scholarly journals Microbleeds and Medial Temporal Atrophy Determine Cognitive Trajectories in Normal Aging: A Longitudinal PET-MRI Study

2020 ◽  
Vol 77 (4) ◽  
pp. 1431-1442
Author(s):  
Marie-Louise Montandon ◽  
François R. Herrmann ◽  
Valentina Garibotto ◽  
Cristelle Rodriguez ◽  
Sven Haller ◽  
...  
Keyword(s):  
Fold Increase ◽  
Normal Aging ◽  
Cognitive Outcome ◽  
Amyloid Pet ◽  
Elderly Persons ◽  
Visual Rating ◽  
Highly Educated ◽  
Multivariable Models ◽  
Mri Study

Background: The cognitive trajectories in normal aging may be affected by medial temporal atrophy (MTA) and amyloid burden, as well as vascular pathologies such as cortical microbleeds (CMB) and white matter hyperintensities (WMH). Objective: We addressed here the role of imaging markers in their prediction in a real-world situation. Methods: We performed a 4.5-year longitudinal study in 90 older community-dwellers coupling two neuropsychological assessments, MTA estimated with the Schelten’s scale, number of CMB, and WMH evaluated with the Fazekas score at inclusion and follow-up, visual rating of amyloid PET and glucose hypometabolism at follow-up, and APOE genotyping. Regression models were built to explore the association between the continuous cognitive score (CCS) and imaging parameters. Results: The number of strictly lobar CMB at baseline (4 or more) was related to a 5.5-fold increase of the risk of cognitive decrement. This association persisted in multivariable models explaining 10.6% of the CCS decrease variance. MTA, and Fazekas score at baseline and amyloid positivity or abnormal FDG PET, were not related to the cognitive outcome. The increase of right MTA at follow-up was the only correlate of CCS decrease both in univariate and multivariable models explaining 9.2% of its variance. Conclusion: The present data show that the accumulation of more than four CMB is associated with significant cognitive decrement over time in highly educated elderly persons. They also reveal that the progressive deterioration of cognitive performance within the age-adjusted norms is also related to the increase of visually assessed MTA.

Determinants of Cognitive Trajectories in Normal Aging: A Longitudinal PET-MRI Study in a Community-based Cohort

2021 ◽  
Vol 18 ◽  
Author(s):  
François R. Herrmann ◽  
Marie-Louise Montandon ◽  
Valentina Garibotto ◽  
Cristelle Rodriguez ◽  
Sven Haller ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Normal Aging ◽  
Cognitive Outcome ◽  
Vascular Lesions ◽  
Personality Factors ◽  
Psychological Variables ◽  
Visual Rating ◽  
Healthy Elderly ◽  
Main Determinants

Background: The determinants of the progressive decrement of cognition in normal aging are still a matter of debate. Alzheimer disease (AD)-signature markers and vascular lesions, but also psychological variables such as personality factors, are thought to have an impact on the longitudinal trajectories of neuropsychological performances in healthy elderly individuals. Objective: The current research aimed to identify the main determinants associated with cognitive trajectories in normal aging. Methods: We performed a 4.5-year longitudinal study in 90 older community-dwellers coupling two neuropsychological assessments, medial temporal atrophy (MTA), number of cerebral mi- crobleeds (CMB), and white matter hyperintensities (WMH) at inclusion, visual rating of amyloid and FDG PET at follow-up, and APOE genotyping. Personality factors were assessed at baseline using the NEO-PI-R. Univariate and backward stepwise regression models were built to explore the association between the continuous cognitive score (CCS) and both imaging and personality variables. Results: The number of strictly lobar CMB at baseline (4 or more) was related to a significant in- crease in the risk of cognitive decrement. In multivariable models, amyloid positivity was associat- ed with a 1.73 unit decrease of the CCS at follow-up. MTA, WMH and abnormal FDG PET were not related to the cognitive outcome. Among personality factors, only higher agreeableness was re- lated to better preservation of neuropsychological performances. Conclusion: CMB and amyloid positivity are the only imaging determinants of cognitive trajecto- ries in this highly selected series of healthy controls. Among personality factors, higher agreeable- ness confers a modest but significant protection against the decline of cognitive performances.

