Cardiac Disease Associated With Increased Risk of Nonamnestic Cognitive Impairment

Roberts, Rosebud O.; Geda, Yonas E.; Knopman, David S.; Ruth, H.; Pankratz, V. Shane; Boeve, Bradley F.; Tangalos, Eric G.; Ivnik, Robert J.; Mielke, Michelle M.; Petersen, Ronald C.

doi:10.1001/jamaneurol.2013.607

Cited by 54 publications

(49 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Effectively monitoring and managing persons with hypertension particularly in midlife may also prevent adverse cardiovascular outcomes that increase MCI risk. 21,22 Interestingly, our findings suggest that nonpharmacologic preventive strategies may reduce naMCI risk in the oldest old. Higher education may reduce risk by increasing cognitive reserve, which in turn may delay clinical expression of symptoms or counteract vascular assaults on the brain.…”

Section: -19mentioning

confidence: 69%

Risk and protective factors for cognitive impairment in persons aged 85 years and older

et al. 2015

View full text Add to dashboard Cite

Objective: To determine risk and protective factors for mild cognitive impairment (MCI) among persons 85 years and older.Methods: Participants in the population-based prospective Mayo Clinic Study of Aging were comprehensively evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed by self-reported questionnaire; vascular and comorbid conditions were abstracted from participants' medical records.Results: Of 256 participants who were cognitively normal at enrollment (median age 87.3 years, Individuals aged 85 years and older are the most rapidly growing group in the United States and worldwide.1 Studies of the oldest old are difficult to conduct and to interpret. Persons aged 90 years and older typically have sensory losses, difficulty providing valid and reliable information, high comorbidity, and a high prevalence of dementia 2 ; most are typically women. Often, factors associated with risk of cognitive impairment at younger ages are no longer predictive, raising the possibility that multiple coexisting diseases might be more predictive than solitary diseases. Because many individuals aged 90 years and older already have early stages of mild cognitive impairment (MCI), studies are often cross-sectional and can only assess risk of dementia or Alzheimer disease (AD). Furthermore, potential interventions at these ages may have limited long-term benefit. The goal of this study was to identify risk and protective factors for incident MCI among cognitively normal persons aged 85-89 years at enrollment to the Mayo Clinic Study of Aging (MCSA).METHODS Study cohort at baseline. Participants were randomly selected from among Olmsted County, Minnesota, residents for participation in the MCSA. Details of the study design and methodology have been published. 3,4 Briefly, residents aged 70-89 years were identified using the medical records linkage system of the Rochester Epidemiology Project (REP).5 Eligible participants wereFrom the Divisions

show abstract

Section: -19mentioning

confidence: 69%

Risk and protective factors for cognitive impairment in persons aged 85 years and older

et al. 2015

View full text Add to dashboard Cite

show abstract

“…[1][2][3] Analyses of MCSA data have identified several factors associated with the risk of MCI including age, education, sex, APOE genotype, 4 parkinsonism, 5 diabetes, [6][7][8] depressive symptoms, 9 cardiovascular disease, 10,11 stroke, 12 and slow gait. 13 In the present study, we focused on developing an algorithm that uses these variables to predict the risk of transitioning from cognitively normal (CN) to MCI.…”

mentioning

confidence: 99%

Predicting the risk of mild cognitive impairment in the Mayo Clinic Study of Aging

