- Email: [email protected]
THE IMPACT OF WHITE MATTER HYPERINTENSITIES ON COGNITIVE FUNCTION IN PATIENTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT IN KOREA
P768
Poster Presentations: Monday, July 25, 2016
Table 1 Demographics, sample averages, and reference values of blood markers and indicators Reference values
Variables Age, y Female, % (n) Cholesterol, mg/dL HDL, mg/dL LDL, mg/dL Triglycerides, mg/dL Chol/HDL Ratio Average Glucose, mg/dL HbAlC, % Insulin, uIU/mL Fasting Glucose, mg/dL HOMA-IR Albumin, g/dL BUN, mg/dL Creatinine, mg/dL eGFR, mL/min/1.73 m2 CCL, mL/min
Total Protein, g/dL
< 200 40 to 60 < 130 < 150 5 77 to 137 4.3 to 6.4 2.6 to 25.0 70 to 110 < 2.5 3.3 to 5.0 8 to 25 0.6 to 1.5 60 97 to 137 for men, 88 to 128 for women 6.0 to 8.3
Mean (standard deviation) Range 59.36 (9.80) 50 (11) 179.73 (26.73) 57.36 (19.86) 104.41 (20.83) 89.95 (53.31) 3.45 (1.16) 112.68 (11.35) 5.55 (0.40) 10.40 (7.85) 89.73 (9.54) 2.39 (2.00) 4.47 (0.21) 16.95 (4.48) 1.07 (0.20) 69.60 (13.30) 81.58 (33.12)
7.37 (0.39)
40.54-79.55 130-242 30-94 61-147 40-213 1.8-6.4 91-137 4.8-6.4 3.1-33 80-122 0.70-7.83 4-4.9 10-30 0.76-1.47 45.68-103.71 44.27-182.15
6.5-8.1
HDL ¼ high density lipoprotein; LDL ¼ low density lipoprotein; Chol ¼ cholesterol; HbAlC ¼ glycated hemoglobin; HOMA-IR ¼ homeostatic model assessment of insulin resistance; BUN ¼ blood urea nitrogen; eGFR ¼ estimated glomerulus filtration rate; CCL ¼ creatinine clearance
total cholesterol and LDL levels and cognitive performance; in particular, spatial cognition. While higher total cholesterol and LDL levels are generally considered a risk factor for vascular disease, they were linked in this study to greater ability in the mental rotation computer task. However, the levels observed in this study were generally within the normal reference range of clinical practice. Future work will aim to determine if these effects are mediated through brain structure, particularly white matter microstructure. References: [1] Leritz, et al. Elevated Levels of Serum Cholesterol are Associated with Better Performance on Tasks of Episodic Memory. Metabolic Brain Disease (in press). [2] Ryu SY, et al. Neurology 2014; 82: 1862–70. [3] Sedaghat, et al. Neurology 2015; 85: 154–161. P2-328
PERFORMANCE OF HYPERTENSIVE SUBJECTS ON THE MONTREAL COGNITIVE ASSESSMENT
Cl audia Mem oria, Henrique Muela, M^onica Sanches Yassuda, Natalia Moraes, Valeria Costa-Hong, Michel Machado, Eduardo Nakano, Ricardo Nitrini, Luiz Bortolotto, University of S~ao Paulo, S~ao Paulo, Brazil. Contact e-mail: [email protected] Background: Age is the main risk factor for dementia, and early stages of cognitive decline may be challenging to identify. Medical care for other age-related disorders such as arterial hypertension may also have significant impact on reducing dementia prevalence. Patients with suboptimal blood pressure (BP) control may remain with an elevated cardiovascular risk and risk for cognitive impairment. Methods: One hundred and fifty-six patients were screened: mean age 52.1 6 11.8 years and a mean hypertension history of 10.3 6 8.5 years and were compared with a group of normotensive subjects (age 51,4 6 13.8 years). The control group was originally recruited from community sources. We gathered full medical and hypertension history, physical examination, laboratory screening and ambulatory blood pressure monitoring. Neuropsychological profile
was assessed with the Montreal Cognitive Assessment (MoCA). The MOCA scores were compared between normotensive and hypertensive subjects by an ANCOVA (analysis of covariance) considering education as a control covariate. Results: In the MoCA test (total score), patients with higher blood pressure level differed from the control group (respectively: 23.5 6 0.5 x 24.9 6 0.3; p ¼ 0.017). Higher systolic blood pressure values were correlated with lower scores in the MoCA (r ¼ -0,221; p ¼ 0.001). The time of hypertension history was not correlated to greater cognitive impairment in the MoCA (r ¼ -0015; p ¼ 0.190), probably because this is a group of patients with good compliance to pharmacological treatment. Conclusions: The relationship between impairment on the MoCA with hypertension suggests a greater sensitivity for vascular-origin cognitive impairment. Use of the MoCA should improve sensitivity for the detection of cognitive impairment and treatment effects. P2-329