Elucidating the risk factors for progression from amyloid-negative amnestic mild cognitive impairment to dementia

2020 ◽  
Vol 17 ◽  
Author(s):  
Hyung-Ji Kim ◽  
Jae-Hong Lee ◽  
E-nae Cheong ◽  
Sung-Eun Chung ◽  
Sungyang Jo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Amnestic Mild Cognitive Impairment ◽  
Amyloid Pet ◽  
Clinical Progression ◽  
Amnestic Mci

Background: Amyloid PET allows for the assessment of amyloid β status in the brain, distinguishing true Alzheimer’s disease from Alzheimer’s disease-mimicking conditions. Around 15–20% of patients with clinically probable Alzheimer’s disease have been found to have no significant Alzheimer’s pathology on amyloid PET. However, a limited number of studies had been conducted this subpopulation in terms of clinical progression. Objective: We investigated the risk factors that could affect the progression to dementia in patients with amyloid-negative amnestic mild cognitive impairment (MCI). Methods: This study was a single-institutional, retrospective cohort study of patients over the age of 50 with amyloidnegative amnestic MCI who visited the memory clinic of Asan Medical Center with a follow-up period of more than 36 months. All participants underwent brain magnetic resonance imaging (MRI), detailed neuropsychological testing, and fluorine-18[F18]-florbetaben amyloid PET. Results: During the follow-up period, 39 of 107 patients progressed to dementia from amnestic MCI. In comparison with the stationary group, the progressed group had a more severe impairment in verbal and visual episodic memory function and hippocampal atrophy, which showed an Alzheimer’s disease-like pattern despite the lack of evidence for significant Alzheimer’s disease pathology. Voxel-based morphometric MRI analysis revealed that the progressed group had a reduced gray matter volume in the bilateral cerebellar cortices, right temporal cortex, and bilateral insular cortices. Conclusion: Considering the lack of evidence of amyloid pathology, clinical progression of these subpopulation may be caused by other neuropathologies such as TDP-43, abnormal tau or alpha synuclein that lead to neurodegeneration independent of amyloid-driven pathway. Further prospective studies incorporating biomarkers of Alzheimer’s diseasemimicking dementia are warranted.

scholarly journals Cognitive trajectories of patients with focal ß-amyloid deposition

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Si Eun Kim ◽  
Byungju Lee ◽  
Hyemin Jang ◽  
Juhee Chin ◽  
Ching Soong Khoo ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Neuropsychological Tests ◽  
Mixed Effects ◽  
Amnestic Mild Cognitive Impairment ◽  
Emission Tomography ◽  
Amyloid Pet ◽  
Cognitive Level ◽  
Visual Rating ◽  
Positron Emission ◽  
The Brain

Abstract Background The presence of ß-amyloid (Aß) in the brain can be identified using amyloid PET. In clinical practice, the amyloid PET is interpreted based on dichotomous visual rating, which renders focal Aß accumulation be read as positive for Aß. However, the prognosis of patients with focal Aß deposition is not well established. Thus, we investigated cognitive trajectories of patients with focal Aß deposition. Methods We followed up 240 participants (112 cognitively unimpaired [CU], 78 amnestic mild cognitive impairment [aMCI], and 50 Alzheimer’s disease (AD) dementia [ADD]) for 2 years from 9 referral centers in South Korea. Participants were assessed with neuropsychological tests and 18F-flutemetamol (FMM) positron emission tomography (PET). Ten regions (frontal, precuneus/posterior cingulate (PPC), lateral temporal, parietal, and striatum of each hemisphere) were visually examined in the FMM scan, and participants were divided into three groups: No-FMM, Focal-FMM (FMM uptake in 1–9 regions), and Diffuse-FMM. We used mixed-effects model to investigate the speed of cognitive decline in the Focal-FMM group according to the cognitive level, extent, and location of Aß involvement, in comparison with the No- or Diffuse-FMM group. Results Forty-five of 240 (18.8%) individuals were categorized as Focal-FMM. The rate of cognitive decline in the Focal-FMM group was faster than the No-FMM group (especially in the CU and aMCI stage) and slower than the Diffuse-FMM group (in particular in the CU stage). Within the Focal-FMM group, participants with FMM uptake to a larger extent (7–9 regions) showed faster cognitive decline compared to those with uptake to a smaller extent (1–3 or 4–6 regions). The Focal-FMM group was found to have faster cognitive decline in comparison with the No-FMM when there was uptake in the PPC, striatum, and frontal cortex. Conclusions When predicting cognitive decline of patients with focal Aß deposition, the patients’ cognitive level, extent, and location of the focal involvement are important.

