Stroke Prevention and Cognitive Reserve: Emerging Approaches to Modifying Risk and Delaying Onset of Dementia

Willis, Kevin; Hakim, Antoine M.

doi:10.3389/fneur.2013.00013

Cited by 17 publications

(14 citation statements)

References 88 publications

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“…The finding of increased risk of VaD in older women is consistent with lower schooling among elderly women in Mexico, and also, it probably indicates the presence of mixed degenerative/vascular lesions, a very common occurrence among elderly demented patients in other ethnic groups [3]. Finally, a higher educational level appeared to be protective may be because it was associated with better functional cognitive reserve [34,35]. Except for diabetes, we found no association with other clinical variables or vascular risk factors.…”

Section: Discussionsupporting

confidence: 52%

Vascular Cognitive Disorders and Depression After First-Ever Stroke: The Fogarty-Mexico Stroke Cohort

et al. 2014

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Background and Purpose: Stroke is the major cause of vascular behavior and cognitive disorders worldwide.In developing countries, there is a dearth of information regarding the public health magnitude of stroke. The aim of the Fogarty-Mexico cohort was to assess the prevalence of vascular behavioral and cognitive disorders, ranging from mild vascular cognitive impairment (VCI) to vascular dementia (VaD), in a cohort of acute first-ever symptomatic stroke patients in Mexico. Methods: A total of165 consecutive, first-ever stroke patients admitted to the National Institute of Neurology and Neurosurgery in Mexico City, were included in the cohort. Patients were eligible if they had an ischemic stroke, primary intracerebral hemorrhage, or cerebral venous thrombosis (CVT). Stroke diagnosis required the presence of an acute focal deficit lasting more than 24 h, confirmed by a corresponding lesion on CT/MRI. Stroke severity was established with the NIH Stroke Scale. The pre-stroke functional status was determined by the IQCODE. Three months after the occurrence of stroke, 110 survivor patients returned for follow-up and were able to undergo functional outcome (modified Rankin scale, Barthel index), along with neurological, psychiatric, neuropsychological, laboratory, and imaging assessments. We compared depression, demographic, and clinical and imaging features between patients with and without dementia, and between patients with VCI and those with intact cognition. Results: Of the 110 patients (62% men, mean age 56 ± 17.8, education 7.7 ± 5.2 years) 93 (84%) had ischemic strokes, 14 (13%) intracerebral hemorrhage, and 3 (3%) CVT. The main risk factors were hypertension (50%), smoking (40%), hypercholesterolemia (29%), hyperhomocysteinemia (24%), and diabetes (22%). Clinical and neuropsychological evaluations demonstrated post-stroke depression in 56%, VCI in 41%, and VaD in 12%; 17% of the latter had pre-stroke functional impairment (IQCODE >3.5). Cognitive deficits included executive function in 69%, verbal memory in 49%, language in 38%, perception in 36%, and attention in 38%. Executive dysfunction occurred in 36% of non-demented subjects, 65% of them with mild-moderate deficits in daily living activities. Female gender (p ≤ 0.054), older age (mean age 65.6 years vs. 49.3, p < 0.001), diabetes (p ≤ 0.004), illiteracy and lower education (p ≤ 0.001), and PSD (p = 0.03) were significantly higher in VCI-VaD compared with cognitively intact post-stroke subjects. We could not demonstrate an association with lesion site and distribution of the cognitive deficits. Conclusions: The Fogarty-Mexico cohort recruited relatively young acute stroke patients, compared with other Mexican stroke cohorts. PSD and VCI occurred frequently but prevalence of VaD (12%) was lower than expected. A high prevalence of treatable stroke risk factors suggests that preventive interventions are advisable.

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Section: Discussionsupporting

confidence: 52%

Vascular Cognitive Disorders and Depression After First-Ever Stroke: The Fogarty-Mexico Stroke Cohort

et al. 2014

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“…Cognitive reserve has been defined as education, occupational achievement (Murray et al, 2011), intelligence quotient (Koenen et al, 2009), leisurely engagement (Scarmeas et al, 2004), and bilingualism (Schweizer et al, 2012). Measures of cognitive reserve have been successful in predicting clinical status in Alzheimer’s disease (Stern, 2006), HIV (Foley et al, 2012; Shapiro et al, 2014; Stern, 1996), multiple sclerosis (Booth et al, 2013; Schwartz et al, 2013), normal aging (Sole-Padulles et al, 2009; Tucker & Stern, 2011), stroke (Nunnari et al, 2014; Willis & Hakim, 2013), and traumatic brain injury (Levi et al, 2013). However, the neurophysiological mechanisms that facilitate effective assimilation of experience and development of neuroprotective intellectual abilities over the lifespan remain unclear.…”