THE IMPACT OF WHITE MATTER HYPERINTENSITIES ON COGNITIVE FUNCTION IN PATIENTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT IN KOREA
Bon D. Ku1,2,3, Key Chung Park4, Sung Sang Yoon5, 1International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea; 2International St. Mary’s Hospital, Institute for Translational & Clinical Research, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea; 3Institute for Translational & Clinical Research, Incheon, Republic of Korea; 4Kyung Hee University Medical Center, Seoul, Republic of Korea; 5Kyung Hee Medical Center, KyungHee University School of Medicine, Seoul, Republic of Korea. Contact e-mail: [email protected] Background: White matter hyperintensities (WMH) are frequently
observed in the elderly people and have raised cognitive impairment in patients with dementia. However there has been little attention to the influences of WMH to the patients with mild cognitive impairment (MCI). We conducted this study to identify the clinical and cognitive impact of WMH to the patients with MCI. Methods: The participants completed a comprehensive neuropsychological test, magnetic resonance imaging (MRI), and structured medical neurological and laboratory evaluations. On MRI, deep white matter (DWM) hyperintensities was classified into D1 (the longest diameter of DWM lesion <10 mm), D2 (10mmDWM24mm), and D3 (25mm
THE HIGH PREVALENCE OF ALZHEIMER’S DISEASE IN FEMALE APOE4 ALLELE CARRIERS IS CONTRIBUTED FROM A COMBINATION OF APOE4 INCREASED ACTIVITY AND FEMALE SEX RELATED HIGH EXPRESSION OF BACE1
Jun Ming Wang1, Xu Hou1, Baoying Zheng1, Thomas H. Mosley, Jr.2, 1 University Mississippi Medical Center, Jackson, MS, USA; 2University of
Poster Presentations: Monday, July 25, 2016
Table 1 Demographics, sample averages, and reference values of blood markers and indicators Reference values
Variables Age, y Female, % (n) Cholesterol, mg/dL HDL, mg/dL LDL, mg/dL Triglycerides, mg/dL Chol/HDL Ratio Average Glucose, mg/dL HbAlC, % Insulin, uIU/mL Fasting Glucose, mg/dL HOMA-IR Albumin, g/dL BUN, mg/dL Creatinine, mg/dL eGFR, mL/min/1.73 m2 CCL, mL/min
Total Protein, g/dL
< 200 40 to 60 < 130 < 150 5 77 to 137 4.3 to 6.4 2.6 to 25.0 70 to 110 < 2.5 3.3 to 5.0 8 to 25 0.6 to 1.5 60 97 to 137 for men, 88 to 128 for women 6.0 to 8.3
Mean (standard deviation) Range 59.36 (9.80) 50 (11) 179.73 (26.73) 57.36 (19.86) 104.41 (20.83) 89.95 (53.31) 3.45 (1.16) 112.68 (11.35) 5.55 (0.40) 10.40 (7.85) 89.73 (9.54) 2.39 (2.00) 4.47 (0.21) 16.95 (4.48) 1.07 (0.20) 69.60 (13.30) 81.58 (33.12)
7.37 (0.39)
40.54-79.55 130-242 30-94 61-147 40-213 1.8-6.4 91-137 4.8-6.4 3.1-33 80-122 0.70-7.83 4-4.9 10-30 0.76-1.47 45.68-103.71 44.27-182.15
6.5-8.1
HDL ¼ high density lipoprotein; LDL ¼ low density lipoprotein; Chol ¼ cholesterol; HbAlC ¼ glycated hemoglobin; HOMA-IR ¼ homeostatic model assessment of insulin resistance; BUN ¼ blood urea nitrogen; eGFR ¼ estimated glomerulus filtration rate; CCL ¼ creatinine clearance
total cholesterol and LDL levels and cognitive performance; in particular, spatial cognition. While higher total cholesterol and LDL levels are generally considered a risk factor for vascular disease, they were linked in this study to greater ability in the mental rotation computer task. However, the levels observed in this study were generally within the normal reference range of clinical practice. Future work will aim to determine if these effects are mediated through brain structure, particularly white matter microstructure. References: [1] Leritz, et al. Elevated Levels of Serum Cholesterol are Associated with Better Performance on Tasks of Episodic Memory. Metabolic Brain Disease (in press). [2] Ryu SY, et al. Neurology 2014; 82: 1862–70. [3] Sedaghat, et al. Neurology 2015; 85: 154–161. P2-328
