Vascular Burden Moderates the Relationship Between ADHD and Cognition in Older Adults.

Autor:	Callahan BL; Department of Psychology (BLC, SB), University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute (BLC, SB), Calgary, Alberta, Canada. Electronic address: brandy.callahan@ucalgary.ca., Becker S; Department of Psychology (BLC, SB), University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute (BLC, SB), Calgary, Alberta, Canada., Ramirez J; Dr. Sandra Black Centre for Brain Resilience & Recovery (JR, RT, FG, SEB), LC Campbell Cognitive Neurology Unit, Sunnybrook Research Institute, Toronto, Ontario, Canada; Hurvitz Brain Sciences Program (JR, RT, PS, FG, SEB), Sunnybrook Research Institute, Toronto, Ontario, Canada., Taylor R; Dr. Sandra Black Centre for Brain Resilience & Recovery (JR, RT, FG, SEB), LC Campbell Cognitive Neurology Unit, Sunnybrook Research Institute, Toronto, Ontario, Canada; Hurvitz Brain Sciences Program (JR, RT, PS, FG, SEB), Sunnybrook Research Institute, Toronto, Ontario, Canada., Shammi P; Hurvitz Brain Sciences Program (JR, RT, PS, FG, SEB), Sunnybrook Research Institute, Toronto, Ontario, Canada; Neuropsychology & Cognitive Health Program (PS), Baycrest Health Sciences Centre, Toronto, Ontario, Canada., Gao F; Dr. Sandra Black Centre for Brain Resilience & Recovery (JR, RT, FG, SEB), LC Campbell Cognitive Neurology Unit, Sunnybrook Research Institute, Toronto, Ontario, Canada; Hurvitz Brain Sciences Program (JR, RT, PS, FG, SEB), Sunnybrook Research Institute, Toronto, Ontario, Canada., Black SE; Dr. Sandra Black Centre for Brain Resilience & Recovery (JR, RT, FG, SEB), LC Campbell Cognitive Neurology Unit, Sunnybrook Research Institute, Toronto, Ontario, Canada; Hurvitz Brain Sciences Program (JR, RT, PS, FG, SEB), Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medicine (Neurology) (SEB), University of Toronto, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2024 Apr; Vol. 32 (4), pp. 427-442. Date of Electronic Publication: 2023 Oct 30.
DOI:	10.1016/j.jagp.2023.10.018
Abstrakt:	Objectives: Recent evidence suggests attention-deficit/hyperactivity disorder (ADHD) is a risk factor for cognitive impairment in later life. Here, we investigated cerebrovascular burden, quantified using white matter hyperintensity (WMH) volumes, as a potential mediator of this relationship. Design: This was a cross-sectional observational study. Setting: Participants were recruited from a cognitive neurology clinic where they had been referred for cognitive assessment, or from the community. Participants: Thirty-nine older adults with clinical ADHD and 50 age- and gender-matched older adults without ADHD. Measurements: A semiautomated structural MRI pipeline was used to quantify periventricular (pWMH) and deep WMH (dWMH) volumes. Cognition was measured using standardized tests of memory, processing speed, visuo-construction, language, and executive functioning. Mediation models, adjusted for sex, were built to test the hypothesis that ADHD status exerts a deleterious impact on cognitive performance via WMH burden. Results: Results did not support a mediated effect of ADHD on cognition. Post hoc inspection of the data rather suggested a moderated effect, which was investigated as an a posteriori hypothesis. These results revealed a significant moderating effect of WMH on the relationship between ADHD memory, speed, and executive functioning, wherein ADHD was negatively associated with cognition at high and medium levels of WMH, but not when WMH volumes were low. Conclusions: ADHD increases older adults' susceptibility to the deleterious cognitive effects of WMH in the brain. Older adults with ADHD may be at risk for cognitive impairment if they have deep WMH volumes above 61 mm 3 and periventricular WMH above 260 mm 3 . (Copyright © 2023 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu