Atherosclerosis, Hypertension, and Diabetes in Alzheimer’s Disease, Vascular dementia, and Mixed Dementia: Prevalence and Presentation

Javanshiri, Keivan; Waldö, María Landqvist; Friberg, Niklas; Sjövall, Fredrik; Wickerström, Karin; Haglund, Mattias; Englund, Elisabet

doi:10.3233/jad-189011

Cited by 5 publications

(7 citation statements)

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“…Furthermore, it is also possible that the two cognitive domains identified in the present study, executive function and explicit memory, are reflective of two pathways in which metabolic risk factors may affect mobility. Dementia is a disease that affects memory, language, planning, and problemsolving, and most prevalent subtypes of dementia are Alzheimer's disease and vascular dementia (Javanshiri et al, 2018). While Alzheimer's disease is neuropathologically defined as the presence of amyloid plaques and accumulation of neurofibrillary tangles composed of filamentous tau protein (Perl, 2010), vascular dementia is a cognitive disorder that is derived from cerebrovascular cases (Iadecola, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Previously, cardiovascular disease, cerebrovascular disease, atherosclerosis, hypertension, diabetes mellitus, and stroke were considered risk factors for developing vascular dementia (Song, Lee, Park, & Lee, 2014). However, recent evidence suggests that these risk factors are also common in Alzheimer's disease (Javanshiri et al, 2018); thus, cardiometabolic abnormalities may impact both dementia subtypes. While Alzheimer's disease is commonly associated with impaired explicit memory (Bondi & Kaszniak, 1991), executive dysfunction is associated with both Alzheimer's disease and vascular dementia (McGuinness, Barrett, Craig, Lawson, & Passmore, 2010).…”

Section: Discussionmentioning

confidence: 99%

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Metabolic Syndrome and Physical Performance: The Moderating Role of Cognition among Middle-to-Older-Aged Adults

Ogawa

Leritz

McGlinchey

et al. 2020

J Int Neuropsychol Soc

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Objective: Mobility limitation and cognitive decline are related. Metabolic syndrome (MetS), the clustering of three or more cardiovascular risk factors, is associated with decline in both mobility and cognition. However, the interrelationship among MetS, mobility, and cognition is unknown. This study investigated a proposed pathway where cognition moderates the relationship between MetS and Mobility. Method: Adults ages 45–90 years were recruited. MetS risk factors and mobility performance (Short Physical Performance Battery (SPPB) and gait speed) were evaluated. Cognition was assessed using a comprehensive neuropsychological battery. A factor analysis of neuropsychological test scores yielded three factors: executive function, explicit memory, and semantic/contextual memory. Multivariable linear regression models were used to examine the relationship among MetS, mobility, and cognition. Results: Of the 74 participants (average age 61 ± 9 years; 41% female; 69% White), 27 (36%) participants manifested MetS. Mean SPPB score was 10.9 ± 1.2 out of 12 and gait speed was 1.0 ± 0.2 m/s. There were no statistically significant differences in mobility by MetS status. However, increase in any one of the MetS risk factors was associated with decreased mobility performance after adjusting for age and gender (SPPB score: β (SE) -.17 (0.08), p < .05; gait speed: -.03 (.01), p < .01). Further adjusting for cognitive factors (SPPB score: explicit memory .31 (.14), p = .03; executive function 0.45 (0.13), p < .01; gait speed: explicit memory 0.04 (0.02), p = .03; executive function 0.06 (0.02), p < .01) moderated the relationships between number of metabolic risk factors and mobility. Conclusion: The relationship between metabolic risk factors and mobility may be moderated by cognitive performance, specifically through executive function and explicit memory.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome and Physical Performance: The Moderating Role of Cognition among Middle-to-Older-Aged Adults

Ogawa

Leritz

McGlinchey

et al. 2020

J Int Neuropsychol Soc

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“…Vascular dementia (VD) is a type of cognitive impairment contributed by cerebrovascular disease, whose clinical manifestations are memory decline, early gait disorder, incontinence with mood (e.g., depression and apathy), and personality changes (Habeych and Castilla-Puentes, 2015). The WHO estimates there will be about 82 million people with dementia in 2050, twice as many as now (Javanshiri et al, 2018). VD is a fatal subtype of dementia.…”

Section: Introductionmentioning

confidence: 99%

“…According to an experiment by Chen et al, vegetarians with a lower risk of AS also had a lower incidence of cognitive impairment (Chen et al, 2018), which reflects the relationship between blood vessels and cognition, allowing further hypothesis about AS playing a role in VD. Prior trials have shown that AS has a significant influence on VD (Chen et al, 2018;Javanshiri et al, 2018). There are currently two theories about their relationship.…”