PERFORMANCE OF HYPERTENSIVE SUBJECTS ON THE MONTREAL COGNITIVE ASSESSMENT
Cl audia Mem oria, Henrique Muela, M^onica Sanches Yassuda, Natalia Moraes, Valeria Costa-Hong, Michel Machado, Eduardo Nakano, Ricardo Nitrini, Luiz Bortolotto, University of S~ao Paulo, S~ao Paulo, Brazil. Contact e-mail: [email protected] Background: Age is the main risk factor for dementia, and early stages of cognitive decline may be challenging to identify. Medical care for other age-related disorders such as arterial hypertension may also have significant impact on reducing dementia prevalence. Patients with suboptimal blood pressure (BP) control may remain with an elevated cardiovascular risk and risk for cognitive impairment. Methods: One hundred and fifty-six patients were screened: mean age 52.1 6 11.8 years and a mean hypertension history of 10.3 6 8.5 years and were compared with a group of normotensive subjects (age 51,4 6 13.8 years). The control group was originally recruited from community sources. We gathered full medical and hypertension history, physical examination, laboratory screening and ambulatory blood pressure monitoring. Neuropsychological profile
was assessed with the Montreal Cognitive Assessment (MoCA). The MOCA scores were compared between normotensive and hypertensive subjects by an ANCOVA (analysis of covariance) considering education as a control covariate. Results: In the MoCA test (total score), patients with higher blood pressure level differed from the control group (respectively: 23.5 6 0.5 x 24.9 6 0.3; p ¼ 0.017). Higher systolic blood pressure values were correlated with lower scores in the MoCA (r ¼ -0,221; p ¼ 0.001). The time of hypertension history was not correlated to greater cognitive impairment in the MoCA (r ¼ -0015; p ¼ 0.190), probably because this is a group of patients with good compliance to pharmacological treatment. Conclusions: The relationship between impairment on the MoCA with hypertension suggests a greater sensitivity for vascular-origin cognitive impairment. Use of the MoCA should improve sensitivity for the detection of cognitive impairment and treatment effects. P2-329
THE IMPACT OF WHITE MATTER HYPERINTENSITIES ON COGNITIVE FUNCTION IN PATIENTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT IN KOREA
Bon D. Ku1,2,3, Key Chung Park4, Sung Sang Yoon5, 1International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea; 2International St. Mary’s Hospital, Institute for Translational & Clinical Research, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea; 3Institute for Translational & Clinical Research, Incheon, Republic of Korea; 4Kyung Hee University Medical Center, Seoul, Republic of Korea; 5Kyung Hee Medical Center, KyungHee University School of Medicine, Seoul, Republic of Korea. Contact e-mail: [email protected] Background: White matter hyperintensities (WMH) are frequently
observed in the elderly people and have raised cognitive impairment in patients with dementia. However there has been little attention to the influences of WMH to the patients with mild cognitive impairment (MCI). We conducted this study to identify the clinical and cognitive impact of WMH to the patients with MCI. Methods: The participants completed a comprehensive neuropsychological test, magnetic resonance imaging (MRI), and structured medical neurological and laboratory evaluations. On MRI, deep white matter (DWM) hyperintensities was classified into D1 (the longest diameter of DWM lesion <10 mm), D2 (10mmDWM24mm), and D3 (25mm
THE HIGH PREVALENCE OF ALZHEIMER’S DISEASE IN FEMALE APOE4 ALLELE CARRIERS IS CONTRIBUTED FROM A COMBINATION OF APOE4 INCREASED ACTIVITY AND FEMALE SEX RELATED HIGH EXPRESSION OF BACE1
Jun Ming Wang1, Xu Hou1, Baoying Zheng1, Thomas H. Mosley, Jr.2, 1 University Mississippi Medical Center, Jackson, MS, USA; 2University of