Determinants of vascular dementia in the Cardiovascular Health Cognition Study

Kuller, Lewis H.; López, Oscar L.; Jagust, W.J.; Becker, James T.; DeKosky, Steven T.; Lyketsos, Constantine G.; Kawas, Claudia H.; Breitner, John C.S.; Fitzpatrick, Annette L.; Dulberg, Corinne

doi:10.1212/01.wnl.0000160115.55756.de

Cited by 166 publications

(115 citation statements)

References 24 publications

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“…Other studies have confirmed the relationship between hypertension, heart disease, diabetes, stroke and AD [55][56][57][58][59][60][61][62]. Our study confirmed that hypertension is a risk factor for early onset AD [63].…”

Section: Comorbiditiessupporting

confidence: 88%

Ethnic Differences in Early Onset Alzheimer’s Disease

Chen¹,

Panegyres²

2017

J Alzheimers Dis Parkinsonism

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Section: Comorbiditiessupporting

confidence: 88%

Ethnic Differences in Early Onset Alzheimer’s Disease

Chen¹,

Panegyres²

2017

J Alzheimers Dis Parkinsonism

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“…A number of factors are known to increase the risk of vascular dementia, including a history of hypertension, DM, hyperlipidemia, smoking and cardiac conditions [2][3][4]. Several studies have addressed the contribution of each risk factor to VaD and the question 1 These authors contributed equally to this work.…”

Section: Introductionmentioning

confidence: 99%

Does Diabetes Mellitus Alter the Onset and Clinical Course of Vascular Dementia?

Murthy

Jawaid

Qureshi

et al. 2010

Behavioural Neurology

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Abstract. Background: Vascular dementia (VaD) is the second most common dementing illness. Multiple risk factors are associated with VaD, but the individual contribution of each to disease onset and progression is unclear. We examined the relationship between diabetes mellitus type 2 (DM) and the clinical variables of VaD. Methods: Data from 593 patients evaluated between June, 2003 and June, 2008 for cognitive impairment were prospectively entered into a database. We retrospectively reviewed the charts of 63 patients who fit the NINDS-AIREN criteria for VaD. The patients were divided into those with DM (VaD-DM, n = 29) and those without DM (VaD, n = 34). The groups were compared with regard to multiple variables. Results: Patients with DM had a significantly earlier onset of VaD (71.9 ± 6.54 vs. 77.2 ± 6.03, p < 0.001), a faster rate of decline per year on the mini mental state examination (MMSE; 3.60 ± 1.82 vs. 2.54 ± 1.60 points, p = 0.02), and a greater prevalence of neuropsychiatric symptoms at the time of diagnosis (62% vs. 21%, p = 0.02). Conclusions: A history of pre-morbid DM was associated with an earlier onset and faster cognitive deterioration in VaD. Moreover, DM was associated with neuropsychiatric symptoms in patients with VaD. A larger study is needed to verify these associations. It will be important to investigate whether better glycemic control will mitigate the potential effects of DM on VaD.

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“…Fish consumption is associated with decreased risk of dementia and cognitive decline, 5 for which major risk factors are subclinical brain abnormalities. 6 We hypothesized that, as with overt infarcts, 4 consumption of tuna/other fish would be associated with lower risk of subclinical infarcts among older adults, while fried fish consumption would be associated with higher risk. We also investigated associations of fish consumption with MRI-defined white matter abnormalities and ventricular and sulcal enlargement.…”

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confidence: 99%

Fish consumption and risk of subclinical brain abnormalities on MRI in older adults

Virtanen

Siscovick²,

Longstreth

et al. 2008

Neurology

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Objective: To investigate the association between fish consumption and subclinical brain abnormalities. Methods:In the population-based Cardiovascular Health Study, 3,660 participants age Ն65 underwent an MRI scan in 1992-1994. Five years later, 2,313 were scanned. Neuroradiologists assessed MRI scans in a standardized and blinded manner. Food frequency questionnaires were used to assess dietary intakes. Participants with known cerebrovascular disease were excluded from the analyses. Results:After adjustment for multiple risk factors, the risk of having one or more prevalent subclinical infarcts was lower among those consuming tuna/other fish Ն3 times/week, compared to Ͻ1/month (relative risk 0.74, 95% CI ϭ 0.54 -1.01, p ϭ 0.06, p trend ϭ 0.03). Tuna/other fish consumption was also associated with trends toward lower incidence of subclinical infarcts. Additionally, tuna/other fish intake was associated with better white matter grade, but not with sulcal and ventricular grades, markers of brain atrophy. No significant associations were found between fried fish consumption and any subclinical brain abnormalities. Conclusions:Among older adults, modest consumption of tuna/other fish, but not fried fish, was associated with lower prevalence of subclinical infarcts and white matter abnormalities on MRI examinations. Our results add to prior evidence that suggest that dietary intake of fish with higher eicosapentaenoic acid and docosahexaenoic acid content, and not fried fish intake, may have clinically important health benefits. Neurology ® 2008;71:439-446 GLOSSARY ARR ϭ absolute risk reduction; BMI ϭ body mass index; CHD ϭ coronary heart disease; CHS ϭ Cardiovascular Health Study; DHA ϭ docosahexaenoic acid; EPA ϭ eicosapentaenoic acid; FFQ ϭ food frequency questionnaire; HDL-C ϭ high-density lipoprotein cholesterol; LDL-C ϭ low-density lipoprotein cholesterol; PUFA ϭ polyunsaturated fatty acid; RR ϭ relative risk.Clinically unrecognized or "silent" brain infarcts are very common, particularly with advancing age. Among adults age Ն65 without infarcts on initial brain MRI, nearly 20% had at least one new infarct when MRI was performed about 5 years later, but without recognized TIA or clinical stroke in nearly 90% of cases.1 Persons with MRI-defined infarcts experience greater cognitive decline than persons without infarcts, and such individuals are also at higher risk of future clinical stroke.

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Determinants of vascular dementia in the Cardiovascular Health Cognition Study

Cited by 166 publications

References 24 publications

Ethnic Differences in Early Onset Alzheimer’s Disease

Ethnic Differences in Early Onset Alzheimer’s Disease

Does Diabetes Mellitus Alter the Onset and Clinical Course of Vascular Dementia?

Fish consumption and risk of subclinical brain abnormalities on MRI in older adults

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