Abstract 25: Mild Cognitive Impairment the New Risk Factor for Stroke?

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Trudy Gaillard ◽  
Elaine T Miller ◽  
Debi Sampsel ◽  
Tamilyn Bakas

Background and Purpose: Hypertension, prediabetes and type 2 diabetes are major risk factors for stroke, particularly among elderly African Americans (AAs). However, whether there are racial differences in the characteristics of patients with mild cognitive impairment (MCI) are unknown. The purpose of this study is to explore racial differences in MCI, blood pressure and glucose levels among older AAs and White Americans (WAs). Methods: We recruited 79 free living older adults (>65 years) (40 AAs and 39 WAs). Cognitive impairment was measured using the Montreal Cognitive Assessment (MoCA). We defined MCI as MoCA score between 18-26. In addition, systolic and diastolic blood pressure and hemoglobin A1C (A1C) were obtained in each participant. Results: The mean age of our group was 71.4±5.0 years and body mass index 29.1±5.9 kg/m 2 . The AAs were younger than WAs (70.3±5.1 vs. 72.4±4.7 years, p=0.06), there were no difference in body mass index (29.1±5.9 vs 27.7±5.4kg/m 2 , p=0.26). We found racial differences in MCI between our AA and WA participants. The AAs in our group had significantly lower MoCA scores compared to WAs (21±4.3 vs 25.5±3.2, p=0.0004). In addition, the systolic blood pressure (137.4±17.1 vs.128.25±14.9 mmHg, p=0.01) and diastolic blood pressure (77.3±10.8 vs.72.9±9 mmHg, p=0.05) were statistically higher in our AAs compared to WAs. Finally, the A1C was statistically higher in our AA vs. WA participants (5.8±0.4 vs. 5.5±0.29%, p=0.001). Conclusions: Our pilot data clearly demonstrates racial differences in MCI. Our study confirms that AAs with MCI are younger, have higher blood pressure and A1C levels when compared to WAs. Therefore, future studies are warranted to determine whether treatment of blood pressure and dysglycemia can reverse MCI in older AAs.

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2496-PUB
Author(s):  
ZHANG CHENGHUI ◽  
LI MINGXIA ◽  
WANG SUYUAN ◽  
WU YUNHONG

2020 ◽  
Vol 17 (2) ◽  
pp. 185-195
Author(s):  
Jianxiong Xi ◽  
Ding Ding ◽  
Qianhua Zhao ◽  
Xiaoniu Liang ◽  
Li Zheng ◽  
...  

Background: Approximately 40 independent Single Nucleotide Polymorphisms (SNPs) have been associated with Alzheimer’s Disease (AD) or cognitive decline in genome-wide association studies. Methods: We aimed to evaluate the joint effect of genetic polymorphisms and environmental factors on the progression from Mild Cognitive Impairment (MCI) to AD (MCI-AD progression) in a Chinese community cohort. Conclusion: Demographic, DNA and incident AD diagnosis data were derived from the follow-up of 316 participants with MCI at baseline of the Shanghai Aging Study. The associations of 40 SNPs and environmental predictors with MCI-AD progression were assessed using the Kaplan-Meier method with the log-rank test and Cox regression model. Results: Rs4147929 at ATP-binding cassette family A member 7 (ABCA7) (AG/AA vs. GG, hazard ratio [HR] = 2.43, 95% confidence interval [CI] 1.24-4.76) and body mass index (BMI) (overweight vs. non-overweight, HR = 0.41, 95% CI 0.22-0.78) were independent predictors of MCI-AD progression. In the combined analyses, MCI participants with the copresence of non-overweight BMI and the ABCA7 rs4147929 (AG/AA) risk genotype had an approximately 6-fold higher risk of MCI-AD progression than those with an overweight BMI and a non-risk genotype (HR = 6.77, 95% CI 2.60-17.63). However, a nonsignificant result was found when participants carried only one of these two risk factors (nonoverweight BMI and AG/AA of ABCA7 rs4147929). Conclusion: ABCA7 rs4147929 and BMI jointly affect MCI-AD progression. MCI participants with the rs4147929 risk genotype may benefit from maintaining an overweight BMI level with regard to their risk for incident AD.


