Risk factors accelerating cerebral degenerative changes, cognitive decline and dementia

Abstract

Objectives Factors accelerating cerebral degenerative changes represent potentially modifiable risks for cognitive decline. Putative risk factors accelerating subtle cognitive decline and dementia were correlated with repeated measures of cerebral atrophy, CT densitometry, perfusions and cognitive testing among neurologically and cognitively normative ageing volunteers. Methods Two hundred and twenty‐four normative subjects at increased risk for cognitive decline were admitted to the study. Mean entry age was 59.5±15.8 years. Mean follow‐up is 4.3±3.1 years. At follow‐up, 22 developed subtle cognitive decline (δCCSE≥−3), 19 became demented, eight with vascular type (VAD) and 11 with Alzheimer's type (DAT) and 183 remain cognitively unchanged. Standardized questionnaires, medical, neuropsychological, neurological and blood work examinations were obtained. Cerebral atrophy, tissue densities and perfusions were measured by xenon‐enhanced CT. Results After age 60, cerebral atrophy, ventricular enlargement, polio‐ and leuko‐araiosis geometrically increased as perfusions declined. Risk factors accelerating perfusional decline, cerebral atrophy, polio‐araiosis and leuko‐araiosis (thinning of grey–white matter densities) were: transient ischaemic attacks (TIAs), hypertension, smoking, hyperlipidemia, male gender. At age 71.5±11.9, subtle cognitive decline began, accelerated by TIAs, hypertension and heart disease. Leuko‐araiosis began before cognitive decline. TIAs, hypertension and hyperlipidemia correlated with VAD. Excessive cortical perfusional decreases and cerebral atrophy correlated with cognitive decline. Family history of neurodegenerative disease correlated with DAT. Conclusion TIAs, hypertension, hyperlipidemia, smoking and male gender accelerate cerebral degenerative changes, cognitive decline and dementia. Copyright © 1999 John Wiley & Sons, Ltd.

Voxel-based morphometry demonstrates reduced grey matter density on brain MRI in patients with diabetic retinopathy

“…Although some studies point to a possible causal relationship with dementia [30][31][32][33], others challenge this point of view [34]. Shrinkage and atrophy of the brain are generally considered to be a risk factor for cognitive decline [35][36][37][38][39].…”

Non-treatment-seeking heavy drinkers: Effects of chronic cigarette smoking on brain structure

“…Therefore, in addition to greater brain morphological abnormalities, chronic cigarette smoking among individuals with AUD appears to modulate neurocognition. In general, brain shrinkage is a risk factor for cognitive decline and memory impairment in the elderly (e.g., Meyer et al, 1999;Visser et al, 1999), and, if occurring in middle age, may increase the risk for earlier and more rapid cognitive decline with advancing age.…”

Gender and Sexual Orientation Differences in Cognition Across Adulthood: Age Is Kinder to Women than to Men Regardless of Sexual Orientation

“…For example, using magnetic resonance imaging (MRI) scans, Gur et al (1991) observed that brain atrophy as indicated by increased cerebrospinal fluid volume with age was greater in males than in females; Cowell et al (1994) found greater age-related reductions in brain volume for both frontal and temporal lobes in males than in females; and Pruessner, Collins, Pruessner and Evans (2001) found a reduction in hippocampal volume across early adulthood for males but not for females. From such findings, it would be predicted that corresponding age by gender interactions would be found in behavioral data and, indeed, greater age-related cognitive decline in males than in females has been observed in both cross-sectional and longitudinal studies (e.g., Barrett-Connor & Kritz-Silverstein, 1999;Larrabee & Crook, 1993;Meyer et al, 1999;Rowe, Turcotte, & Hasher, 2004;Wiederholt et al, 1993;Zelinski & Stewart, 1998). Interestingly, similar results have been found in two studies of spatial memory in rhesus monkeys (Lacreuse et al, 2005;Lacreuse, Herndon, Killiany, Rosene, & Moss, 1999), suggesting that biological rather than sociocultural factors may underlie the gender differences in age-related decline.…”