Background: It is unclear how post-stroke cognitive trajectories differ by stroke type and ischemic stroke subtype. We studied associations between stroke types (ischemic, hemorrhagic), ischemic stroke subtypes (cardioembolic, large artery atherosclerotic, lacunar/small vessel, cryptogenic/other determined etiology), and post-stroke cognitive decline.
Methods: This pooled cohort analysis from four US cohort studies (1971-2019) identified 1,143 dementia-free individuals with acute stroke during follow-up: 1,061 (92.
Background: The large and increasing number of adults living with dementia is a pressing societal priority, which may be partially mitigated through improved population-level blood pressure (BP) control. We explored how tighter population-level BP control affects the incidence of atherosclerotic cardiovascular disease (ASCVD) events and dementia.
Methods: Using an open-source ASCVD and dementia simulation analysis platform, the Michigan Chronic Disease Simulation Model, we evaluated how optimal implementation of 2 BP treatments based on the Eighth Joint National Committee recommendations and SPRINT (Systolic Blood Pressure Intervention Trial) protocol would influence population-level ASCVD events, global cognitive performance, and all-cause dementia.
Strategies to prevent or delay Alzheimer's disease and related dementias (AD/ADRD) are urgently needed, and blood pressure (BP) management is a promising strategy. Yet the effects of different BP control strategies across the life course on AD/ADRD are unknown. Randomized trials may be infeasible due to prolonged follow-up and large sample sizes.
View Article and Find Full Text PDFImportance: The magnitude of cognitive change after incident myocardial infarction (MI) is unclear.
Objective: To assess whether incident MI is associated with changes in cognitive function after adjusting for pre-MI cognitive trajectories.
Design, Setting, And Participants: This cohort study included adults without MI, dementia, or stroke and with complete covariates from the following US population-based cohort studies conducted from 1971 to 2019: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, Multi-Ethnic Study of Atherosclerosis, and Northern Manhattan Study.
Importance: Incident stroke is associated with accelerated cognitive decline. Whether poststroke vascular risk factor levels are associated with faster cognitive decline is uncertain.
Objective: To evaluate associations of poststroke systolic blood pressure (SBP), glucose, and low-density lipoprotein (LDL) cholesterol levels with cognitive decline.
Goals: Evidence suggests that patients with mild cognitive impairment (MCI) receive fewer treatments for acute ischemic stroke and other cardiovascular diseases than patients with normal cognition. Little is known about how patient and care partner preferences for ischemic stroke treatment differ between the patient population with MCI and the population with normal cognition. This study aimed to understand how patient MCI diagnosis influences patient and care partner decision-making for acute ischemic stroke treatments.
View Article and Find Full Text PDFBackground: Ethnic differences in cognitive decline have been reported. Whether they can be explained by differences in systolic blood pressure (SBP) is uncertain.
Objective: Determine whether cumulative mean SBP levels explain differences in cognitive decline between Hispanic and White individuals.
Background: Meta-analyses of individuals' cognitive data are increasing to investigate the biomedical, lifestyle, and sociocultural factors that influence cognitive decline and dementia risk. Pre-statistical harmonization of cognitive instruments is a critical methodological step for accurate cognitive data harmonization, yet specific approaches for this process are unclear.
Objective: To describe pre-statistical harmonization of cognitive instruments for an individual-level meta-analysis in the blood pressure and cognition (BP COG) study.
Actigraphy has been used to measure older adults' sleep, but few studies have evaluated the factor structure among actigraphy-measured sleep parameters. Additionally, previous studies have reported the association between actigraphy-measured and self-reported sleep parameters in older adults but have not controlled for covariates of gender, insomnia, cognitive impairment, depression, and health conditions. We therefore investigated the factor structure of actigraphy-measured sleep parameters and, controlling for covariates, the association between actigraphy-measured and self-reported sleep parameters in 62 older adults (female: 75.
View Article and Find Full Text PDFBackground: Dementia screening is an important step for appropriate dementia-related referrals to diagnosis and treat possible dementia.
Objective: We sought to estimate the prevalence of no reported dementia-related diagnosis in a nationally representative sample of older Americans with a cognitive impairment consistent with dementia (CICD).
Methods: The weighted analytical sample included 6,036,224 Americans aged at least 65 years old that were identified as having a CICD without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 Health and Retirement Study.
Importance: Sex differences in dementia risk are unclear, but some studies have found greater risk for women.
Objective: To determine associations between sex and cognitive decline in order to better understand sex differences in dementia risk.
Design, Setting, And Participants: This cohort study used pooled analysis of individual participant data from 5 cohort studies for years 1971 to 2017: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study.
Sleep-wake disturbances have been associated with episodic memory loss, but past studies were limited by use of single measures of objective or perceived disturbances. Notably, cognitive reserve and depressive symptoms have been associated with sleep-wake disturbances and poorer episodic memory in older adults. The aims of this study were to determine the relationship between episodic memory and sleep-wake disturbances using objective and perceived measures in older adults and to examine cognitive reserve and depressive symptoms as moderators of this relationship.
