Additive effect of cerebral atrophy on cognition in dementia-free elderly with cerebrovascular disease

• Published in: Stroke and vascular neurology 2019-09, Vol.4 (3), p.135-140
• Main Authors: Xu, Xin, Phua, April, Collinson, Simon L, Hilal, Saima, Ikram, Mohammad Kamran, Wong, Tien Yin, Cheng, Ching Yu, Venketasubramanian, Narayanaswamy, Chen, Christopher
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer's disease; Atrophy; Blood pressure; Brain - diagnostic imaging; Brain - pathology; Brain research; Cardiovascular disease; Cerebrovascular disease; Cerebrovascular Disorders - diagnostic imaging; Cerebrovascular Disorders - epidemiology; Cerebrovascular Disorders - pathology; Cognition; Cognition & reasoning; Cognitive ability; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - epidemiology; Cognitive Dysfunction - psychology; Cross-Sectional Studies; Dementia; Diabetes; Epidemiology; Female; Humans; Hypertension; Magnetic Resonance Imaging; Male; Medical imaging; Memory; Middle Aged; Neuroimaging; Neuropsychological Tests; Neuropsychology; Original; Original article; Population; Risk Factors; Severity of Illness Index; Singapore - epidemiology
• ISSN: 2059-8688; 2059-8696
• DOI: 10.1136/svn-2018-000202

ObjectiveTo explore the additive effect of neurodegenerative diseases, measured by atrophy, on neurocognitive function in Asian dementia-free elderly with cerebrovascular disease (CeVD).MethodsThe present study employed a cross-sectional design and was conducted between 2010 and 2015 among community-dwelling elderly participants recruited into the study. Eligible participants were evaluated with an extensive neuropsychological battery and neuroimaging. The weighted CeVD burden scale comprising markers of both small- and large-vessel diseases was applied, with a score of ≥2, indicating significant CeVD burden. Cortical atrophy (CA) and medial temporal atrophy (MTA) were graded using the global cortical atrophy scale and Schelten’s scale, respectively. Global and domain-specific (attention, executive function, language, visuomotor speed, visuoconstruction, visual memory, and verbal memory) neurocognitive performance was measured using a locally validated neuropsychological battery (Vascular Dementia Battery, VDB).ResultsA total of 819 dementia-free participants were included in the analysis. Among none-mild CeVD subjects, there was no significant difference in the global cognitive performance across atrophy groups (no atrophy, CA, and CA+MTA). However, in moderate-severe CeVD subjects, CA+MTA showed significantly worse global cognitive performance compared with those with CA alone (mean difference=−0.35, 95% CI −0.60 to −0.11, p=0.002) and those without atrophy (mean difference=−0.46, 95% CI −0.74 to −0.19, p