Section: Introductionmentioning

confidence: 99%

Atherosclerosis: The Culprit and Co-victim of Vascular Dementia

2021

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Vascular dementia (VD), a cerebrovascular disease which causes cognitive impairment, is one of the significant factors that affects the quality of senectitude. Atherosclerosis (AS) is a chronic inflammatory syndrome and closely associated with VD. Analyzing the role of AS in VD contribute greatly to its early detection and prevention, but their relationship has not been integrated into a complete network. This review summarizes AS biomarkers as VD predictors for the first time and describes the direct mechanisms of AS causing VD from five aspects: vascular morphogenesis, hemodynamic change, neurovascular unit damage (NVU), oxidative stress, and microRNA (miRNA). Finally, it discriminates the relationship between AS and VD in common risk factors which can be disease or some molecules. In particular, these data imply that the role of AS in VD is not only a pathogenic factor but also a comorbidity in VD. This review aims to bring new ideas for the prediction and treatment of VD.

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“…Pharmacological control of blood pressure may reduce dementia incidence 8 . However, not all studies show a link between high blood pressure and Alzheimer's disease forms of dementia 13 , and it is noted that blood pressure decreases with age 14 . The exact mechanism by which hypertension increases dementia risk is not yet clear, but it is thought that hypertension may contribute to vascular dementia via cerebrovasculature damage 15,16 .…”

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confidence: 99%

Investigation of hypertension and type 2 diabetes as risk factors for dementia in the All of Us cohort

Nagar

Pemu

Qian

et al. 2022

Sci Rep

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The World Health Organization recently defined hypertension and type 2 diabetes (T2D) as modifiable comorbidities leading to dementia and Alzheimer’s disease. In the United States (US), hypertension and T2D are health disparities, with higher prevalence seen for Black and Hispanic minority groups compared to the majority White population. We hypothesized that elevated prevalence of hypertension and T2D risk factors in Black and Hispanic groups may be associated with dementia disparities. We interrogated this hypothesis using a cross-sectional analysis of participant data from the All of Us (AoU) Research Program, a large observational cohort study of US residents. The specific objectives of our study were: (1) to compare the prevalence of dementia, hypertension, and T2D in the AoU cohort to previously reported prevalence values for the US population, (2) to investigate the association of hypertension, T2D, and race/ethnicity with dementia, and (3) to investigate whether race/ethnicity modify the association of hypertension and T2D with dementia. AoU participants were recruited from 2018 to 2019 as part of the initial project cohort (R2019Q4R3). Participants aged 40–80 with electronic health records and demographic data (age, sex, race, and ethnicity) were included for analysis, yielding a final cohort of 125,637 individuals. AoU participants show similar prevalence of hypertension (32.1%) and T2D (13.9%) compared to the US population (32.0% and 10.5%, respectively); however, the prevalence of dementia for AoU participants (0.44%) is an order of magnitude lower than seen for the US population (5%). AoU participants with dementia show a higher prevalence of hypertension (81.6% vs. 31.9%) and T2D (45.9% vs. 11.4%) compared to non-dementia participants. Dominance analysis of a multivariable logistic regression model with dementia as the outcome shows that hypertension, age, and T2D have the strongest associations with dementia. Hispanic was the only race/ethnicity group that showed a significant association with dementia, and the association of sex with dementia was non-significant. The association of T2D with dementia is likely explained by concurrent hypertension, since > 90% of participants with T2D also had hypertension. Black race and Hispanic ethnicity interact with hypertension, but not T2D, to increase the odds of dementia. This study underscores the utility of the AoU participant cohort to study disease prevalence and risk factors. We do notice a lower participation of aged minorities and participants with dementia, revealing an opportunity for targeted engagement. Our results indicate that targeting hypertension should be a priority for risk factor modifications to reduce dementia incidence.

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Atherosclerosis, Hypertension, and Diabetes in Alzheimer’s Disease, Vascular dementia, and Mixed Dementia: Prevalence and Presentation

Cited by 5 publications

References 0 publications

Metabolic Syndrome and Physical Performance: The Moderating Role of Cognition among Middle-to-Older-Aged Adults

Metabolic Syndrome and Physical Performance: The Moderating Role of Cognition among Middle-to-Older-Aged Adults

Atherosclerosis: The Culprit and Co-victim of Vascular Dementia

Investigation of hypertension and type 2 diabetes as risk factors for dementia in the All of Us cohort

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