Brain Imaging Findings in Elderly Adults and Years of Life, Healthy Life, and Able Life over the Ensuing 16 Years: The Cardiovascular Health Study

Longstreth, W. T.; Diehr, Paula; Yee, Laura M.; Newman, Anne B.; Beauchamp, Norman J.

doi:10.1111/jgs.13068

Cited by 10 publications

(6 citation statements)

References 12 publications

(38 reference statements)

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“…For all other time points, 0.3% to 12.5% of ADL data were missing and were also imputed. This method of imputation of CHS data has been previously described . Remaining YAL for 544 participants who survived to the end of follow‐up was imputed using regression equations .…”

Section: Methodsmentioning

confidence: 99%

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Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?

Jacob

Yee

Diehr

et al. 2016

J American Geriatrics Society

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Objectives To determine whether lifestyle factors measured late in life could compress the disabled period towards the end of life. Design Community-based cohort study of older adults followed from 1989 to 2015. Setting Four US communities. Participants Men and women ages 65 and older (N= 5248, mean age 72.7 ± 5.5 years, 57% women, 15.2% minority) who were living in the community, not wheel-chair dependent and able to give informed consent at baseline. Measurements Multiple lifestyle factors including smoking, alcohol consumption, physical activity, diet, body mass index (BMI), social networks and social support were measured at baseline. Activities of Daily Living (ADL) were assessed at baseline and throughout follow-up. Years of Life (YoL) was defined as years until death. Years of Able Life (YAL) was defined as years without any ADL difficulty. YAL/YoL%, the proportion of life lived able, was used to indicate the relative compression/expansion of the disabled period. Results The average duration of disabled years was 4.5 (out of 15.4 mean YoL) for women and 2.9 (out of 12.4 mean YoL) for men. In a multivariable model, obesity (compared to normal BMI) was associated with 7.3% (95% CI, 5.4–9.2) lower YAL/YoL%. Scores in the lowest quintile of the Alternate Healthy Eating Index (compared to highest) were associated with a 3.7% (95% CI, 1.6–5.9) lower YAL/YoL%. Every 25 blocks walked in a week was associated with 0.5% (95% CI, 0.3–0.8) higher YAL/YoL%. Conclusion The effects of healthy lifestyle factors on the proportion of future life lived free of disability indicate that the disabled period can be compressed, given the right combination of these factors.

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Section: Methodsmentioning

confidence: 99%

“…This method of imputation of CHS data has been previously described. 14,15 Remaining YAL for 544 participants who survived to the end of follow-up was imputed using regression equations. 13 YAL/YoL% was calculated to represent the relative proportion of the observed life span that was lived free of ADL difficulty.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?

Jacob

Yee

Diehr

et al. 2016

J American Geriatrics Society

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“…7,[31][32][33]95 In the prospective Cardiovascular Health Study, the combination of WMHs and infarcts carried the worst prognosis with regard to long-term survival, self-rated health, and limitation in activities of daily living (ADLs). 96 In the Rotterdam Scan Study, progression of WMHs in the periventricular regions was paralleled by declines in information processing speed and general cognition, as well as decline on the MMSE. 28 The LADIS study reported 2.4-year followup data for its observational cohort of 633 older people, and found a transition rate of 29.5% to death or disability in ADLs for those with severe WMH (Fazekas 3) at entry, compared with 10% in those with only mild changes.…”

Section: Wmhs and The Development Of Dementiamentioning

confidence: 99%

White matter hyperintensities, cognitive impairment and dementia: an update

2015

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White matter hyperintensities (WMHs) in the brain are the consequence of cerebral small vessel disease, and can easily be detected on MRI. Over the past three decades, research has shown that the presence and extent of white matter hyperintense signals on MRI are important for clinical outcome, in terms of cognitive and functional impairment. Large, longitudinal population-based and hospital-based studies have confirmed a dose-dependent relationship between WMHs and clinical outcome, and have demonstrated a causal link between large confluent WMHs and dementia and disability. Adequate differential diagnostic assessment and management is of the utmost importance in any patient, but most notably those with incipient cognitive impairment. Novel imaging techniques such as diffusion tensor imaging might reveal subtle damage before it is visible on standard MRI. Even in Alzheimer disease, which is thought to be primarily caused by amyloid, vascular pathology, such as small vessel disease, may be of greater importance than amyloid itself in terms of influencing the disease course, especially in older individuals. Modification of risk factors for small vessel disease could be an important therapeutic goal, although evidence for effective interventions is still lacking. Here, we provide a timely Review on WMHs, including their relationship with cognitive decline and dementia.

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“…White matter hyperintensities (WMHs) are common brain magnetic resonance imaging (MRI) changes in the elderly and play an important role in their quality of daily life. 1 WMHs are usually located in basal ganglia, periventricular, subcortical or semioval center regions, caused by demyelination and axonal loss resulting from cerebral small vessel disease. 2,3 Many studies suggested that WMHs were associated with cognitive impairment and dementia.…”

Section: Introductionmentioning

confidence: 99%

White Matter Hyperintensities Predict Cognitive Decline: A Community-Based Study

Tang

Luo

et al. 2019

Can. J. Neurol. Sci.

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ABSTRACT:Introduction: White matter hyperintensities (WMHs) were commonly seen in brain magnetic resonance imaging (MRI) of the elderly. Many studies found that WMHs were associated with cognitive decline and dementia. However, the association between WMHs in different brain regions and cognitive decline remains debated. Methods: We explored the association of the severity of WMHs and cognitive decline in 115 non-demented elderly (≥50 years old) sampled from the Wuliqiao Community located in urban area of Shanghai. MRI scans were done during 2009–2011 at the beginning of the study. Severity of WMHs in different brain regions was scored by Improved Scheltens Scale and Cholinergic Pathways Hyperintensities Scale (CHIPS). Cognitive function was evaluated by Mini-Mental State Examination (MMSE) every 2 to 4 years during 2009–2018. Results: After adjusting for confounding factors including age, gender, education level, smoking status, alcohol consumption, depression, hypertension, diabetes, hyperlipidemia, brain infarcts, brain atrophy, apoE4 status, and baseline MMSE score, periventricular and subcortical WMH lesions as well as WMHs in cholinergic pathways were significantly associated with annual MMSE decline ( p < 0.05), in which the severity of periventricular WMHs predicted a faster MMSE decline (–0.187 points/year, 95% confidence interval: –0.349, –0.026, p = 0.024). Conclusions: The severity of WMHs at baseline was associated with cognitive decline in the non-demented elderly over time. Interventions on WMH lesions may offer some benefits for cognitive deterioration.

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Brain Imaging Findings in Elderly Adults and Years of Life, Healthy Life, and Able Life over the Ensuing 16 Years: The Cardiovascular Health Study

Cited by 10 publications

References 12 publications

Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?

Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?

White matter hyperintensities, cognitive impairment and dementia: an update

White Matter Hyperintensities Predict Cognitive Decline: A Community-Based Study

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