Global cerebrovascular burden and long-term clinical outcomes in Asian elderly across the spectrum of cognitive impairment.
Int Psychogeriatr
; 30(9): 1355-1363, 2018 09.
Article
en En
| MEDLINE
| ID: mdl-29665875
ABSTRACT
ABSTRACTBackground/Aim:
To investigate the predictive ability of the previously established global cerebrovascular disease (CeVD) burden scale on long-term clinical outcomes in a longitudinal study of Asian elderly participants across the spectrum of cognitive impairment.METHODS:
A case-control study was conducted over a 2-year period involving participants with no cognitive impairment, cognitive impairment-no dementia (CIND), and Alzheimer's disease (AD). Annually, cognitive function was assessed with a comprehensive neuropsychological battery and the clinical dementia rating (CDR) scale was used to stage disease severity.RESULTS:
Of 314 participants, 102 had none/very mild CeVD, 31 mild CeVD, 94 moderate CeVD, and 87 severe CeVD at baseline. There was a 1.14 and 1.42 units decline per year on global cognitive z-scores in moderate and severe CeVD groups, respectively, compared to none/very mild CeVD. Moderate-severe CeVD predicted significant functional deterioration at year 2 (HR = 2.0, 95% CI = 1.2-3.4), and conversion to AD (HR = 6.3, 95% CI = 1.7-22.5), independent of medial temporal atrophy.CONCLUSION:
The global CeVD burden scale predicts poor long-term clinical outcome independent of neurodegenerative markers. Furthermore, CeVD severity affects the rate of cognitive and functional deterioration. Hence, cerebrovascular burden, which is potentially preventable, is a strong prognostic indicator, both at preclinical and clinical stages of AD, independent of neurodegenerative processes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Trastornos Cerebrovasculares
/
Costo de Enfermedad
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Enfermedad de Alzheimer
/
Disfunción Cognitiva
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
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Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
Int Psychogeriatr
Asunto de la revista:
GERIATRIA
/
PSIQUIATRIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Singapur