Subclinical Atherosclerosis and Brain Metabolism in Middle-Aged Individuals

Cortes‐Canteli, Marta; Gispert, Juan Domingo; Salvadó, Gemma; Toribio-Fernández, Raquel; Tristão‐Pereira, Catarina; Falcon, Carles; Oliva, Belén; Mendiguren, José M.; Fernández‐Friera, Leticia; Sanz, Javier; García-Ruiz, José M.; Fernández‐Ortíz, Antonio; Sánchez‐González, Javier; Ibáñez, Borja; Molinuevo, José Luís; Fuster, Valentín

doi:10.1016/j.jacc.2020.12.027

Cited by 30 publications

(29 citation statements)

References 51 publications

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“…48 Preclinical markers of cardiovascular disease (such as subclinical atherosclerosis, aortic stiffness, and intima-media thickness of the carotid artery) have been linked to both an increased risk of AF and cognitive impairment. 15,48,49…”

Section: Inflammation and Atherosclerotic Vascular Diseasementioning

confidence: 99%

“…Furthermore, the relationship between AF and dementia is complex, because they share epidemiologic similarities and several risk factors such as advanced age, arterial hypertension, diabetes, hyperlipidemia, sleep apnea, coronary artery disease, heart failure, chronic kidney disease, obesity, physical inactivity, and excessive alcohol consumption. 14,15 It is therefore pertinent to question whether the association between AF and cognitive impairment/dementia could be explained by shared pathophysiology or whether AF is implicated in the causal pathway (Table 1). The association between AF and cognitive impairment/dementia seems to persist even after adjusting for known risk factors 6,10,16,17 and is stronger in younger patients compared with older patients with a higher burden of shared risk factors, which would not be expected if the association was purely attributable to confounding.…”

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confidence: 99%

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Atrial Fibrillation and Dementia: A Report From the AF-SCREEN International Collaboration

et al. 2022

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Growing evidence suggests a consistent association between atrial fibrillation (AF) and cognitive impairment and dementia that is independent of clinical stroke. This report from the AF-SCREEN International Collaboration summarizes the evidence linking AF to cognitive impairment and dementia. It provides guidance on the investigation and management of dementia in patients with AF on the basis of best available evidence. The document also addresses suspected pathophysiologic mechanisms and identifies knowledge gaps for future research. Whereas AF and dementia share numerous risk factors, the association appears to be independent of these variables. Nevertheless, the evidence remains inconclusive regarding a direct causal effect. Several pathophysiologic mechanisms have been proposed, some of which are potentially amenable to early intervention, including cerebral microinfarction, AF-related cerebral hypoperfusion, inflammation, microhemorrhage, brain atrophy, and systemic atherosclerotic vascular disease. The mitigating role of oral anticoagulation in specific subgroups (eg, low stroke risk, short duration or silent AF, after successful AF ablation, or atrial cardiopathy) and the effect of rhythm versus rate control strategies remain unknown. Likewise, screening for AF (in cognitively normal or cognitively impaired patients) and screening for cognitive impairment in patients with AF are debated. The pathophysiology of dementia and therapeutic strategies to reduce cognitive impairment warrant further investigation in individuals with AF. Cognition should be evaluated in future AF studies and integrated with patient-specific outcome priorities and patient preferences. Further large-scale prospective studies and randomized trials are needed to establish whether AF is a risk factor for cognitive impairment, to investigate strategies to prevent dementia, and to determine whether screening for unknown AF followed by targeted therapy might prevent or reduce cognitive impairment and dementia.

