Preventing Covert Brain Infarct-Related Cognitive Impairment and Dementia

Durrani, Romella; Hill, Michael D.; Smith, Eric E.

doi:10.1017/cjn.2020.45

Cited by 7 publications

(6 citation statements)

References 52 publications

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“…Most of the research on cognitive reserve has focused on markers that influence the expression of Alzheimer disease pathology in older individuals, with comparatively few studies of cognitive reserve in midlife or of cognitive dysfunction from cerebrovascular pathology. 2 A few studies suggest that the association of white matter hyperintensities (WMH) with lower cognition is attenuated in persons with higher education. 3 However, whether other potential factors modify the degree of cognitive dysfunction in persons with WMH is not known.…”

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confidence: 99%

Effect of Cognitive Reserve on the Association of Vascular Brain Injury With Cognition

Durrani

Friedrich²,

Schulze³

et al. 2021

Neurology

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Objective:To determine whether cognitive reserve attenuates the association of vascular brain injury with cognition.Methods:Cross-sectional data were analyzed from two harmonized studies: the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and the Prospective Urban and Rural Epidemiology (PURE) study. Markers of cognitive reserve were education, involvement in social activities, marital status, height, and leisure physical activity, which were combined into a composite score. Vascular brain injury was defined asnon-lacunar brain infarcts or high white matter hyperintensity (WMH) burden on MRI. Cognition was assessed using the Montreal Cognitive Assessment Tool (MoCA) and the Digit Symbol Substitution Test (DSST).Results:There were 10,450 participants age 35-81. Mean age was 58.8 years (range 35 to 81) and 55.8% were female. Education, moderate leisure physical activity, being in a marital partnership, being taller, and participating in social groups were each independently associated with higher cognition, as was the composite cognitive reserve score. Vascular brain injury was associated with lower cognition (beta-0.35 [95% CI -0.53 to -0.17] for MoCA and beta -2.19 [95% CI-3.22 to -1.15] for DSST)-but the association was not modified by the composite cognitive reserve variable (interaction p=0.59 for MoCA and p=0.72 for DSST).Conclusions:Both vascular brain injury and markers of cognitive reserve are associated with cognition. However, the effects were independent such that the adverse effects of covert vascular brain injury were not attenuated by higher cognitive reserve. To improve cognitive brain health, interventions to both prevent cerebrovascular disease and promote positive lifestyles are needed.

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confidence: 99%

Effect of Cognitive Reserve on the Association of Vascular Brain Injury With Cognition

Durrani

Friedrich²,

Schulze³

et al. 2021

Neurology

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“…A limitation of literature on cognitive reserve is that it has mostly been tested in the context of Alzheimer's disease (AD) pathology, where the hypothesis has gained some support [5]. There are few studies on whether cognitive reserve can mitigate the adverse effects of vascular brain pathology, such as white matter hyperintensities (WMHs).…”

Section: Introductionmentioning

confidence: 99%

“…A limitation of literature on cognitive reserve is that it has mostly been tested in the context of Alzheimer’s disease (AD) pathology, where the hypothesis has gained some support. There are few studies on whether cognitive reserve can mitigate the adverse effects of vascular brain pathology, such as white matter hyperintensities (WMHs) [ 5 ]. This is important because vascular pathology is the second biggest contributor to dementia, present in the brain of most persons with AD, mild cognitive impairment (MCI), and dementia.…”

Section: Introductionmentioning

confidence: 99%

Vascular Brain Lesions, Cognitive Reserve, and Their Association with Cognitive Profile in Persons with Early-Stage Cognitive Decline

Durrani

Badhwar

Bhangu

et al. 2022

Journal of Alzheimer's Disease Reports

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“…Epidemiological research showed that silent cerebrovascular disease is five times more prevalent than symptomatic brain infarcts (10) and is associated with future risk for stroke and dementia (11) , thus representing an important opportunity for stroke prevention (1) .…”

Section: Introductionmentioning

confidence: 99%

Positive Susceptibility Vessel Sign on SWI-MRI Sequence Imaging Might Differentiate Patients Had Silent Brain Ischemia among Apparently Neurologically-Free Patients

hemeda

2022

The Egyptian Journal of Hospital Medicine

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Background: The susceptibility-weighted imaging (SWI) is an essential MRI sequence in the assessment of acute ischemic stroke. Silent cerebrovascular disease is five times more prevalent than symptomatic brain infarcts and is associated with future risk for stroke and dementia. Objectives: Evaluation of the diagnostic performance of susceptibility-weighted magnetic resonance sequence imaging (SWI) for early diagnosis of silent brain infarction (SBI) in apparently neurologically-free patients presented by transient neurological manifestations. Patients and Methods:The study included 218 patients who were clinically evaluated for demographic, clinical data concerning presence of chronic medical diseases, presenting symptoms and its frequency and severity. Routine lab investigations and lipid profile were performed and the plasma atherogenic index (PAI) for oncoming cardiovascular insults was calculated. MRI scan was performed using 1.5 T MRI scanner (Toshiba Vantage) with a head coil. Results: 102 patients (46.8%) had chronic medical diseases and hypertension (HTN) and diabetes mellitus (DM) are the most common. The commonest complaint was occasional amnesia, slurred speech and weak handgrip. PAI defined 53 patients at high, 101 patients at intermediate and 64 patients at low risk of cardiovascular insults. Susceptibility vein sign (SVS)+ were detected in 78 SWI scans and showed positive significant correlation with smoking, multiple comorbidities, presence of chronic kidney disease, DM, hypertension and with PAI. Conclusion:The presence of SVS in SWI during MRI examination is pathognomonic sign for the presence of SBI. The incidence of SBI on SWI scans of apparently neurologically free patients who presented by transient neurological manifestations is high and was found to be associated with the presence of chronic medical diseases especially in obese dyslipidemic patients.

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Preventing Covert Brain Infarct-Related Cognitive Impairment and Dementia

Cited by 7 publications

References 52 publications

Effect of Cognitive Reserve on the Association of Vascular Brain Injury With Cognition

Effect of Cognitive Reserve on the Association of Vascular Brain Injury With Cognition

Vascular Brain Lesions, Cognitive Reserve, and Their Association with Cognitive Profile in Persons with Early-Stage Cognitive Decline

Positive Susceptibility Vessel Sign on SWI-MRI Sequence Imaging Might Differentiate Patients Had Silent Brain Ischemia among Apparently Neurologically-Free Patients

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