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Stroke, dementia

Jessica Heward, Lydia Stone, Stella-Maria Paddick, Sarah Mkenda, William K Gray, Catherine L Dotchin, John Kissima, Cecilia Collingwood, Bernadetha Swai, Richard W Walker
BACKGROUND: The number of people living with dementia in sub-Saharan Africa (SSA) is expected to increase rapidly in the coming decades. However, our understanding of how best to reduce dementia risk in the population is very limited. As a first step in developing intervention strategies to manage dementia risk in this setting, we investigated rates of cognitive decline in a rural population in Tanzania and attempted to identify associated factors. METHODS: The study was conducted in the rural Hai district of northern Tanzania...
March 21, 2018: International Psychogeriatrics
Sven Haller, Meike W Vernooij, Joost P A Kuijer, Elna-Marie Larsson, Hans Rolf Jäger, Frederik Barkhof
Cerebral microbleeds (CMBs), also referred to as microhemorrhages, appear on magnetic resonance (MR) images as hypointense foci notably at T2*-weighted or susceptibility-weighted (SW) imaging. CMBs are detected with increasing frequency because of the more widespread use of high magnetic field strength and of newer dedicated MR imaging techniques such as three-dimensional gradient-echo T2*-weighted and SW imaging. The imaging appearance of CMBs is mainly because of changes in local magnetic susceptibility and reflects the pathologic iron accumulation, most often in perivascular macrophages, because of vasculopathy...
April 2018: Radiology
Alberto Avolio, Mi Ok Kim, Audrey Adji, Sumudu Gangoda, Bhargava Avadhanam, Isabella Tan, Mark Butlin
PURPOSE OF REVIEW: Concepts of pulsatile arterial haemodynamics, including relationships between oscillatory blood pressure and flow in systemic arteries, arterial stiffness and wave propagation phenomena have provided basic understanding of underlying haemodynamic mechanisms associated with elevated arterial blood pressure as a major factor of cardiovascular risk, particularly the deleterious effects of isolated systolic hypertension in the elderly. This topical review assesses the effects of pulsatility of blood pressure and flow in the systemic arteries on the brain...
March 19, 2018: Current Hypertension Reports
Emily A Kringle, Lauren Terhorst, Meryl A Butters, Elizabeth R Skidmore
OBJECTIVES: The purpose of this exploratory study was to identify clinical predictors that could distinguish clients' level of engagement in inpatient rehabilitation following stroke. METHODS: This is a secondary analysis of pooled data from three randomized controlled trials that examined the effects of a behavioral intervention. The sample (n=208) consisted of clients with stroke who had cognitive deficits (Quick-EXIT≥3) and were admitted to inpatient rehabilitation facilities associated with a university medical center...
March 19, 2018: Journal of the International Neuropsychological Society: JINS
Jun-Jun Yeh, Yu-Feng Wei, Cheng-Li Lin, Wu-Huei Hsu
Background: To evaluate the association of asthma-chronic obstructive pulmonary disease syndrome (ACOS) with neurodegenerative diseases (stroke, Parkinson's disease and dementia) and the role of the steroids in the neurodegenerative diseases among the ACOS cohort. Materials and Methods: Comparison of the ACOS cohort ( N = 10,260) with the non-ACOS cohort ( n = 20,513) based on the patients aged ≧40 years in the National Health Insurance Research Database from January 1, 2000 to December 31, 2010...
February 23, 2018: Oncotarget
John R Best, Janice J Eng, Jennifer C Davis, Robin Hsiung, Peter A Hall, Laura E Middleton, Peter Graf, Charles H Goldsmith, Teresa Liu-Ambrose
INTRODUCTION: Cerebrovascular disease-such as stroke-is the second most common cause of dementia (ie, vascular dementia). Specifically, a stroke increases one's risk for dementia by a factor of two. Thus, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. The current standard of care in stroke rehabilitation does not adequately address the significant cognitive consequences of stroke, especially for those who are in the chronic phase (ie, >12 months since an index stroke)...
March 17, 2018: BMJ Open
Ayesha Sherzai, Bruce Ovbiagele, Dean Sherzai
BACKGROUND: Little is known about how prevalent dementia rates among patients with stroke have evolved over the last decade or how this relationship varies by gender, race ethnicity, stroke type, or dementia type. We assessed time trends and demographic predictors of coexisting dementia in a large cohort of patients hospitalized for stroke. MATERIALS AND METHODS: Patient admission data between 1999 and 2012 were sourced from the National Inpatient Sample. Patient admission records were included in the retrospective analysis if they were diagnosed with ischemic or hemorrhagic stroke during admission...