Section: Problems In Traditional Reserve Researchmentioning

confidence: 99%

Brain and cognitive reserve: Translation via network control theory

Medaglia

Pasqualetti

Hamilton

et al. 2017

Neuroscience & Biobehavioral Reviews

113

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Traditional approaches to understanding the brain’s resilience to neuropathology have identified neurophysiological variables, often described as brain or cognitive “reserve,” associated with better outcomes. However, mechanisms of function and resilience in large-scale brain networks remain poorly understood. Dynamic network theory may provide a basis for substantive advances in understanding functional resilience in the human brain. In this perspective, we describe recent theoretical approaches from network control theory as a framework for investigating network level mechanisms underlying cognitive function and the dynamics of neuroplasticity in the human brain. We describe the theoretical opportunities offered by the application of network control theory at the level of the human connectome to understand cognitive resilience and inform translational intervention.

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“…Much research has focused on specific risk factors for Alzheimer's disease because it has been considered the primary underlying cause of pathological later-life cognitive decline (Willis and Hakim 2013), contributing to 60 % to 80 % of dementias 1 (Alzheimer's Association 2015). Evidence suggests an association between Alzheimer's disease and education (Mayeux and Stern 2012;Meng and D'Arcy 2012;Stern 2012); exercise (Farina et al 2014); social activity (Reed et al 2011); and physical health, including stroke (Willis and Hakim 2013), hypertension (Borenstein et al 2006), body mass index (BMI), and diabetes (Profenno et al 2010).…”

Section: Introductionmentioning

confidence: 99%

“…Evidence suggests an association between Alzheimer's disease and education (Mayeux and Stern 2012;Meng and D'Arcy 2012;Stern 2012); exercise (Farina et al 2014); social activity (Reed et al 2011); and physical health, including stroke (Willis and Hakim 2013), hypertension (Borenstein et al 2006), body mass index (BMI), and diabetes (Profenno et al 2010). There is mixed evidence for whether mid-to later-life cognitive function is associated with socioeconomic status (SES) (Cagney and Lauderdale 2002;Kaplan et al 2001;Luo and Waite 2005;Moceri et al 2000;Singh-Manoux et al 2005Turrell et al 2002;Zeki Al-Hazzouri et al 2011).…”

Section: Introductionmentioning

confidence: 99%

Cognitive Disparities: The Impact of the Great Depression and Cumulative Inequality on Later-Life Cognitive Function

Hale

2017

Demography

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Population aging has driven a spate of recent research on later-life cognitive function. Greater longevity increases the lifetime risk of memory diseases that compromise the cognitive abilities vital to well-being. Alzheimer's disease, thought to be the most common underlying pathology for elders' cognitive dysfunction (Willis and Hakim 2013), is already the sixth leading cause of death in the United States (Alzheimer's Association 2016). Understanding social determinants of pathological cognitive decline is key to crafting interventions, but evidence is inconclusive for how social factors interact over the life course to affect cognitive function. I study whether early-life exposure to the Great Depression is directly associated with later-life cognitive function, influences risky behaviors over the life course, and/or accumulates with other life-course disadvantages. Using growth curve models to analyze the Health and Retirement Study, I find that early-life exposure to the Great Depression is associated with fluid cognition, controlling for intervening factors-evidence for a critical period model. I find little support for a social trajectory model. Disadvantage accumulates over the life course to predict worse cognitive function, providing strong evidence for a cumulative inequality model.

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Stroke Prevention and Cognitive Reserve: Emerging Approaches to Modifying Risk and Delaying Onset of Dementia

Cited by 17 publications

References 88 publications

Vascular Cognitive Disorders and Depression After First-Ever Stroke: The Fogarty-Mexico Stroke Cohort

Vascular Cognitive Disorders and Depression After First-Ever Stroke: The Fogarty-Mexico Stroke Cohort

Brain and cognitive reserve: Translation via network control theory

Cognitive Disparities: The Impact of the Great Depression and Cumulative Inequality on Later-Life Cognitive Function

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