2021 ◽  
pp. 1-11
Author(s):  
Kylie R. Kadey ◽  
John L. Woodard ◽  
Allison C. Moll ◽  
Kristy A. Nielson ◽  
J. Carson Smith ◽  
...  

Background: Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia. Objective: The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults. Methods: The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer’s Coordinating Center (NACC) database. Results: After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p <  0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96–1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96–1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78–1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53–0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57–0.94). Conclusion: A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.


2010 ◽  
Vol 63 (9-10) ◽  
pp. 611-615 ◽  
Author(s):  
Branka Koprivica ◽  
Teodora Beljic-Zivkovic ◽  
Tatjana Ille

Introduction. Insulin resistance is a well-known leading factor in the development of metabolic syndrome. The aim of this study was to evaluate metabolic effects of metformin added to sulfonylurea in unsuccessfully treated type 2 diabetic patients with metabolic syndrome. Material and methods. A group of thirty subjects, with type 2 diabetes, secondary sulfonylurea failure and metabolic syndrome were administered the combined therapy of sulfonylurea plus metformin for six months. Metformin 2000 mg/d was added to previously used sulfonylurea agent in maximum daily dose. Antihypertensive and hypolipemic therapy was not changed. The following parameters were assessed at the beginning and after six months of therapy: glycemic control, body mass index, waist circumference, blood pressure, triglycerides, total cholesterol and its fractions, homeostatic models for evaluation of insulin resistance and secretion (HOMA R, HOMA B) and C- peptide. Results. Glycemic control was significantly improved after six months of the combined therapy: (fasting 7.89 vs. 10.61 mmol/l. p<0.01; postprandial 11.12 vs. 12.61 mmol/l. p<0.01, p<0.01; glycosylated hemoglobin 6.81 vs. 8.83%. p<0.01). the body mass index and waist circumference were significantly lower (26.7 vs. 27.8 kg/m2, p<0.01 and 99.7 vs. 101.4 cm for men, p<0.01; 87.2 vs. 88.5 for women, p<0.01). Fasting plasma triglycerides decreased from 3.37 to 2.45 mmol/l (p<0.001) and HOMA R from 7.04 to 5.23 (p<0.001). No treatment effects were observed on blood pressure, cholesterol, and residual insulin secretion. Conclusion. Administration of metformin in type 2 diabetes with metabolic syndrome decreased cardiovascular risk factors by reducing glycemia, triglycerides, BMI, central obesity and insulin resistance.


2017 ◽  
Vol 25 (3) ◽  
pp. 60
Author(s):  
Renata Emilia Marques Aguiar ◽  
Cauê Vazquez La Scala Teixeira ◽  
Heverton Paulino ◽  
José Rodrigo Pauli ◽  
Alessandra Medeiros ◽  
...  

Aerobic and resistance exercise have been prescript to prevention and non pharmacological treatment of hypertension. However, there is a lack of studies investigating the effects of concurrent training in hypertensive women. Thus, the aim of this study was to investigate the effects of concurrent training program on rest blood pressure, biochemical variables (blood glucose and total cholesterol) , anthropometric (body mass index and waist circumference) and functional fitness in hypertensive women. Eighteen hypertensive postmenopausal and untrained women (59±12 years old) started in the intervention, but only ten subjects finished. The voluntaries were enrolled in concurrent training, 60 min/day, 3 times a week, during 6 months. Systolic and diastolic blood pressure, blood glucose, total cholesterol, body mass index, waist circumference and functional fitness (AAPHERD) were measured pre and post experimental period. Data were analyzed using the Student’s t test with significance level set at 5% (P?0.05) and Cohen's Effect Size (ES). The results showed significant improvement in systolic and diastolic blood pressure at rest. The other variables did not show significantly changes, but the ES was medium and large for several variables (body mass index, blood glucose, total cholesterol, agility, coordination, aerobic fitness, strength endurance and general functional fitness index). In conclusion, this study confirms that 6 month of concurrent training program improved systolic and diastolic blood pressure in hypertensive women. In addition, the protocol suggests an improvement in anthropometric, biochemical and functional variables related to health.