March 14, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Makoto Hara, Eugenia Martinez-Hernandez, Helena Ariño, Thais Armangué, Marianna Spatola, Mar Petit-Pedrol, Albert Saiz, Myrna R Rosenfeld, Francesc Graus, Josep Dalmau
OBJECTIVE: To determine the frequency and clinical relevance of immunoglobulin (Ig)G, IgA, and IgM N -methyl-d-aspartate receptor (NMDAR) antibodies in several diseases, and whether the IgG antibodies occur in disorders other than anti-NMDAR encephalitis. METHODS: Evaluation of IgG, IgA, and IgM NMDAR antibodies in serum of 300 patients with anti-NMDAR encephalitis, stroke, dementia, schizophrenia, or seronegative autoimmune encephalitis. Antibodies and their effect on cultured neurons were examined with cell-based assays and brain and live neuronal immunostaining...
March 16, 2018: Neurology
Xin Zhao, Jinyu Liu, Shijun Yang, Dandan Song, Chen Wang, Chen Chen, Xiaoya Li, Qiuting Wang, Shasha Ge, Runmei Yang, Xiuhua Liu, Yulin Lin, Dayong Cai
ETHNOPHARMACOLOGICAL RELEVANCE: Vascular dementia (VaD) is the common cognitive disorder derived mainly from lacunar stroke (LS). The oxidative stress induced neurovascular coupling (NVC) dysfunction involves in the pathogenesis of VaD. Currently, there is no specific drug for VaD. Ling-Yang-Gou-Teng -Decoction (LG), a well-known traditional Chinese formula, has been used for preventing VaD in clinic. AIM OF THE STUDY: In this study, we aimed to investigate the underlying mechanism of LG on VaD in rats...
March 12, 2018: Journal of Ethnopharmacology
Paola Gilsanz, Elizabeth Rose Mayeda, Jason Flatt, M Maria Glymour, Charles P Quesenberry, Rachel A Whitmer
BACKGROUND: Poor pulmonary function (PPF) is associated with increased risk of dementia, yet it is unclear if PPF in early adulthood to midlife increases risk, independent of smoking and subsequent vascular disease. OBJECTIVE: This study evaluated the association between multiple markers of PPF in early adulthood to midlife and long-term risk of dementia. METHODS: We evaluated 27,387 members of an integrated health care system with forced expiratory volume in 1, 2 seconds, and vital capacity collected from 1964 to 1973 (mean age=41...
March 14, 2018: Alzheimer Disease and Associated Disorders
Graciela Muniz-Terrera, Fernando Massa, Tatiana Benaglia, Boo Johansson, Andrea Piccinin, Annie Robitaille
OBJECTIVES: To model trajectories of visuospatial reasoning measured using Kohs Block Design test under realistic missing data assumptions and evaluate their association with hazard of death. METHODS: A joint longitudinal-survival model was used to estimate trajectories of visuospatial reasoning under a missing not at random assumption of participants from the Origins of Variance in the Old-Old: Octogenarian Twins study. Sensitivity analyses to missing data assumptions were conducted...
March 1, 2018: Journal of Aging and Health
Jacek Staszewski, Renata Piusińska-Macoch, Ewa Skrobowska, Bogdan Brodacki, Katarzyna Macek, Adam Stępień
BACKGROUND: The clinical significance of aspirin resistance (AR) in patients with symptomatic cerebrovascular disease is not well known. The aim of this single-center, prospective study was to examine the prevalence, risk factors and prognostic significance of AR in patients with different clinical manifestations of cerebral small vessel disease (CSVD) over 24-month follow-up. METHODS: We studied 104 patients with MRI confirmed CSVD, including those with recent lacunar stroke (LS, n=49), vascular parkinsonism (VaP, n=16) and dementia (VaD, n=39)...
January 2018: Annals of Clinical and Laboratory Science
Beatrice J Edwards, Xiaotao Zhang, Ming Sun, Holly M Holmes, Leena Ketonen, Nandita Guha, Peter Khalil, Juhee Song, Shelli Kesler, Jay B Shah, Debasish Tripathy, Vicente Valero, Richard E Champlin
OBJECTIVE: To assess cognitive function in older adults undergoing cancer care. MATERIALS AND METHODS: This is a cross-sectional study, in the University of Texas MD Anderson Cancer Center, in older adults undergoing cancer care. Comprehensive geriatric assessments were conducted prior to surgery, chemotherapy or allogeneic stem cell transplantation, at the Program for Healthy Aging from January 1, 2013 through March 31, 2015. Cognitive assessment was conducted through personal and family interview, and the Montreal cognitive assessment (MoCA)...
