Effect of the Interaction Between Hypertension and Cerebral White Matter Changes on the Progression of Alzheimer Disease

2018 ◽  
Vol 15 (14) ◽  
pp. 1354-1360 ◽  
Author(s):  
Ping-Song Chou ◽  
Yi-Hui Kao ◽  
Meng-Ni Wu ◽  
Mei-Chuan Chou ◽  
Chun-Hung Chen ◽  
...  
Keyword(s):  
White Matter ◽  
Alzheimer Disease ◽  
Rating Scale ◽  
Vital Role ◽  
Independent Effect ◽  
Cerebral White Matter ◽  
Clinical Dementia Rating ◽  
White Matter Changes ◽  
Age Related ◽  
The Mean

Background: Cerebrovascular pathologies and hypertension could play a vital role in Alzheimer disease (AD) progression. However, whether cerebrovascular pathologies and hypertension accelerate the AD progression through an independent or interaction effect is unknown. Objective: To investigate the effect of the interactions of cerebrovascular pathologies and hypertension on AD progression. Method: A retrospective longitudinal study was conducted to compare AD courses in patients with different severities of cerebral White Matter Changes (WMCs) in relation to hypertension. Annual comprehensive psychometrics were performed. WMCs were rated using a rating scale for Age-related WMCs (ARWMC). Results: In total, 278 patients with sporadic AD were enrolled in this study. The mean age of the patients was 76.6 ± 7.4 years, and 166 patients had hypertension. Among AD patients with hypertension, those with deterioration in clinical dementia rating-sum of box (CDR-SB) and CDR had significantly severe baseline ARWMC scales in total (CDR-SB: 5.8 vs. 3.6, adjusted P = 0.04; CDR: 6.4 vs. 4.4, adjusted P = 0.04) and frontal area (CDR-SB: 2.4 vs. 1.2, adjusted P = 0.01; CDR: 2.4 vs. 1.7, adjusted P < 0.01) compared with those with no deterioration in psychometrics after adjustment for confounders. By contrast, among AD patients without hypertension, no significant differences in ARWMC scales were observed between patients with and without deterioration. Conclusion: The effect of cerebrovascular pathologies on AD progression between those with and without hypertension might differ. An interaction but not independent effect of hypertension and WMCs on the progression of AD is possible.

scholarly journals White Matter Changes in Patients with Alzheimer’s Disease and Associated Factors

2019 ◽  
Vol 8 (2) ◽  
pp. 167 ◽  
Author(s):  
Yi-Hui Kao ◽  
Mei-Chuan Chou ◽  
Chun-Hung Chen ◽  
Yuan-Han Yang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
White Matter ◽  
Rating Scale ◽  
Beta Amyloid ◽  
Future Research ◽  
White Matter Changes ◽  
Age Related ◽  
And Gender ◽  
Fazekas Scale

Alzheimer’s disease (AD) is traditionally thought of as a neurodegenerative disease. Recent evidence shows that beta amyloid-independent vascular changes and beta amyloid-dependent neuronal dysfunction both equally influence the disease, leading to loss of structural and functional connectivity. White matter changes (WMCs) in the brain are commonly observed in dementia patients. The effect of vascular factors on WMCs and the relationship between WMCs and severity of AD in patients remain to be clarified. We recruited 501 clinically diagnosed probable AD patients with a series of comprehensive neuropsychological tests and brain imaging. The WMCs in cerebral CT or MRI were rated using both the modified Fazekas scale and the combined CT-MRI age related WMC (ARWMC) rating scale. Periventricular WMCs were observed in 79.4% of the patients and deep WMCs were also seen in 48.7% of the patients. WMC scores were significantly higher in the advanced dementia stage in periventricular WMCs (p = 0.001) and total ARWMCs (p < 0.001). Age and disease severity were both independently associated with WMCs score, particularly in the total, frontal and parieto-occipital areas. Vascular factors including hypertension, diabetes mellitus, and gender were not significantly associated with WMCs. In conclusion, both age and severity of dementia were significantly associated with WMCs in AD patients. These associations highlight future research targets.

scholarly journals Age-related cerebral white matter changes on computed tomography.