2000 ◽  
Vol 12 (2) ◽  
pp. 71-78 ◽  
Author(s):  
N.C. Hazarika ◽  
D. Biswas ◽  
K. Narain ◽  
R.K. Phukan ◽  
H.C. Kalita ◽  
...  

A cross sectional study on hypertension was done on 294 subjects aged 30 years and above. 150 households were selected randomly representing 50 households from each locality inhabited exclusively by the rural Mizos, indigenous rural Assamese and the tea-garden workers respectively, in the northeastern region of India. Blood pressure was measured by sphygmo-manorneter in sitting posture. Anthro-pometric measurements were taken using standard procedure for measuring height, weight, waist and hip girth. Information on age, sex, ethnicity, literacy, alcohol intake, smoking pattern, physical activity, occupation, amount of salt consumption was collected using a standard and pre-tested questionnaire. Significant differences were observed in both the systolic and diastolic blood pressure levels among the three different ethnic groups selected for this study ( p<0.0001). Multiple regression analyses indicated that in Mizos, age, waist circumference and alcohol intake were independently associated with increase in systolic blood pressure whereas smoking was found to be negatively associated with systolic blood pressure ( R2=0.391, p<0.001). Factors, which were the best predictors of diastolic blood pressure, were age and body mass index [(kg/m2) ( R2=0.227, p<0.001)]. In the rural Assamese population, the best predictors of systolic blood pressure were age and waist circumference ( R2=0.263, p=0.018). For the diastolic blood pressure, age, alcohol intake and body mass index were important correlates ( R2 = 0.131, p<0.001). In the tea garden community, important predictors of systolic blood pressure were age, gender and marital status ( R2=0.187, p<0.001). On the other hand, age and alcohol intake were best predictors for diastolic blood pressure ( R2=0.09, p<0.001). Asia Pac J Public Health 2000,-12(2): 71-78


PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 465-470
Author(s):  
Steven Shea ◽  
Charles E. Basch ◽  
Bernard Gutin ◽  
Aryeh D. Stein ◽  
Isobel R. Contento ◽  
...  

Objective. To determine whether changes in aerobic fitness and body mass index are related to the age-related rise in blood pressure in healthy preschool children. Study design. Longitudinal analyses of 196 free-living children aged 5 years at baseline who were followed over a mean of 19:7 months. Aerobic fitness was assessed using a treadmill All measures were obtained on multiple occasions at scheduled visits as part of a longitudinal cohort study. Setting. An inner-city medical center. Outcome measures. Blood pressure was measured using an automated Dinamap device. Results. Mean systolic blood pressure was 95.3 mmHg (SD 8.38) at baseline and increased by 4.46 mmHg per year. Mean diastolic blood pressure was 53.9 mmHg (SD 5.81) at baseline and did not change significantly. Children in the highest quintile of increase in fitness had a significantly smaller increase in systolic blood pressure compared to children in the lowest quintile (2.92 vs 5.10 mmHg/year; P = .03). Children in the lowest quintile of increase in body mass index did not differ significantly in rate of increase in systolic blood pressure compared to children in the highest quintile (3.92 vs 4.96 mmHg/year). In a multiple regression model including baseline systolic blood pressure, fitness, height, body mass index, and other covariates, greater increase in fitness (P = .03) and lesser increase in body mass index (P &lt; .01) were associated with lower rates of increase in systolic blood pressure. In a similar multivariate analysis, an increase in fitness was also associated with a lower rate of increase in diastolic blood pressure (P = .02) Conclusion. Young children who increase their aerobic fitness or decrease their body mass index reduce the rate of the age-related increase in blood pressure. These observations may have implications for development of interventions directed at the primary prevention of hypertension.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Joseph Thomas III ◽  
Mindy Paulet ◽  
Jigar R. Rajpura