March 9, 2018: Journal of Geriatric Oncology
Wenke Cheng, Weijun Liu, Bin Li, Dongfang Li
BACKGROUND: Currently, it is considered that atrial fibrillation (AF) is a risk factor for cognitive impairment and dementia, which is independent of stroke. However, the relationship between anticoagulant drugs and cognitive function in patients with atrial fibrillation is unknown. OBJECTIVES: This study aimed to complete a meta-analysis, and investigate the association between Anticoagulant therapy and cognitive impairment in patients undergoing AF. METHODS AND RESULTS: Two investigators systematically searched the Cochrane Library, PubMed, Embase databases and Web of Science for all studies showing associations...
March 2, 2018: Journal of Cardiovascular Pharmacology
Xin Zhao, Jinyu Liu, Shijun Yang, Dandan Song, Chen Wang, Chen Chen, Chengcheng Wang, Feifei Pu, Runmei Yang, Xiaoya Li, Qiuting Wang, Shasha Ge, Yulin Lin, Xiuhua Liu, Dayong Cai
Vascular dementia (VaD) is the common cognitive disorder derived mainly from lacunar stroke. The neurovascular coupling (NVC) dysfunction involves in its pathogenesis. VaD lacks suitable animal models for developing preventive therapies. This study aimed to confirm a model for preventing VaD via maintaing NVC sensitivity in rats. The model was replicated with autologous microthrombi against the background of hypercholesterolemia. A phosphodiesterase inhibitor (pentoxyfylline) was preventively administrated to confirm the role of NVC sensitivity...
March 8, 2018: European Journal of Pharmacology
Richard Salazar
INTRODUCTION: Sporadic Creutzfeldt-Jakob disease is a prion disease characterized by rapidly progressive dementia, ataxia and myoclonus. Atypical phenotype masquerading as stroke, movement disorders or autoimmune encephalitis have been described. Here, I report a probable case of sCJD with an atypical presentation associated with anti-Zic4 antibody and review the literature of neuronal antibodies in CJD. CASE REPORT: A 70 year-old gentleman is admitted with a 2-month history of recurrent stroke-like symptoms associated with behavioral disturbances, gait ataxia and rapidly progressive dementia...
March 5, 2018: Clinical Neurology and Neurosurgery
M Fareed K Suri, Jincheng Zhou, Ye Qiao, Haitao Chu, Adnan I Qureshi, Tom Mosley, Rebecca F Gottesman, Lisa Wruck, A Richey Sharrett, Alvaro Alonso, Bruce A Wasserman
OBJECTIVE: To investigate the association between asymptomatic intracranial atherosclerosis and cognitive impairment in the Atherosclerosis Risk in Communities (ARIC) cohort. METHODS: ARIC participants underwent high-resolution 3T magnetic resonance angiography and a neuropsychology battery and neurologic examination adjudicated by an expert panel to detect mild cognitive impairment (MCI) and dementia. We adjusted for demographic and vascular risk factors in weighted logistic regression analysis, accounting for stratified sampling design and attrition, to determine the association of intracranial atherosclerotic stenosis (ICAS) with cognitive impairment...
March 9, 2018: Neurology
Lin Y Chen, Faye L Norby, Rebecca F Gottesman, Thomas H Mosley, Elsayed Z Soliman, Sunil K Agarwal, Laura R Loehr, Aaron R Folsom, Josef Coresh, Alvaro Alonso
BACKGROUND: Previous studies have reported that atrial fibrillation (AF) is associated with cognitive decline and dementia. These studies, however, had limited follow-up, were based mostly on white and highly selected populations, and did not account for attrition. We evaluated the association of incident AF with 20-year change in cognitive performance (accounting for attrition) and incident dementia in the ARIC (Atherosclerosis Risk in Communities) Study. METHODS AND RESULTS: We analyzed data from 12 515 participants (mean age, 56...
March 7, 2018: Journal of the American Heart Association
Oliver T Mytton, Christopher Jackson, Arno Steinacher, Anna Goodman, Claudia Langenberg, Simon Griffin, Nick Wareham, James Woodcock
BACKGROUND: The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. However, its current benefit and impact on health inequalities are unknown. It is also unclear whether feasible changes in how it is delivered could result in increased benefits. It is one of the first such programmes in the world. We sought to estimate the health benefits and effect on inequalities of the current NHS Health Check programme and the impact of making feasible changes to its implementation...
March 2018: PLoS Medicine
Patrick M Zueger, Holly M Holmes, Gregory S Calip, Dima M Qato, A Simon Pickard, Todd A Lee
OBJECTIVES: To describe medications that older hospice beneficiaries receive through Medicare Part D and assess patterns in Part D use for individuals admitted to hospice for cancer and noncancer causes. DESIGN: Descriptive cohort analysis using the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. SETTING: U.S. hospice programs PARTICIPANTS: Part D-enrolled Medicare beneficiaries aged 66 and older who were admitted to hospice and died while under hospice care between January 1, 2008, and December 31, 2013 (N = 88,957)...
March 6, 2018: Journal of the American Geriatrics Society
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