Bereavement and behavioral changes as risk factors for cognitive decline in adults with Down syndrome

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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Unravelling Genetic Factors Underlying Corticobasal Syndrome: A Systematic Review

Cells ◽

10.3390/cells10010171 ◽

2021 ◽

Vol 10 (1) ◽

pp. 171

Author(s):

Federica Arienti ◽

Giulia Lazzeri ◽

Maria Vizziello ◽

Edoardo Monfrini ◽

Nereo Bresolin ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Genetic Risk ◽

Genetic Factors ◽

Diagnostic Algorithm ◽

Behavioral Changes ◽

Corticobasal Syndrome ◽

Cochrane Library ◽

Radiological Features ◽

Genetically Determined

Corticobasal syndrome (CBS) is an atypical parkinsonian presentation characterized by heterogeneous clinical features and different underlying neuropathology. Most CBS cases are sporadic; nevertheless, reports of families and isolated individuals with genetically determined CBS have been reported. In this systematic review, we analyze the demographical, clinical, radiological, and anatomopathological features of genetically confirmed cases of CBS. A systematic search was performed using the PubMed, EMBASE, and Cochrane Library databases, included all publications in English from 1 January 1999 through 1 August 2020. We found forty publications with fifty-eight eligible cases. A second search for publications dealing with genetic risk factors for CBS led to the review of eight additional articles. GRN was the most common gene involved in CBS, representing 28 out of 58 cases, followed by MAPT, C9ORF72, and PRNP. A set of symptoms was shown to be significantly more common in GRN-CBS patients, including visuospatial impairment, behavioral changes, aphasia, and language alterations. In addition, specific demographical, clinical, biochemical, and radiological features may suggest mutations in other genes. We suggest a diagnostic algorithm to help in identifying potential genetic cases of CBS in order to improve the diagnostic accuracy and to better understand the still poorly defined underlying pathogenetic process.

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Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

European Journal of Epidemiology ◽

10.1007/s10654-021-00732-w ◽

2021 ◽

Vol 36 (3) ◽

pp. 287-298

Author(s):

Jonathan Bergman ◽

Marcel Ballin ◽

Anna Nordström ◽

Peter Nordström

Keyword(s):

Risk Factors ◽

Down Syndrome ◽

Long Term Care ◽

Care Facility ◽

Prescription Medication ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility ◽

All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

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Cerebral venous thrombosis in a patient with Down syndrome and coronavirus disease 2019: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02908-0 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Henry Robayo-Amortegui ◽

Natalia Valenzuela-Faccini ◽

Cesar Quecano-Rosas ◽

Darlyng Zabala-Muñoz ◽

Michel Perez-Garzon

Keyword(s):

Risk Factors ◽

Down Syndrome ◽

Case Report ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Epidemiological Data ◽

Thromboembolic Disease ◽

Hispanic Woman ◽

Case Presentation ◽

The World

Abstract Background The new coronavirus disease 2019 pandemic has spread throughout most of the world. Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. Case presentation We report the case of a Hispanic woman with Down syndrome who has coronavirus disease 2019 and presents as a complication extensive cerebral venous thrombosis. Conclusions Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. In the absence of clinical and epidemiological data, it is important to carry out further investigation of the risk factors and pathophysiological causes related to the development of cerebrovascular thrombotic events in patients with Down syndrome with coronavirus disease 2019 infection.

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Analyses of Visuospatial and Visuoperceptual Errors as Predictors of Dementia in Parkinson’s Disease Patients with Subjective Cognitive Decline and Mild Cognitive Impairment

Journal of the International Neuropsychological Society ◽

10.1017/s1355617720001216 ◽

2020 ◽

pp. 1-11

Author(s):

Iván Galtier ◽

Antonieta Nieto ◽

María Mata ◽

Jesús N. Lorenzo ◽

José Barroso

Keyword(s):

Risk Factors ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Poor Performance ◽