Objectives. This study evaluated consistency between self-reported values for clinical measures and recorded clinical measures.Methods. Self-reported values were collected for the clinical measures: systolic blood pressure, diastolic blood pressure, glucose level, height, weight, and cholesterol from health risk assessments completed by enrollees in a privately insured cohort. Body mass index (BMI) was computed from reported height and weight. Practitioner recorded values for the clinical measures were obtained from health screenings. We used bivariate Pearson correlation analysis and descriptive statistics to evaluate consistency between self-reported data and recorded clinic measurements.Results. There was high correlation between self-reported clinical values and recorded clinical measures for diastolic blood pressure (r=0.91,P=<0.0001), systolic blood pressure (r=0.93,P=<0.0001), cholesterol (r=0.97,P=<0.0001), body mass index (r=0.96,P=<0.0001), glucose (r=0.96,P=<0.0001), weight (r=0.98,P=<0.0001), and height (r=0.89,P=<0.0001).Conclusions. Self-reported clinical values for each of the eight clinical measures examined had good consistency with practitioner recorded data.


2014 ◽  
Vol 28 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Lilah M. Besser ◽  
Dawn P. Gill ◽  
Sarah E. Monsell ◽  
Willa Brenowitz ◽  
Dana H. Meranus ◽  
...  

2018 ◽  
Vol 128 (03) ◽  
pp. 170-181 ◽  
Author(s):  
Rainer Lundershausen ◽  
Sabrina Müller ◽  
Mahmoud Hashim ◽  
Joachim Kienhöfer ◽  
Stefan Kipper ◽  
...  

Abstract Purpose To assess quality of life, glycemic control, and safety/tolerability associated with liraglutide versus insulin initiation in patients with type 2 diabetes in Germany. Methods Liraglutide/insulin-naïve adults with type 2 diabetes and inadequate glycemic control despite using oral antidiabetic medication were assigned to liraglutide (≤1.8 mg daily; n=878) or any insulin (n=382) according to the treating physician’s decision and followed for 52 weeks. The primary objective was to evaluate Audit of Diabetes-Dependent Quality of Life (ADDQoL) scores. Results At baseline, the liraglutide group was younger and had shorter type 2 diabetes duration, lower glycated hemoglobin (HbA1c), higher body mass index, and a lower prevalence of certain diabetes-related complications than the insulin group (all p<0.05). ADDQoL average weighted impact scores improved numerically in both groups from baseline to 52 weeks (mean difference [95% confidence interval], liraglutide vs. insulin: 0.159 [−0.023;0.340]; not significant). Changes in general wellbeing and five ADDQoL domains significantly favored liraglutide (remaining 14 domains, not significant). HbA1c reductions were greater with insulin than liraglutide (−2.0% vs. −1.2%; p<0.01); however, mean HbA1c after 52 weeks was 7.2% in both groups. Compared with insulin, liraglutide significantly decreased body mass index (−1.54 kg/m2 vs. +0.27 kg/m2; p<0.001), systolic blood pressure (−5.03 mmHg vs. −1.03 mmHg; p<0.01) and non-severe hypoglycemia (0.85% vs. 4.55% at 52 weeks; p<0.01). Adverse drug reactions were reported for<3% of patients in both groups. Conclusions Liraglutide improved certain ADDQoL components and reduced body mass index, systolic blood pressure, and non-severe hypoglycemia versus insulin. Both treatments improved glycemic control.


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