scholarly journals The Relationship Between the Home Environment and Falls for Older Adults With Visual Impairments

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 770-770
Author(s):  
Bonnielin Swenor ◽  
Aleksandra Mihailovic ◽  
Pradeep Ramulu
Keyword(s):  
Older Adults ◽  
Home Environment ◽  
Visually Impaired ◽  
Visual Impairments ◽  
Fold Increase ◽  
Engineering Society ◽  
Environment Assessment ◽  
Risk Factors For Falls ◽  
The Relationship

Abstract The home environment and features of the home have been identified as important risk factors for falls, and may pose particular risk for older adults with visual impairments given difficulty with hazard perception. We used data from 245 participants in the Falls in Glaucoma Study [mean age: 71 years, mean follow-up: 31 months] with homes graded using our previously validated Home Environment Assessment for the Visually Impaired (HEAVI), which quantifies the number of in-home fall-related hazards and found that neither the number of hazards nor the percentage of hazardous items were associated falls/year. However, each 10-fold increase in lighting was associated with a 35% lower rate of falls/year (RR=0.65, 95%CI=0.46 to 0.92) and there was a 50% reduction in falls/year when lighting was at or above 30 footcandles (minimum lighting level recommended by the Engineering Society of North America) compared to lighting <30 footcandles (RR=0.50, 95%CI=0.26 to 0.96).

scholarly journals Mycosis fungoides and Sézary syndrome: a population-wide study on prevalence and health care use in Finland in 1998–2016

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jaana Keto ◽  
Sonja Hahtola ◽  
Miika Linna ◽  
Liisa Väkevä
Keyword(s):  
Health Care ◽  
Mycosis Fungoides ◽  
Hospital Costs ◽  
Fold Increase ◽  
Medical Specialty ◽  
Health Care Use ◽  
Sézary Syndrome ◽  
Sezary Syndrome ◽  
Outpatient Visits

Abstract Background Information about health care use and costs of cutaneous T-cell lymphoma (CTCL) patients is limited, particularly in a European setting. Methods In this population-wide study we set out to investigate prevalence, and trends in health care use in two CTCL subtypes, mycosis fungoides (MF) and Sézary syndrome (SS) over a time period of 19 years in 1998–2016 by using a nation-wide patient register containing data on all diagnosed MF and SS cases in Finland. Results The prevalence of diagnosed MF and SS rose from 2.04 to 5.38/100000, and from 0.16 to 0.36/100000 for MF and SS respectively during 1998–2016. We found a substantial decrease in inpatient treatment of MF/SS in the past two decades with a mean of 2 inpatient days/patient/year due to MF/SS in 2016, while the mean numbers of MF/SS related outpatient visits remained stable at 8 visits/year/patient. Most MF/SS-related outpatient visits occurred in the medical specialty of dermatology. In a ten-year follow-up after MF/SS diagnosis, the main causes for outpatient visits and inpatient stays were MF/SS itself, other cancers, and other skin conditions. Also cardiovascular disease and infections contributed to the number of inpatient days. Mean total hospital costs decreased from 11,600 eur/patient/year to 3600 eur/patient/year by year 4 of the follow-up, and remained at that level for the remainder of the 10-year follow-up. MF/SS accounted for approximately half of the hospital costs of these patients throughout the follow-up. Conclusions The nearly 3-fold increase in prevalence of diagnosed MF/SS during 1998–2016 puts pressure on the health care system, as this is a high-cost patient group with a heavy burden of comorbidities. The challenge can be in part answered by shifting the treatment of MF/SS to a more outpatient-based practice, and by adapting new pharmacotherapy, as has been done in Finland.

