[Show abstract][Hide abstract]ABSTRACT: Subcortical lacunar infarcts and white matter hyperintensities (WMH) are common neuroradiological findings, but few studies associate between these insults and cognition in a community-dwelling population.
The Dallas Heart Study is a population-based initiative whose assessments included demographic and clinical findings including brain MRI and the Montreal Cognitive Assessment (MoCA). The presence and number of lacunes in subjects aged over 55 years were assessed by study physicians. The WMH volume was measured by an automated method. The association between the presence and number of lacunar infarcts and of WMH volume with the total MoCA score and subdomains was assessed using linear regression with adjustment for age, gender and self-reported ethnicity.
In 609 subjects with valid data, both the presence and the increasing number of lacunes were associated with lower MoCA scores, even after adjusting for demographic variables. The presence of lacunes was also associated with lower scores in the memory, executive and attention subdomains. The WMH volume was not significantly associated with the MoCA score.
The presence and increasing number of lacunes in midlife is associated with a lower performance in multiple domains of a cognitive screening measure after adjusting for demographic factors.
[Show abstract][Hide abstract]ABSTRACT: Background and purpose:
Age-related white matter hyperintensities have prognostic implications, but no accepted clinical standard exists for their assessment. We propose a simple objective visual rating system by using 3T brain MR imaging.
Materials and methods:
MR imaging from 559 participants was processed by using an automated method to determine WMH volumes and evaluated with a new visual rating scale based on the single largest WMH lesion diameter regardless of location. The reproducibility of the visual system was assessed. The association of WMH visual scores and automated volumes was then compared with cognitive scores from the Montreal Cognitive Assessment, which was available for 510 participants.
Inter-reader reproducibility was good for subsamples with both high (n=52) and low (n=40) prevalence of large automated WMH volumes (agreement of 67% and 87.5%, κ=0.71 and 0.76, respectively). Correlation between increased WMH and cognitive deficit measurements was equal for our visual ratings and automated volumes (Spearman ρ=0.118 and 0.109; P values=0.008 and 0.014, respectively). The visual scale retained a significant association with MoCA score after adjusting for age, sex, and education (standardized β=-0.087, P=.042).
We propose a simple visual WMH scoring system suitable for use as a baseline evaluation in clinical practice.
Article · Oct 2012 · American Journal of Neuroradiology
[Show abstract][Hide abstract]ABSTRACT: Leptin has been reported to have positive effects on cognition but has not been studied in a population-based sample or stratified by race or gender.
Leptin and fat mass were measured in 2,731 subjects, including 50% African Americans. Eight years later, subjects were administered the Montreal Cognitive Assessment (MoCA). Demographic factors and baseline measures, including a deficiency in leptin or levels in excess of what was predicted by fat, were investigated to see which predicted cognitive performance.
There was a statistical trend for lower leptin levels to be associated with higher cognitive scores. Once stratified by race and gender, excessive leptin was associated with lower MoCA total scores and delayed recall domain score for black men, but white men demonstrated a reverse relationship.
Excess leptin appears to have differential effects on delayed recall in black and white men.
Article · Jul 2012 · Dementia and Geriatric Cognitive Disorders
[Show abstract][Hide abstract]ABSTRACT: To determine if measures of adipokines and other blood lipids differentiate between normal controls and persons with Alzheimer's disease (AD), we examined levels of leptin, adiponectin, total cholesterol, high density lipoproteins (HDL), calculated low density lipoproteins (LDL), triglycerides and apolipoprotein E allele status in 148 early AD subjects and 198 normal controls. We were unable to demonstrate a significant difference between leptin and adiponectin levels between normal controls and AD subjects. We were able to confirm observations of lower HDL and higher total and LDL cholesterol concentration in AD subjects than in controls. As expected, the presence of the apolipoprotein E4 allele distinguished between the two groups.
Article · Jan 2012 · Journal of Alzheimer's disease: JAD
[Show abstract][Hide abstract]ABSTRACT: We examined the relationship between a brief cogni-tive screening measure and Framingham Coronary and Stroke Risk scores. We administered the Mon-treal Cognitive Assessment (MoCA) to participants in the Dallas Heart Study, a community-based mul-tiethnic study investigating the development of athe-rosclerosis. The composition of the group was 50% African American, 36% Caucasian and 14% Hispan-ic. There were 765 subjects (mean age 51 years) who had both Coronary and Stroke Risk scores and an additional 144 subjects with only Coronary Risk scores available. There was a small significant inverse relationship between MoCA and Framingham Coro-nary and Stroke Risk scores. MoCA scores were in-fluenced by education, but were not influenced by age or by the presence of one or more apoE4 alleles.