Subjective Cognitive Decline ◽

Independent Risk Factors

ABSTRACT Objective: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in Parkinson’s disease (PD) are considered as the risk factors for dementia (PDD). Posterior cortically based functions, such as visuospatial and visuoperceptual (VS-VP) processing, have been described as predictors of PDD. However, no investigations have focused on the qualitative analysis of the Judgment of Line Orientation Test (JLOT) and the Facial Recognition Test (FRT) in PD-SCD and PD-MCI. The aim of this work was to study the VS-VP errors in JLOT and FRT. Moreover, these variables are considered as predictors of PDD. Method: Forty-two PD patients and 19 controls were evaluated with a neuropsychological protocol. Patients were classified as PD-SCD and PD-MCI. Analyses of errors were conducted following the procedure described by Ska, Poissant, and Joanette (1990). Follow-up assessment was conducted to a mean of 7.5 years after the baseline. Results: PD-MCI patients showed a poor performance in JLOT and FRT total score and made a greater proportion of severe intraquadrant (QO2) and interquadrant errors (IQO). PD-SCD showed a poor performance in FRT and made mild errors in JLOT. PD-MCI and QO2/IQO errors were independent risk factors for PDD during the follow-up. Moreover, the combination of both PD-MCI diagnosis and QO2/IQO errors was associated with a greater risk. Conclusions: PD-MCI patients presented a greater alteration in VS-VP processing observable by the presence of severe misjudgments. PD-SCD patients also showed mild difficulties in VS-SP functions. Finally, QO2/IQO errors in PD-MCI are a useful predictor of PDD, more than PD-MCI diagnosis alone.

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Cognitive decline and dementia in Down syndrome

Current Opinion in Psychiatry ◽

10.1097/yco.0000000000000307 ◽

2017 ◽

Vol 30 (2) ◽

pp. 102-107 ◽

Cited By ~ 28

Author(s):

Rosalyn Hithersay ◽

Sarah Hamburg ◽

Bernice Knight ◽

André Strydom

Keyword(s):

Down Syndrome ◽

Cognitive Decline

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ALZHEIMER’S ASSOCIATION: INITIATIVES & PUBLIC HEALTH PERSPECTIVE

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2016.111 ◽

2016 ◽

pp. 1-3

Author(s):

H.M. Snyder ◽

M.C. Carrillo

Keyword(s):

Public Health ◽

Physical Activity ◽

Risk Factors ◽

Cognitive Decline ◽

Population Based ◽

Current Evidence ◽

Public Health Perspective ◽

Reduce Risk ◽

Number Of Individuals ◽

Do So

An estimated 47 million people worldwide are living with dementia in 2015 and this number is expected to triple by 2050. There is a clear urgency for therapies and / or interventions to slow, stop or prevent dementia. Amounting evidence suggests strategies to reduce risk of development dementia may be of growing import for reducing the number of individuals affected. The Alzheimer’s Association believes, from a population based perspective that: (1) Regular physical activity and management of cardiovascular risk factors (e.g. diabetes, obesity, smoking and hypertension) have been shown to reduce the risk of cognitive decline and may reduce the risk of dementia; (2) A healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline. The current evidence underscores the need to communicate to the broader population what the science indicates and to do so with diverse stakeholders and consistent messaging. There has never been a better time to define and distribute global messaging on public health for dementia.

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Long-Term Cognitive Decline After Stroke: An Individual Participant Data Meta-Analysis

Stroke ◽

10.1161/strokeaha.121.035796 ◽

2021 ◽

Author(s):

Jessica W. Lo ◽

John D. Crawford ◽

David W. Desmond ◽

Hee-Joon Bae ◽

Jae-Sung Lim ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Cognitive Decline ◽

Recurrent Stroke ◽

Meta Analysis ◽

Older Age ◽

Individual Participant Data ◽

Individual Participant ◽

Global Cognition

Background and Purpose: Poststroke cognitive impairment is common, but the trajectory and magnitude of cognitive decline after stroke is unclear. We examined the course and determinants of cognitive change after stroke using individual participant data from the Stroke and Cognition Consortium. Methods: Nine longitudinal hospital-based cohorts from 7 countries were included. Neuropsychological test scores and normative data were used to calculate standardized scores for global cognition and 5 cognitive domains. One-step individual participant data meta-analysis was used to examine the rate of change in cognitive function and risk factors for cognitive decline after stroke. Stroke-free controls were included to examine rate differences. Based on the literature and our own data that showed short-term improvement in cognitive function after stroke, key analyses were restricted to the period beginning 1-year poststroke to focus on its long-term effects. Results: A total of 1488 patients (mean age, 66.3 years; SD, 11.1; 98% ischemic stroke) were followed for a median of 2.68 years (25th–75th percentile: 1.21–4.14 years). After an initial period of improvement through up to 1-year poststroke, decline was seen in global cognition and all domains except executive function after adjusting for age, sex, education, vascular risk factors, and stroke characteristics (−0.053 SD/year [95% CI, −0.073 to −0.033]; P <0.001 for global cognition). Recurrent stroke and older age were associated with faster decline. Decline was significantly faster in patients with stroke compared with controls (difference=−0.078 SD/year [95% CI, −0.11 to −0.045]; P <0.001 for global cognition in a subgroup analysis). Conclusions: Patients with stroke experience cognitive decline that is faster than that of stroke-free controls from 1 to 3 years after onset. An increased rate of decline is associated with older age and recurrent stroke.

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