Synergistic associations of cognitive and motor impairments with functional outcome in covert cerebral small vessel disease
| Autor: | Hanna M. Laakso, Juha Lempiäinen, Timo Erkinjuntti, Anne Arola, Antti Korvenoja, Teemu Paajanen, Jyrki Lötjönen, Sietske A.M. Sikkes, Hanna Jokinen, Matti Ahlström, Juha Koikkalainen, Johanna Pitkänen, Susanna Melkas |
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| Přispěvatelé: | Clinical Neuropsychology, Amsterdam Neuroscience - Neurodegeneration, Faculty Common Matters (Faculty of Medicine), Department of Psychology and Logopedics, HUS Neurocenter, Neurologian yksikkö, Department of Neurosciences, HUS Medical Imaging Center, HUS Diagnostic Center, Staff Services, Faculty Common Matters, University of Helsinki, Finnish Institute of Occupational Health, Vrije Universiteit Amsterdam, Combinostics Ltd, Department of Neuroscience and Biomedical Engineering, Aalto-yliopisto, Aalto University, Neurology |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
cognition
medicine.medical_specialty Activities of daily living small vessel disease 515 Psychology Motor Disorders neuropsychology Neuropsychological Tests 3124 Neurology and psychiatry instrumental activities of daily living 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Quality of life (healthcare) Atrophy mental disorders Activities of Daily Living motor functions Medicine Humans Cognitive Dysfunction 030212 general & internal medicine Association (psychology) Vascular dementia vascular cognitive impairment Balance (ability) 030304 developmental biology Aged 0303 health sciences business.industry Neuropsychology Cognition vascular dementia medicine.disease Executive functions Magnetic Resonance Imaging White Matter Hyperintensity Neurology quality of life Cerebral Small Vessel Diseases Neurology (clinical) business human activities 030217 neurology & neurosurgery |
| Zdroj: | European Journal of Neurology, 29(1), 158-167. Wiley-Blackwell Jokinen, H, Laakso, H M, Ahlström, M, Arola, A, Lempiäinen, J, Pitkänen, J, Paajanen, T, Sikkes, S A M, Koikkalainen, J, Lötjönen, J, Korvenoja, A, Erkinjuntti, T & Melkas, S 2022, ' Synergistic associations of cognitive and motor impairments with functional outcome in covert cerebral small vessel disease ', European Journal of Neurology, vol. 29, no. 1, pp. 158-167 . https://doi.org/10.1111/ene.15108 |
| ISSN: | 1351-5101 |
| DOI: | 10.1111/ene.15108 |
| Popis: | ObjectiveCognitive and motor impairments are the key clinical manifestations of cerebral small vessel disease (SVD), but their interrelations and combined effects on functional outcome have not been elucidated. We investigated the associations between cognitive and motor functions and their interactions and mediating effects on instrumental activities of daily living (IADL) and quality of life in older individuals with various degrees of white matter hyperintensities (WMH).MethodsParticipants of the Helsinki Small Vessel Disease Study (n=152) were assessed according to an extensive clinical, neuropsychological and MRI protocol. Cognitive composite scores for global cognition, processing speed, executive functions and memory were constructed from multiple tests within each domain. Physical examination included measures of gait speed, balance (single-leg-stance) and functional mobility (timed-up-and-go test). IADL was evaluated with a proxy-based Amsterdam IADL questionnaire and quality of life with a self-report EUROHIS-Qol index. Volumes of WMH and gray matter (GM) were obtained with automated segmentation. Sets of linear regression analyses were used to model the associations between motor and cognitive performances, WMH and GM volumes, and IADL and quality of life.ResultsDomain-specific cognitive and motor functions had strong interrelations with each other, and they were significantly associated with IADL, quality of life as well as WMH and GM volumes. A consistent pattern on significant interactions between cognitive and motor functions was found on IADL, but not on quality of life. In particular, low cognitive scores together with decline in the timed-up-and-go test and gait speed were strongly related to impaired IADL. The association of WMH volume with IADL was mediated by global cognition, whereas the association of GM volume with IADL was mediated by global cognition and timed up-and-go performance.ConclusionThe results highlight the complex interplay and synergism between motor and cognitive abilities on functional outcome in SVD. The combined effect of motor and cognitive disturbances on IADL is likely to be greater than the individual effects of each of the two impairments. WMH and brain atrophy contribute to disability through cognitive and motor impairment. |
| Databáze: | OpenAIRE |
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