Does Vertebral Body Tethering Cause Disc and Facet Joint Degeneration? A Preliminary MRI Study with Minimum 2-years Follow-up

2021 ◽  
Author(s):  
Altug Yucekul ◽  
Burcu Akpunarli ◽  
Atahan Durbas ◽  
Tais Zulemyan ◽  
Irem Havlucu ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Facet Joint ◽  
Joint Degeneration ◽  
Facet Joint Degeneration ◽  
Mri Study

A Six-Year Follow-Up MRI Study of Complicated Early Childhood Convulsion

2006 ◽  
Vol 35 (4) ◽  
pp. 257-260 ◽  
Author(s):  
Tom F.D. Farrow ◽  
Jon M. Dickson ◽  
Richard A. Grünewald
Keyword(s):  
Early Childhood ◽  
Mri Study

Do apolipoprotein E genotype and educational attainment predict the rate of cognitive decline in normal aging? A 12-year follow-up of the Maastricht Aging Study.

2012 ◽  
Vol 26 (4) ◽  
pp. 459-472 ◽  
Author(s):  
Pascal W. M. Van Gerven ◽  
Martin P. J. Van Boxtel ◽  
Eleonora E. B. Ausems ◽  
Otto Bekers ◽  
Jelle Jolles
Keyword(s):  
Educational Attainment ◽  
Cognitive Decline ◽  
Apolipoprotein E ◽  
Normal Aging ◽  
Aging Study ◽  
Apolipoprotein E Genotype

122. Does vertebral body tethering cause disc and facet joint degeneration? An MRI study with minimum two years of follow-up

2021 ◽  
Vol 21 (9) ◽  
pp. S60
Author(s):  
Altug Yucekul ◽  
Burcu Akpunarli ◽  
Atahan Durbas ◽  
Tais Zulemyan ◽  
Irem Havlucu ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Facet Joint ◽  
Joint Degeneration ◽  
Facet Joint Degeneration ◽  
Mri Study

Association of Dipeptidyl Peptidase-4 Inhibitor Use and Amyloid Burden in Diabetic Patients With AD-Related Cognitive Impairment

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012534
Author(s):  
Seong Ho Jeong ◽  
Hye Ryun Kim ◽  
Jeonghun Kim ◽  
Hankyeol Kim ◽  
Namki Hong ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mmse Score ◽  
Dipeptidyl Peptidase ◽  
Cognitive Outcome ◽  
Diabetic Patients ◽  
Carrier Status ◽  
Amyloid Pet ◽  
Amyloid Burden ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors

Objectives:To investigate whether dipeptidyl peptidase-4 inhibitors (DPP-4i) have beneficial effects on amyloid aggregation and longitudinal cognitive outcome in diabetic Alzheimer’s disease-related cognitive impairment (ADCI).Methods:We retrospectively reviewed 282 patients with ADCI who had positive scan of 18F-florbetaben amyloid PET images were classified into three groups according to a prior diagnosis of diabetes and DPP-4i use: diabetic patients being treated with (ADCI-DPP-4i+, n=70) or without DPP-4i (ADCI-DPP-4i-, n=71), and non-diabetic patients (n=141). Multiple linear regression analyses were performed to determine inter-group differences in global and regional amyloid retention using standardized uptake value ratios calculated from cortical areas. We assessed the longitudinal changes in Mini-Mental State Examination (MMSE) score using a linear mixed model.Results:The ADCI-DPP-4i+ group had lower global amyloid burden than the ADCI-DPP-4i− group (β = 0.075, SE = 0.024, p = 0.002) and the non-diabetic ADCI group (β = 0.054, SE = 0.021, p = 0.010) after adjusting for age, sex, education, cognitive status, and APOE ε4 carrier status. Additionally, the ADCI-DPP-4i+ group had lower regional amyloid burden in temporo-parietal areas than either the ADCI-DPP-4i− group or the non-diabetic ADCI group. The ADCI-DPP-4i+ group showed a slower longitudinal decrease in MMSE score (β = 0.772, SE = 0.272, p = 0.005) and memory recall sub-score (β = 0.291, SE = 0.116, p = 0.012) than the ADCI-DPP-4i− group.Conclusions:These findings suggest that DPP-4i use is associated with low amyloid burden and favorable long-term cognitive outcome in diabetic patients with ADCI.

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