View Article and Find Full Text PDFImportance: Black individuals are more likely than white individuals to develop dementia. Whether higher blood pressure (BP) levels in black individuals explain differences between black and white individuals in dementia risk is uncertain.
Objective: To determine whether cumulative BP levels explain racial differences in cognitive decline.
Latinx populations are rapidly growing and aging in the United States. There is a critical need to accurately and efficiently detect those at risk for dementia, particularly those with mild cognitive impairment (MCI). MCI diagnosis often relies on neuropsychological assessment, although cultural, demographic, and linguistic characteristics may impact test scores.
View Article and Find Full Text PDFImpaired episodic memory in older adults has been linked to many factors. One of these factors is sleep disturbances, which are reported by more than 50% of older adults. The relationship between episodic memory and sleep disturbances remains unclear, however, because of the multiple types of measures of sleep and episodic memory used in previous studies.
View Article and Find Full Text PDFBackground: Evaluation of differences in neuropsychological outcomes in patients undergoing surgical clipping (SC) vs endovascular coiling (EC) for unruptured cerebral aneurysms is essential in guiding patients seeking treatment of asymptomatic cerebral aneurysms.
Objective: To perform a prospective longitudinal analysis of neuropsychological outcomes in patients who underwent microsurgery or coiling for unruptured cerebral aneurysms.
Methods: SC (50 patients), EC (35 patients), and healthy controls (43 individuals) were included.
Background: Barriers to recruiting and retaining acutely ill older adults in clinical research include complexity of illness, fatigue, and early discharge.
Objective: To describe recruitment and retention challenges of examining cognitive dysfunction in older adults hospitalized for acute heart failure.
Methods: An examination of the reasons for recruitment and retention issues within an acute care, university-affiliated health care system.
Self-schemas have received increased attention as favorable targets for therapeutic intervention because of their central role in self-perception and behavior. The purpose of this integrative review was to identify, evaluate, and synthesize existing research pertaining to drinking-related self-schemas. Russell's integrative review strategy guided the search.
View Article and Find Full Text PDFObjective: We aimed to explore factors associated with clinical evaluations for cognitive impairment among older residents of the United States.
Methods: Two hundred ninety-seven of 845 subjects in the Aging, Demographics, and Memory Study (ADAMS), a nationally representative community-based cohort study, met criteria for dementia after a detailed in-person study examination. Informants for these subjects reported whether or not they had ever received a clinical cognitive evaluation outside of the context of ADAMS.
Objective: The aim of this study was to assess the frequency and potential clinical impact of periodic leg movements during sleep (PLMS), with or without arousals, as recorded incidentally from children before and after adenotonsillectomy (AT).
Methods: Children scheduled for AT for any clinical indications who participated in the Washtenaw County Adenotonsillectomy Cohort II were studied at enrollment and again 6 months thereafter. Assessments included laboratory-based polysomnography, a Multiple Sleep Latency Test (MSLT), parent-completed behavioral rating scales, neuropsychological testing, and psychiatric evaluation.
Study Objectives: Pediatric obstructive sleep apnea (OSA) is associated with hyperactive behavior, cognitive deficits, psychiatric morbidity, and sleepiness, but objective polysomnographic measures of OSA presence or severity among children scheduled for adenotonsillectomy have not explained why. To assess whether sleep fragmentation might explain neurobehavioral outcomes, we prospectively assessed the predictive value of standard arousals and also respiratory cycle-related EEG changes (RCREC), thought to reflect inspiratory microarousals.
Methods: Washtenaw County Adenotonsillectomy Cohort II participants included children (ages 3-12 years) scheduled for adenotonsillectomy, for any clinical indication.
Background: Few studies have measured cognitive dysfunction in older adults during acute exacerbations of heart failure (HF), even though 25% of patients are readmitted within 30 days. The aims of this study were to examine cognitive dysfunction and acute HF symptoms in older adults hospitalized for HF and to evaluate the relationship between cognitive dysfunction and 30-day rehospitalization rates for acute HF.
Methods And Results: A cross-sectional descriptive design was used to characterize cognitive function in 53 older adults hospitalized for acute HF with the use of Cogstate computerized neuropsychologic tests.
Introduction: Assessment of the effects of disease on neurocognitive outcomes in children over time presents several challenges. These challenges are particularly pronounced when conducting studies in low-income countries, where standardization and validation is required for tests developed originally in high-income countries. We present a statistical methodology to assess multiple neurocognitive outcomes over time.
View Article and Find Full Text PDFWhether persons with dementia benefit from fall prevention exercise is unclear. Applying the Positive Emotion-Motivated Tai Chi protocol, preliminary findings concerning adherence and effects of a dyadic Tai Chi exercise program on persons with Alzheimer's disease (AD) are reported. Using pre/posttest design, 22 community-dwelling AD-caregiver dyads participated in the program.
View Article and Find Full Text PDFBackground: Esophageal pressure monitoring during polysomnography in children offers a gold-standard, “preferred” assessment for work of breathing, but is not commonly used in part because prospective data on incremental clinical utility are scarce. We compared a standard pediatric apnea/hypopnea index to quantitative esophageal pressures as predictors of apnea-related neurobehavioral morbidity and treatment response.
Methods: Eighty-one children aged 7.