1989 ◽  
Vol 26 (1) ◽  
pp. 19-25
Author(s):  
Hitoshi Fukuda ◽  
Shotai Kobayashi ◽  
Hiromi Koide ◽  
Shuhei Yamaguchi ◽  
Kazunori Okada ◽  
...  
Keyword(s):  
Computed Tomography ◽  
White Matter ◽  
Cerebral White Matter ◽  
White Matter Changes ◽  
Age Related

Age-related cerebral white matter changes and pulse-wave encephalopathy: observations with three-dimensional MRI

2005 ◽  
Vol 23 (9) ◽  
pp. 929-937 ◽  
Author(s):  
Marie Cécile Henry Feugeas ◽  
Giovanni De Marco ◽  
Ilana Idy Peretti ◽  
Sylvie Godon-Hardy ◽  
Daniel Fredy ◽  
...  
Keyword(s):  
White Matter ◽  
Pulse Wave ◽  
Three Dimensional ◽  
Cerebral White Matter ◽  
White Matter Changes ◽  
Age Related

scholarly journals A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT

Stroke ◽  
2001 ◽  
Vol 32 (6) ◽  
pp. 1318-1322 ◽  
Author(s):  
L. O. Wahlund ◽  
F. Barkhof ◽  
F. Fazekas ◽  
L. Bronge ◽  
M. Augustin ◽  
...  
Keyword(s):  
White Matter ◽  
Rating Scale ◽  
White Matter Changes ◽  
Age Related

Impact of Age-Related Cerebral White Matter Changes on the Transition to Disability – The LADIS Study: Rationale, Design and Methodology

2004 ◽  
Vol 24 (1-2) ◽  
pp. 51-62 ◽  
Author(s):  
Leonardo Pantoni ◽  
Anna Maria Basile ◽  
Giovanni Pracucci ◽  
Kjell Asplund ◽  
Julien Bogousslavsky ◽  
...  
Keyword(s):  
White Matter ◽  
Cerebral White Matter ◽  
White Matter Changes ◽  
Age Related

scholarly journals Adaptation of the Clinical Dementia Rating Scale for adults with Down syndrome

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Christina N. Lessov-Schlaggar ◽  
Olga L. del Rosario ◽  
John C. Morris ◽  
Beau M. Ances ◽  
Bradley L. Schlaggar ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Alzheimer Disease ◽  
Rating Scale ◽  
Assessment Instruments ◽  
Clinical Dementia Rating ◽  
Data Set ◽  
Cognitive Domains ◽  
Increased Risk ◽  
Caregiver Questionnaire ◽  
Raven's Progressive Matrices

Abstract Background Adults with Down syndrome (DS) are at increased risk for Alzheimer disease dementia, and there is a pressing need for the development of assessment instruments that differentiate chronic cognitive impairment, acute neuropsychiatric symptomatology, and dementia in this population of patients. Methods We adapted a widely used instrument, the Clinical Dementia Rating (CDR) Scale, which is a component of the Uniform Data Set used by all federally funded Alzheimer Disease Centers for use in adults with DS, and tested the instrument among 34 DS patients recruited from the community. The participants were assessed using two versions of the modified CDR—a caregiver questionnaire and an in-person interview involving both the caregiver and the DS adult. Assessment also included the Dementia Scale for Down Syndrome (DSDS) and the Raven’s Progressive Matrices to estimate IQ. Results Both modified questionnaire and interview instruments captured a range of cognitive impairments, a majority of which were found to be chronic when accounting for premorbid function. Two individuals in the sample were strongly suspected to have early dementia, both of whom had elevated scores on the modified CDR instruments. Among individuals rated as having no dementia based on the DSDS, about half showed subthreshold impairments on the modified CDR instruments; there was substantial agreement between caregiver questionnaire screening and in-person interview of caregivers and DS adults. Conclusions The modified questionnaire and interview instruments capture a range of impairment in DS adults, including subthreshold symptomatology, and the instruments provide complementary information relevant to the ascertainment of dementia in DS. Decline was seen across all cognitive domains and was generally positively related to age and negatively related to IQ. Most importantly, adjusting instrument scores for chronic, premorbid impairment drastically shifted the distribution toward lower (no impairment) scores.

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