309 research outputs found
MRI Biomarkers of Vascular Damage and Atrophy Predicting Mortality in a Memory Clinic Population
Progression of Mild Cognitive Impairment to Dementia Contribution of Cerebrovascular Disease Compared With Medial Temporal Lobe Atrophy
Patients With Alzheimer Disease With Multiple Microbleeds Relation With Cerebrospinal Fluid Biomarkers and Cognition
An Operational Definition of ‘Abnormal Cognition’ to Optimize the Prediction of Progression to Dementia: What Are Optimal Cut-Off Points for Univariate and Multivariate Normative Comparisons?
Cerebral Blood Flow by Using Pulsed Arterial Spin-Labeling in Elderly Subjects with White Matter Hyperintensities
Cerebrospinal fluid markers for differential dementia diagnosis in a large memory clinic cohort.
Accelerating regional atrophy rates in the progression from normal aging to Alzheimer's disease
Trajectories and Determinants of Quality of Life in Dementia with Lewy Bodies and Alzheimer's Disease
Background: Quality of Life (QoL) is an important outcome measure in dementia, particularly in the context of interventions.
Research investigating longitudinal QoL in dementia with Lewy bodies (DLB) is currently lacking.
Objective: To investigate determinants and trajectories of QoL in DLB compared to Alzheimer’s disease (AD) and controls.
Methods: QoL was assessed annually in 138 individuals, using the EQ5D-utility-score (0–100) and the health-related Visual
Analogue Scale (VAS, 0–100). Twenty-nine DLB patients (age 69 ± 6), 68 AD patients (age 70 ± 6), and 41 controls (age
70 ± 5) were selected from the Dutch Parelsnoer Institute-Neurodegenerative diseases and Amsterdam Dementia Cohort. We
examined clinical work-up over time as determinants of QoL, including cognitive tests, neuropsychiatric inventory, Geriatric
Depression Scale (GDS), and disability assessment of dementia (DAD).
Results: Mixed models showed lower baseline VAS-scores in DLB compared to AD and controls (AD: ±SE = -7.6 ± 2.8,
controls: ±SE = -7.9 ± 3.0, p < 0.05). An interaction between diagnosis and time since diagnosis indicated steeper decline
on VAS-scores for AD patients compared to DLB patients (±SE = 2.9 ± 1.5, p < 0.1). EQ5D-utility-scores over time did not
differ between groups. Higher GDS and lower DAD-scores were independently associated with lower QoL in dementia patients
(GDS: VAS ±SE = -1.8 ± 0.3, EQ5D-utility ±SE = -3.7 ± 0.4; DAD: VAS = 0.1 ± 0.0, EQ5D-utility ±SE = 0.1 ± 0.1,
p < 0.05). No associations between cognitive tests and QoL remained in the multivariate model.
Conclusion: QoL is lower in DLB, while in AD QoL shows steepe
Brain atrophy accelerates cognitive decline in cerebral small vessel disease: The LADIS study
Objective: To examine the independent contributions and combined interactions of medial temporal lobe atrophy (MTA), cortical and subcortical atrophy, and white matter lesion (WML) volume in longitudinal cognitive performance. Methods: A total of 477 subjects with age-relatedWMLwere evaluated with brain MRI and annual neuropsychological examinations in 3-year follow-up. Baseline MRI determinants of cognitive decline were analyzed with linear mixed models controlling for multiple confounders. Results: MTA and subcortical atrophy predicted significantly steeper rate of decline in global cognitive measures as well as compound scores for psychomotor speed, executive functions, and memory after adjusting for age, gender, education, lacunes/infarcts, and WML volume. Cortical atrophy independently predicted decline in psychomotor speed. WML volume remained significantly associated with cognitive decline even after controlling for the atrophy scores. Moreover, significant synergistic interactions were found between WML and atrophy measures in overall cognitive performance across time and the rate of cognitive decline. Synergistic effects were also observed between baseline lacunar infarcts and all atrophy measures on change in psychomotor speed. The main results remained robust after exclusion of subjects with clinical stroke or incident dementia, and after additional adjustments for progression of WML and lacunes. Conclusions: Brain atrophy and WML are independently related to longitudinal cognitive decline in small vessel disease. MTA, subcortical, and cortical atrophy seem to potentiate the effect ofWML and lacunes on cognitive decline
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