SUMMARYBackground-Neuropsychiatric symptoms are nearly universal in dementia, yet little is known about their longitudinal course in the community.

Major depressive disorder is unremitting in 15% of cases and recurrent in 35%. About half of those with a first-onset episode recover and have no further episodes.

Association of HT use and risk of AD may depend on timing of use. Although possibly beneficial if taken during a critical window near menopause, HT (especially opposed compounds) initiated in later life may be associated with increased risk. The relation of AD risk to timing and type of HT deserves further study.

Background and Purpose Impairments in CVR have been variably associated with increased risk of ischemic events and may stratify stroke risk in patients with high grade internal carotid artery (ICA) stenosis or occlusion. The purpose of this study is to perform a systematic review and meta-analysis to summarize the association of CVR impairment and stroke risk. Methods We performed a literature search evaluating the association of impairments in CVR with future stroke or transient ischemic attack (TIA) in patients with high grade ICA stenosis or occlusion. We included studies with a minimum of one year patient follow up with baseline CVR measures performed via any modality and primary outcome measures of stroke and/or TIA. A meta-analysis with assessment of study heterogeneity and publication bias was performed. Results were presented in a forest plot and summarized using a random-effects model. Results Thirteen studies met the inclusion criteria, representing a total of 1061 independent CVR tests in 991 unique patients with a mean follow up of 32.7 months. We found a significant positive relationship between impairment of CVR and development of stroke, with a pooled random effects odds ratio of 3.86 (95% CI, 1.99–7.48). Subset analysis showed that this association between CVR impairment and future risk of stroke/TIA remained significant regardless of ischemic outcome measure, symptomatic or asymptomatic disease, stenosis or occlusion, or CVR testing method. Conclusions CVR impairment is strongly associated with increased risk of ischemic events in carotid stenosis or occlusion and may be useful for stroke risk stratification.