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Section: Inflammation and Atherosclerotic Vascular Diseasementioning

confidence: 99%

mentioning

confidence: 99%

Atrial Fibrillation and Dementia: A Report From the AF-SCREEN International Collaboration

et al. 2022

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“…21 In middle-aged individuals in the general population, it was shown that the risk for CVD is correlated with a decreased level of brain metabolism and that the major contributing factor for this relationship was hypertension. 22 Even more important, it has been shown that the reduction in brain metabolism is linked to the presence of cardiovascular risk factors even before the clinical symptoms are evident. 22 Recently, a post-mortem analysis investigating the roles of atherosclerosis and cerebral small vessel disease in vascular comorbidities in PwMS has been published.…”

Section: Discussionmentioning

confidence: 99%

“…22 Even more important, it has been shown that the reduction in brain metabolism is linked to the presence of cardiovascular risk factors even before the clinical symptoms are evident. 22 Recently, a post-mortem analysis investigating the roles of atherosclerosis and cerebral small vessel disease in vascular comorbidities in PwMS has been published. 23 Firstly, it was found that, in comparison with MS-free controls, PwMs who died at an earlier age experienced lower systemic cardiovascular and greater cerebral small vessel disease burden.…”

Section: Discussionmentioning

confidence: 99%

“…This association was observed in older individuals with both mild cognitive impairment and dementia 21 . In middle‐aged individuals in the general population, it was shown that the risk for CVD is correlated with a decreased level of brain metabolism and that the major contributing factor for this relationship was hypertension 22 . Even more important, it has been shown that the reduction in brain metabolism is linked to the presence of cardiovascular risk factors even before the clinical symptoms are evident 22 …”

Section: Discussionmentioning

confidence: 99%

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Impact of comorbidities on the disability progression in multiple sclerosis

Marić

Pekmezović

Tamaš

et al. 2021

Acta Neuro Scandinavica

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Multiple sclerosis (MS) is a chronic demyelinating neurological disorder predominantly affecting young adults. Based on the data of the MS Atlas 2020, there are 2.8 million people living with MS worldwide. 1 Investigation of the comorbidity burden in persons with MS (PwMS) has become increasingly important since studies have shown that co-occurring conditions may have negative effects on health outcomes in PwMS. 2-4 Among different comorbidity groups, cardiovascular diseases (CVD) are of particular interest because of their high prevalence in the general population, high rank among

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Omega‐3 blood biomarkers relate to brain glucose uptake in individuals at risk of Alzheimer's disease dementia

Lázaro,

Grau‐Rivera,

Suárez‐Calvet

et al. 2024

Alz & Dem Diag Ass & Dis Mo

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INTRODUCTIONBrain glucose hypometabolism is a preclinical feature of Alzheimer's disease (AD). Dietary omega‐3 fatty acids promote brain glucose metabolism, but clinical research is incipient. Circulating omega‐3s objectively reflect their dietary intake.METHODSThis was a cross‐sectional study in 320 cognitively unimpaired participants at increased risk of AD dementia. Using lipidomics, we determined blood docosahexaenoic (DHA) and alpha‐linolenic (ALA) acid levels (omega‐3s from marine and plant origin, respectively). We assessed brain glucose metabolism using [18‐F]‐fluorodeoxyglucose (FDG) positron emission tomography (PET).RESULTSBlood ALA directly related to FDG uptake in brain areas known to be affected in AD. Stronger associations were observed in apolipoprotein E ε4 carriers and homozygotes. For DHA, significant direct associations were restricted to amyloid beta–positive tau‐positive participants.DISCUSSIONBlood omega‐3 directly relate to preserved glucose metabolism in AD‐vulnerable brain regions in individuals at increased risk of AD dementia. This adds to the benefits of omega‐3 supplementation in the preclinical stage of AD dementia.Highlights Blood omega‐3s were related to brain glucose uptake in participants at risk of Alzheimer's disease (AD) dementia. Complementary associations were observed for omega‐3 from marine and plant sources. Foods rich in omega‐3 might be useful in early features of AD.

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Subclinical Atherosclerosis and Brain Metabolism in Middle-Aged Individuals

Cited by 30 publications

References 51 publications

Atrial Fibrillation and Dementia: A Report From the AF-SCREEN International Collaboration

Atrial Fibrillation and Dementia: A Report From the AF-SCREEN International Collaboration

Impact of comorbidities on the disability progression in multiple sclerosis

Omega‐3 blood biomarkers relate to brain glucose uptake in individuals at risk of Alzheimer's disease dementia

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