Associations between cerebral amyloid and changes in cognitive function and falls risk in subcortical ischemic vascular cognitive impairment

BMC Geriatrics

Research Article

John R. Best¹  Elizabeth Dao¹  Teresa Liu-Ambrose²  Vesna Sossi³  Ging-Yuek Robin Hsiung⁴  Roger Tam⁵  Claudia Jacova⁶ 

[1] Department of Physical Therapy, University of British Columbia, 212 – 2177 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada;Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, V6S 0A9, Vancouver, BC, Canada;Department of Physical Therapy, University of British Columbia, 212 – 2177 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada;Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, V6S 0A9, Vancouver, BC, Canada;Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel Street, V5Z 1M9, Vancouver, BC, Canada;Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, V6T 1Z1, Vancouver, BC, Canada;Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, V6S 0A9, Vancouver, BC, Canada;Department of Medicine, University of British Columbia, UBC Hospital S152, 2211 Wesbrook Mall, V6T 2B5, Vancouver, BC, Canada;MS/MRI Research Group, University of British Columbia, 2215 Wesbrook Mall, V6S 0A9, Vancouver, BC, Canada;School of Graduate Psychology, Pacific University, 190 SE 8th Avenue, 97123, Hillsboro, OR, USA;

关键词: Vascular cognitive impairment;    Alzheimer’s disease;    Amyloid;    Cognitive impairment;    Executive functions;    Falls risk;   

DOI  :  10.1186/s12877-017-0522-4

 received in 2017-03-04, accepted in 2017-06-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTo determine the association between amyloid-beta (Aβ) plaque deposition and changes in global cognition, executive functions, information processing speed, and falls risk over a 12-month period in older adults with a primary clinical diagnosis of subcortical ischemic vascular cognitive impairment (SIVCI).MethodsThis is a secondary analysis of data acquired from a subset of participants (N = 22) who were enrolled in a randomized controlled trial of aerobic exercise (NCT01027858). The subset of individuals completed an 11C Pittsburgh compound B (PIB) scan. Cognitive function and falls risk were assessed at baseline, 6-months, and 12-months. Global cognition, executive functions, and information processing speed were measured using: 1) ADAS-Cog; 2) Trail Making Test; 3) Digit Span Test; 4) Stroop Test, and 5) Digit Symbol Substitution Test. Falls risk was measured using the Physiological Profile Assessment. Hierarchical multiple linear regression analyses determined the unique contribution of Aβ on changes in cognitive function and falls risk at 12-months after controlling for experimental group (i.e. aerobic exercise training or usual care control) and baseline performance. To correct for multiple comparisons, we applied the Benjamini-Hochberg procedure to obtain a false discovery rate corrected threshold using alpha = 0.05.ResultsHigher PIB retention was significantly associated with greater decrements in set shifting (Trail Making Test, adjusted R2 = 35.3%, p = 0.002), attention and conflict resolution (Stroop Test, adjusted R2 = 33.4%, p = 0.01), and information processing speed (Digit Symbol Substitution Test, adjusted R2 = 24.4%, p = 0.001) over a 12-month period. Additionally, higher PIB retention was significantly associated with increased falls risk (Physiological Profile Assessment, adjusted R2 = 49.1%, p = 0.04). PIB retention was not significantly associated with change in ADAS-Cog and Verbal Digit Span Test (p > 0.05).ConclusionsSymptoms associated with SIVCI may be amplified by secondary Aβ pathology.Trial registrationClinicalTrials.gov, NCT01027858, December 7, 2009.

【 授权许可】

CC BY   
© The Author(s). 2017