Please use this identifier to cite or link to this item: https://doi.org/10.1136/svn-2018-000202
Title: Additive effect of cerebral atrophy on cognition in dementia-free elderly with cerebrovascular disease
Authors: Xu, X. 
Phua, A. 
Collinson, S.L. 
Hilal, S. 
Ikram, M.K. 
Wong, T.Y. 
Cheng, C.Y. 
Venketasubramanian, N. 
Chen, C.
Keywords: atrophy
cerebrovascular disease
cognition
dementia
Issue Date: 2019
Publisher: BMJ Publishing Group
Citation: Xu, X., Phua, A., Collinson, S.L., Hilal, S., Ikram, M.K., Wong, T.Y., Cheng, C.Y., Venketasubramanian, N., Chen, C. (2019). Additive effect of cerebral atrophy on cognition in dementia-free elderly with cerebrovascular disease. Stroke and Vascular Neurology 4 (3) : 135-140. ScholarBank@NUS Repository. https://doi.org/10.1136/svn-2018-000202
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
Abstract: To explore the additive effect of neurodegenerative diseases, measured by atrophy, on neurocognitive function in Asian dementia-free elderly with cerebrovascular disease (CeVD). Methods The present study employed a cross-sectional design and was conducted between 2010 and 2015 among community-dwelling elderly participants recruited into the study. Eligible participants were evaluated with an extensive neuropsychological battery and neuroimaging. The weighted CeVD burden scale comprising markers of both small- and large-vessel diseases was applied, with a score of ?2, indicating significant CeVD burden. Cortical atrophy (CA) and medial temporal atrophy (MTA) were graded using the global cortical atrophy scale and Schelten's scale, respectively. Global and domain-specific (attention, executive function, language, visuomotor speed, visuoconstruction, visual memory, and verbal memory) neurocognitive performance was measured using a locally validated neuropsychological battery (Vascular Dementia Battery, VDB). Results A total of 819 dementia-free participants were included in the analysis. Among none-mild CeVD subjects, there was no significant difference in the global cognitive performance across atrophy groups (no atrophy, CA, and CA+MTA). However, in moderate-severe CeVD subjects, CA+MTA showed significantly worse global cognitive performance compared with those with CA alone (mean difference=-0.35, 95% CI -0.60 to -0.11, p=0.002) and those without atrophy (mean difference=-0.46, 95% CI -0.74 to -0.19, p<0.001, p<0.001). In domain-specific cognitive performance, subjects with CA+MTA performed worse than other groups in visual memory (p=0.005), executive function (p=0.001) and visuomotor speed (p<0.001) in moderate-severe CeVD but not in none-mild CeVD. Conclusions and relevance Atrophy and moderate-severe CeVD burden showed an additive effect on global and domain-specific cognitive performance. This study highlights the importance of investigating the mechanisms of clinico-pathological interactions between neurodegenerative processes and vascular damage, particularly in the pre-dementia stage. � Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Source Title: Stroke and Vascular Neurology
URI: https://scholarbank.nus.edu.sg/handle/10635/212941
ISSN: 20598688
DOI: 10.1136/svn-2018-000202
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
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