et al. 2015

View full text Add to dashboard Cite

Objective: We sought to develop risk scores for the progression from cognitively normal (CN) to mild cognitive impairment (MCI). Methods:We recruited into a longitudinal cohort study a randomly selected, population-based sample of Olmsted County, MN, residents, aged 70 to 89 years on October 1, 2004. At baseline and subsequent visits, participants were evaluated for demographic, clinical, and neuropsychological measures, and were classified as CN, MCI, or dementia. Using baseline demographic and clinical variables in proportional hazards models, we derived scores that predicted the risk of progressing from CN to MCI. We evaluated the ability of these risk scores to classify participants for MCI risk. Conclusions:We have developed MCI risk scores using variables easily assessable in the clinical setting and that may be useful in routine patient care. Because of variability among populations, validation in independent samples is required. These models may be useful in identifying patients who might benefit from more expensive or invasive diagnostic testing, and can inform clinical trial design. Inclusion of biomarkers or other risk factors may further enhance the models. As clinicians and researchers strive to identify individuals at the highest risk of dementia in the earliest possible stages, understanding the predictors of mild cognitive impairment (MCI) is crucial because individuals with MCI have an increased risk of developing dementia. A method that predicts an individual's risk of developing MCI, particularly one that is brief, inexpensive, and noninvasive, is essential for risk stratification at the population level and would enhance the design and conduct of interventional trials.Estimates of the prevalence and incidence of MCI have been published from the prospective population-based Mayo Clinic Study of Aging (MCSA), designed to examine cognitive changes among individuals initially without dementia.

show abstract

“…However, it suggests that multimorbidity may be differentially associated with brain pathology in men vs women as observed for other conditions. For instance, cardiac disease was associated with nonamnestic MCI in women but not in men, 33 and atrial fibrillation with cognitive decline in women but not in men. 34 The interaction may also be due in part to different combinations of medical conditions reported in men vs women, 35 or to sex differences in cerebral glucose metabolism.…”

mentioning

confidence: 99%

Multimorbidity and neuroimaging biomarkers among cognitively normal persons

et al. 2016

Self Cite

View full text Add to dashboard Cite

Objective: To assess the cross-sectional association between multimorbidity and imaging biomarkers of brain pathology in the population-based Mayo Clinic Study of Aging (MCSA). Methods:The study consisted of 1,449 MCSA participants who were cognitively normal at the time of MRI. A subset of the participants also had 11 C-Pittsburgh compound B (n 5 689) and 18 fluorodeoxyglucose (n 5 688) PET scans available. Information on multimorbidity (defined as $2 chronic conditions) in the 5 years prior to the first imaging study was captured from the medical record using ICD-9 codes for chronic conditions and the Rochester Epidemiology Project medical records linkage system. The cross-sectional association of multimorbidity and imaging biomarkers was examined using logistic and linear regression models.Results: Among 1,449 cognitively normal participants (mean age 79 years; 50.9% men), 85.4% had multimorbidity ($2 chronic conditions). Multimorbidity and severe multimorbidity ($4 chronic conditions) were associated with abnormal Alzheimer disease (AD) signature meta-region of interest (meta-ROI) 18 Conclusions: Multimorbidity was associated with brain pathology through mechanisms independent of amyloid deposition and such neuronal injury and pathology was present before any symptomatic evidence of cognitive impairment. Longitudinal follow-up will provide insights into potential causal associations of multimorbidity with changes in brain pathology. Multimorbidity has a prevalence of 20%-30% in the general population, 1 and increases with age from 55% to 98% among persons older than 60 years.1 Multimorbidity is becoming the norm among adults in primary care settings, 2 mandating the need to investigate not only the causes, but also the association with future health outcomes. Multimorbidity is associated with an increased risk for hospitalizations and increased length of stay, worsening quality of life and physical functioning, polypharmacy, mild cognitive impairment, 3 and depression, resulting in significant economic costs for the health care system.2 Several of the common chronic conditions that contribute to multimorbidity are established risk factors for mild cognitive impairment (MCI) or dementia (e.g., vascular diseases, cerebrovascular disease, depression, or chronic obstructive pulmonary disease).3-8 We hypothesized, therefore, that multimorbidity may also be associated with abnormal brain imaging findings that are characteristically present in persons with Alzheimer disease (AD) dementia, but this association has not been studied. Thus, the objective of this study was to determine the cross-sectional associations between multimorbidity From the Departments of Health Sciences Research

show abstract

Cardiac Disease Associated With Increased Risk of Nonamnestic Cognitive Impairment

Cited by 54 publications

References 60 publications

Risk and protective factors for cognitive impairment in persons aged 85 years and older

Risk and protective factors for cognitive impairment in persons aged 85 years and older

Predicting the risk of mild cognitive impairment in the Mayo Clinic Study of Aging

Multimorbidity and neuroimaging biomarkers among cognitively normal persons

Contact Info

Product

Resources

About