Cerebral Small Vessel Disease, Risk Factors, and Cognition in Tenants of Precarious Housing
Autor: | Lily W Zhou, William J. Panenka, Alexander Rauscher, Alasdair M. Barr, Melissa L. Woodward, Allen E. Thornton, William G. Honer, Manraj K.S. Heran, Wayne Su, Thalia S. Field, G. William MacEwan, Kristina M. Gicas, Ghadeer Al-Momen, Donna J. Lang, Andrea A. Jones, A. Talia Vertinsky |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male Gerontology Decision Making Hypercholesterolemia Sample (statistics) Disease White matter Young Adult Cognition Memory Risk Factors medicine Humans Attention Cognitive Dysfunction Risk factor Substance Abuse Intravenous Cerebral Hemorrhage Glycated Hemoglobin Advanced and Specialized Nursing British Columbia medicine.diagnostic_test business.industry Smoking Magnetic resonance imaging Cholesterol LDL Middle Aged Overweight Magnetic Resonance Imaging Inhibition Psychological medicine.anatomical_structure Heart Disease Risk Factors Cerebral Small Vessel Diseases Ill-Housed Persons Hypertension Stroke Lacunar Housing Disease risk Female Neurology (clinical) Small vessel Cardiology and Cardiovascular Medicine business |
Zdroj: | Stroke. 51:3271-3278 |
ISSN: | 1524-4628 0039-2499 |
Popis: | Background and Purpose: We aim to describe the burden, characteristics, and cognitive associations of cerebral small vessel disease in a Canadian sample living with multimorbidity in precarious housing. Methods: Participants received T1, T2-fluid-attenuated inversion recovery, and susceptibility-weighted imaging 3T magnetic resonance imaging sequences and comprehensive clinical, laboratory, and cognitive assessments. Cerebral small vessel disease burden was characterized using a modified Small Vessel Disease (mSVD) score. One point each was given for moderate-severe white matter hyperintensities, ≥1 cerebral microbleeds, and ≥1 lacune. Multivariable regression explored associations between mSVD score, risk factors, and cognitive performance. Results: Median age of the 228 participants (77% male) was 44.7 years (range, 23.3–63.2). In n=188 participants with consistent good quality magnetic resonance imaging sequences, mSVD scores were 0 (n=127, 68%), 1 (n=50, 27%), and 2 (n=11, 6%). Overall, one-third had an mSVD ≥1 n=61 (32%); this proportion was unchanged when adding participants with missing sequences n=72/228 (32%). The most prevalent feature was white matter hyperintensities 53/218 (24%) then cerebral microbleed 16/191 (8%) and lacunes 16/228 (7%). Older age (odds ratio, 1.10 [95% CI, 1.05–1.15], P P =0.008), and a history of injection drug use (odds ratio, 3.13 [95% CI, 1.07–9.16], P =0.037) had significant independent associations with a mSVD score of ≥1 in multivariable analysis. mSVD ≥1 was associated with lower performance on tests of verbal memory, sustained attention, and decision-making, contributing 4% to 5% of the variance in each cognitive domain. Conclusions: The 32% prevalence of cerebral small vessel disease in this young, socially marginalized cohort was higher than expected for age and was associated with poorer cognitive performance. |
Databáze: | OpenAIRE |
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