the severity of cognitive impairment (CI) in patients with cerebrovascular disease (CVD) depending on the number of vascular risk factors (VRF). Materials and methods: The study consisted of five hundred and eighty patients with CVD (247 females and 333 males) aged from 45 to 89 years (mean age: 64,1±8,9 years). The patients were divided into 6 groups (I, II, III, IV, V, VI) depending on the number of VRF. The examination consisted of a standard clinical evaluation, neurological examination, the application of neuropsychological tests (the MMSE; the PALT/The Paired Associates Learning Test; clock drawing test), laboratory tests, MRI of brain. Results: According to ANOVA, the greater the number of VRF the patients had, the lower was their total MMSE score corresponding to more pronounced cognitive decline (F=2,97, p=0,012). A significant negative correlation between patients’ age and their MMSE score was detected regardless of their VRF count. The patients of the V and VI groups had substantially lower parameters of immediate, delayed memory and clock drawing test score comparing to the patients of the I group. Conclusions: The presence of 4 and more VRF was related to more pronounced CI in the patients with CVD. Decline of different aspects of memory, attention, spatial orientation, abstract thinking, planning, concentration, executive and visuospatial skills in groups of patients with 4,5 and 6 vascular risk factors was established. Age was substantially associated with cognitive decline in all the group of patients.

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Documentation of vascular risk factors in vascular dementia

Psychiatric Bulletin ◽

10.1192/pb.22.2.97 ◽

1998 ◽

Vol 22 (2) ◽

pp. 97-99

Author(s):

Rahul Rao

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Cerebrovascular Disease ◽

Vascular Dementia ◽

Case Note ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Noticeable Improvement ◽

The Impact ◽

Disease Specific

The diagnosis of vascular dementia may often be made on the basis of structural neuroimaging, this may not always be reliable. In view of this, a retrospective study of 30 case notes with diagnosis of vascular dementia was undertaken to examine the documentation of vascular risk factors and presence of cerebrovascular disease. Specific recommendations were then made for the future case note documentation. Nine months later, 10 case notes were examined to assess the impact of the recommendations. A noticeable improvement in the documentation of most risk factors was observed. The wider implications of these findings are discussed.

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Vascular Risk Factors, Vascular Diseases, and Imaging Findings in a Hospital-based Cohort of Mild Cognitive Impairment Types

Current Alzheimer Research ◽

10.2174/1567205015666180119110712 ◽

2018 ◽

Vol 15 (7) ◽

pp. 679-690 ◽

Cited By ~ 8

Author(s):

Cecilia Camarda ◽

Carmela Pipia ◽

Delia Azzarello ◽

Iacopo Battaglini ◽

Giovanni Romeo ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cerebrovascular Disease ◽

Brain Atrophy ◽

Vascular Diseases ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Amnestic Mci ◽

Multiple Domain

Background: Mild Cognitive Impairment (MCI) is a transitional state between normal cognition and dementia. Objective: The aim of this study is to investigate the role of vascular risk factors, vascular diseases, cerebrovascular disease and brain atrophy in a large hospital-based cohort of MCI types including 471 amnestic MCI (a-MCI), 693 amnestic MCI multiple domain (a-MCImd), 322 single non-memory MCI (snm-MCI), and 202 non amnestic MCI multiple domain (na-MCImd). For comparison, 1,005 neurologically and cognitively healthy subjects were also evaluated. Method: Several vascular risk factors and vascular diseases were assessed. All participants underwent neurological, neuropsychological and behavioural assessments as well as carotid ultrasonography and standard brain MRI. Multinomial logistic regression models on the MCI cohort with the NCH group and a-MCI type as reference categories were used to assess the effects of the variables evaluated on the estimated probability of one of the four MCI types. Results: This study demonstrates that cerebrovascular disease contributes substantially to the risk of non-memory MCI types and a-MCImd type, and that brain atrophy is present in all MCI types and is greater in multiple domain types particularly in the na-MCI type. Conclusion: Improving detection and control of cerebrovascular disease in aging individuals should be mandatory. Since the incidence of MCI and dementia will be expected to rise because of the progressive life expectancy, a better management of cerebrovascular disease could indeed prevent or delay the onset of MCI, or could delay progression of MCI to dementia.

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Prevalence and vascular risk factors of basal ganglia calcifications in patients at risk for cerebrovascular disease

Journal of Neuroradiology ◽

10.1016/j.neurad.2019.04.002 ◽

2020 ◽

Vol 47 (5) ◽

pp. 337-342 ◽

Cited By ~ 1

Author(s):

Esther J.M. de Brouwer ◽

Remko Kockelkoren ◽

Jill B. De Vis ◽

Jan Willem Dankbaar ◽

Birgitta K. Velthuis ◽

...

Keyword(s):

Risk Factors ◽

At Risk ◽

Basal Ganglia ◽

Cerebrovascular Disease ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Patients At Risk

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Ultrasonographic Changes in Brain Hemodynamics in Patients with Parkinson’s Disease and Risk Factors for Cerebrovascular Disease: A Pilot Study

Parkinson s Disease ◽

10.1155/2021/1713496 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Rodrigo Tavares Brisson ◽

Rita de Cássia Leite Fernandes ◽

Josevânia Fulgêncio de Lima Arruda ◽

Liene Duarte Silva ◽

Marco Antônio Sales Dantas de Lima ◽

...

Keyword(s):

Risk Factors ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pilot Study ◽

Cerebrovascular Disease ◽

Doppler Ultrasonography ◽

Vascular Risk Factors ◽

Cerebrovascular Reactivity ◽

Vascular Risk ◽

Brain Hemodynamics

Recent epidemiological studies have revealed a correlation between atypical features and worse functional outcomes in Parkinson’s disease (PD) patients with cerebrovascular disease (CVD). We aimed to evaluate the brain hemodynamics of PD patients with risk factors for CVD using Doppler ultrasonography. In this prospective pilot study, we randomly included 27 outpatients diagnosed with PD. Transcranial color-coded sonography (TCCS) examinations were performed, obtaining measurements of middle cerebral artery mean flow velocities (Vm), the resistance index (RI), and the pulsatility index (PI). The breath-holding index (BHI) was used to assess cerebrovascular reactivity (cVR). Standardized functional scales (UPDRS III, Hoehn & Yahr scale, and MoCA) were administered. The patients were divided into two groups: those with two or more vascular risk factors (PDvasc) and those with fewer than two vascular risk factors (PDnvasc). Patients in the PDvasc group showed higher PI (1.00 vs. 0.85; p = 0.020 ), RI (0.59 vs. 0.5; p = 0.05 ), H&Y mean (2.4 vs. 1.4; p = 0.036 ), higher frequency of altered cVR (90.9% vs. 25.0%; p = 0.001 ), and lower BHI (0.46 vs. 1.01; p = 0.027 ). We also divided the patients in other two groups: one with patients with classical and another with akinetic-rigid PD clinical type. Patients with the akinetic-rigid type of PD had significantly higher RI (0.60 vs. 0.51; p = 0.03 ), PI (0.99 vs. 0.77; p = 0.03 ), higher frequency of altered cVR (80% vs. 35%; p = 0.02 ), and lower BHI (0.48 vs. 0.96; p = 0.05 ) than patients with classic-type PD. We concluded that TCCS displays impaired cerebrovascular reactivity and a more severe disease pattern in Parkinsonian patients with two or more risk factors for CVD and in the akinetic-rigid type. Doppler ultrasonography may be a useful tool in a clinical setting to investigate PD patients.

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