Risk Factors, Lifestyle Behaviors, and Vascular Brain Health

Stroke ◽  
2022 ◽  
Author(s):  
Rebecca F. Gottesman ◽  
Sudha Seshadri
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Health Outcomes ◽  
White Matter Hyperintensities ◽  
Genetic Factors ◽  
Vascular Risk Factors ◽  
Lifestyle Behaviors ◽  
Vascular Risk ◽  
Brain Health ◽  
Reduce Risk

Although a relationship between traditional cardiovascular risk factors and stroke has long been recognized, these risk factors likely play a role in other aspects of brain health. Clinical stroke is only the tip of the iceberg of vascular brain injury that includes covert infarcts, white matter hyperintensities, and microbleeds. Furthermore, an individual’s risk for not only stroke but poor brain health includes not only these traditional vascular risk factors but also lifestyle and genetic factors. The purpose of this narrative review is to summarize the state of the evidence on traditional and nontraditional vascular risk factors and their contributions to brain health. Additionally, we will review important modifiers that interact with these risk factors to increase, or, in some cases, reduce risk of adverse brain health outcomes, with an emphasis on genes and biomarkers associated with Alzheimer disease. Finally, we will consider the importance of social determinants of health in brain health outcomes.

scholarly journals White matter hyperintensities across the adult lifespan: relation to age, Aβ load, and cognition

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Antoine Garnier-Crussard ◽  
Salma Bougacha ◽  
Miranka Wirth ◽  
Claire André ◽  
Marion Delarue ◽  
...  
Keyword(s):  
Risk Factors ◽  
Working Memory ◽  
Executive Functions ◽  
White Matter Hyperintensities ◽  
Vascular Risk Factors ◽  
Age Group ◽  
Vascular Risk ◽  
Middle Aged ◽  
Adult Lifespan ◽  
Middle Aged Adults

Abstract Background White matter hyperintensities (WMH) are very frequent in older adults and associated with worse cognitive performance. Little is known about the links between WMH and vascular risk factors, cortical β-amyloid (Aβ) load, and cognition in cognitively unimpaired adults across the entire lifespan, especially in young and middle-aged adults. Methods One hundred and thirty-seven cognitively unimpaired adults from the community were enrolled (IMAP cohort). Participants underwent (i) a comprehensive neuropsychological assessment of episodic memory, processing speed, working memory, and executive functions; (ii) brain structural T1 and FLAIR MRI scans used for the automatic segmentation of total and regional (frontal, parietal, temporal, occipital, and corpus callosum) WMH; and (iii) a Florbetapir-PET scan to measure cortical Aβ. The relationships of total and regional WMH to age, vascular risk factors, cortical Aβ, and cognition were assessed within the whole sample, but also splitting the sample in two age groups (≤ or > 60 years old). Results WMH increased with age across the adult lifespan, i.e., even in young and middle-aged adults. Systolic blood pressure, diastolic blood pressure, and glycated hemoglobin were all associated with higher WMH before, but not after, adjusting for age and the other vascular risk factors. Higher frontal, temporal, and occipital WMH were associated with greater Aβ, but this association was no longer significant when adjusting for age and vascular risk factors. Higher total and frontal WMH were associated with worse performance in executive functions, with no interactive effect of the age group. In contrast, there was a significant interaction of the age group on the link between WMH and working memory, which was significant within the subgroup of young/middle-aged adults only. Adding cortical Aβ load in the models did not alter the results, and there was no interaction between WMH and Aβ on cognition. Conclusion WMH increased with age and were associated with worse executive functions across the adult lifespan and with worse working memory in young/middle-aged adults. Aβ load was weakly associated with WMH and did not change the relationship found between WMH and executive functions. This study argues for the clinical relevance of WMH across the adult lifespan, even in young and middle-aged adults with low WMH.

Vascular risk factors predisposing to white matter hyperintensities: Сross-sectional study

2013 ◽  
Vol 333 ◽  
pp. e254-e255
Author(s):  
A. Amintaeva ◽  
M. Kravchenko ◽  
O. Andreeva ◽  
Y. Varakin ◽  
G. Gornostaeva ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Sectional Study

scholarly journals White matter hyperintensities and vascular risk factors in monozygotic twins

2018 ◽  
Vol 66 ◽  
pp. 40-48 ◽  
Author(s):  
Mara ten Kate ◽  
Carole H. Sudre ◽  
Anouk den Braber ◽  
Elles Konijnenberg ◽  
Michel G. Nivard ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Monozygotic Twins ◽  
Vascular Risk Factors ◽  
Vascular Risk

Vascular Risk Factors, White Matter Hyperintensities and Hippocampal Volume in Normal Elderly Individuals

2012 ◽  
Vol 33 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Thomas Gattringer ◽  
Christian Enzinger ◽  
Stefan Ropele ◽  
Faton Gorani ◽  
Katja Elisabeth Petrovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Hyperintensities ◽  
Hippocampal Volume ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Elderly Individuals

scholarly journals Network Efficiency Mediates the Relationship Between Vascular Burden and Cognitive Impairment

Stroke ◽  
2020 ◽  
Vol 51 (6) ◽  
pp. 1682-1689 ◽  
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.

scholarly journals Statin usage, vascular diagnosis and vascular risk factors in Parkinson’s disease

2017 ◽  
Vol 62 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Kelvin KW Cheng ◽  
Diane MA Swallow ◽  
Katherine A Grosset ◽  
Donald G Grosset
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cardiovascular Risk ◽  
Statin Therapy ◽  
Cardiac Risk ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Neuroprotective Effects ◽  
Statin Use

Background and aims Vascular disease is a common comorbidity in Parkinson’s disease patients. Statins are potentially neuroprotective for Parkinson’s disease through non-vascular mechanisms. We investigated prevailing statin use in a Parkinson’s disease cohort. Methods and results Data on diagnostic indication for statins, anti-Parkinson therapy, vascular risk factors, and statin prescription, were obtained from electronic medical record review for consecutive Parkinson’s disease patients. The ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network system was used to calculate future cardiovascular risk and identify those warranting statin use. Of 441 patients included, 59.9% were male, with a mean age of 68.9 years (standard deviation 10.3). One hundred and seventy-four (39.5%) patients had at least one diagnostic indication for statin use, of whom 136 (78.2%) were prescribed a statin. In the 267 (60.5%) cases without a diagnostic indication, 54 (20.2%) were excluded owing to age limitations defined in ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network. Of the remaining 213, 62 (29.1%) had an ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network score in the recommended range for statin therapy, of whom 15 (24.1%) were prescribed statins. Conclusion There is suboptimal implementation of statin therapy in Parkinson’s disease patients. Given the possible neuroprotective effects of statins in Parkinson’s disease in addition to reducing cardiovascular risk, reasons for suboptimal implementation warrant further investigation.

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