- Email: [email protected]
The role of neuropsychiatric symptoms as predictors of dementia
Poster Presentations: P1
unchanged after further adjustment for a large set of lifestyle, vascular and cognitive factors. In contrast, we found no relation with grey matter volumes. Conclusions: The MeDi appears to benefit brain health through preservation of structural connectivity. The strong relation of the MeDi with white matter microstructure in extensive areas with no substantial association with grey matter volumes suggests that the MeDi may benefit the brain through a favorable impact on cerebral vasculature; mediation by early vascular mechanisms deserves further research.
P455
hallucinations, depression, anxiety, and aberrant motor behavior) for the risk of incident dementia. The same results were obtained even if the association was controlled by other variables such as sociodemographic, clinical and cognitive reserve. Moreover the neurophysiopathological understanding of the damage associated to NPS is important for knowing and identifying the limits between healthy and pathological aging and recognize the utility of NPS as a risk factor for dementia.
P1-264
THE ROLE OF SEX IN POSTOPERATIVE COGNITIVE AND FUNCTIONAL DECLINE
Katie J. Schenning, Charles F. Murchison, Nora Mattek, Jeffrey Kaye, Joseph F. Quinn, Oregon Health & Science University, Portland, OR, USA. Contact e-mail: [email protected]
Figure 1. Association between higher Mediterranean score, lower diffusivity values (mean, axial and radial diffusivities) and higher fractional anisotropy in older subjects from the Bordeaux sample of the Three-City study (N¼146). The figure represents areas of the WM skeleton where each 1-point increase of the MeDi score was significantly associated with lower diffusivity (i.e. mean, axial and radial diffusivities) and higher fractional anisotropy values, after adjustment for age, gender, education and APOE4 allele carrier status. TBSS results were displayed at p<0.05, TFCE-corrected and overlaid on the MNI template. R ¼ right side.
P1-263
THE ROLE OF NEUROPSYCHIATRIC SYMPTOMS AS PREDICTORS OF DEMENTIA
Gilberto Isaac Acosta-Castillo1,2, Guilherme L. Borges3, Ana Luisa SosaOrtiz1, 1Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 2National Autonomous University of Mexico, Mexico City, Mexico; 3National Institute of Psychiatry, Mexico City, Mexico. Contact e-mail: [email protected] Background: Dementia manifestations are localized in three areas:
cognition, functionality and neuropsychiatric symptoms (NPS). The main interest for the study of NPS is related to its impact; identification and management in patients with dementia and in those who are at risk for the future development of dementia. Methods: This study explores the correlation between NPS and incident dementia in a three years follow-up general population study. We included 1,355 subjects, aged 65 years and older. Several instruments were used for having all the elements for operationalize dementia clinical diagnoses. Results: A total follow-up time of 4,168.6 person years was achieved. The average follow-up was 3.1 years with a median of 3.1 and an interquartile range of 3.0 to 3.2 years. Different strategies were explored to identify NPS related to increased risk for dementia. The associated risk to the develop dementia was estimated by modeling the cumulative incidence with Poisson’s model, socio-demographic, clinical and cognitive variables were adjusted in order to conduct a multivariate model analyses to test the effect of NPS.in the develop of dementia. Conclusions: The results showed a positive correlation between some of the NPS studied (delusions,
Background: Older adults receive >1/3 of the over 40 million anesthetics delivered yearly in the US, and these individuals are at the highest risk for deleterious postoperative neurocognitive outcomes. While women have an increased risk of developing AD, the role of sex in postoperative cognitive decline is unknown. We hypothesized that exposure to general anesthesia (GA) and surgery in older adults is associated with an accelerated deterioration of cognition, function, and brain volumes, and that this decline is more pronounced in women. Methods: We performed a retrospective, cohort analysis in two natural history studies of cognitive aging, the Oregon Brain Aging Study (n¼304) and the Intelligent Systems for Assessing Aging Changes (n¼223). After controlling for age, years of education, and Cumulative Illness Rating Scale, we used mixed-effects models to assess the relationship between exposure to GA/surgery and longitudinal change in measures of cognition, function, and brain volumes (Table 1). Exposure to GA/surgery was modeled as both a dichotomous categorical factor as well as a continuous variable indicating the number of exposure events to evaluate the Table 1 Outcome Measures Dementia
Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), CDR sum of boxes (CDR-SB) Cognitive Consortium to Establish a Registry for AD Word List Delayed Recall (CERAD) Delayed Word List, Animal Category Fluency, Trail Making Test B, Digit Symbol Test, Logical Memory Delayed Recall Functional Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Functional Activities Questionnaire (FAQ) Neuroimaging Total brain volume, Intracranial volume, Hippocampal volume, White matter hyperintensity volume, Ventricular volume Table 2 Participant Characteristics
Mean Age (years) Female (%) Mean Education (years) Cumulative Illness Rating Scale Presence of an APOE4 allele (%)*
Exposed (n¼182 )
Unexposed (n¼345)
p-value
80.0 (SD¼7.4) 61% 15.1 (SD¼2.7) 20.2 (SD¼3.3)
83.9 (SD¼7.0) 68% 14.8 (SD¼2.7) 20.5 (SD¼3.5)
<0.0001 0.10 0.33 0.56
23%
22%
*29 ISAAC participants are missing APOE genotype data.
0.68
unchanged after further adjustment for a large set of lifestyle, vascular and cognitive factors. In contrast, we found no relation with grey matter volumes. Conclusions: The MeDi appears to benefit brain health through preservation of structural connectivity. The strong relation of the MeDi with white matter microstructure in extensive areas with no substantial association with grey matter volumes suggests that the MeDi may benefit the brain through a favorable impact on cerebral vasculature; mediation by early vascular mechanisms deserves further research.
P455
hallucinations, depression, anxiety, and aberrant motor behavior) for the risk of incident dementia. The same results were obtained even if the association was controlled by other variables such as sociodemographic, clinical and cognitive reserve. Moreover the neurophysiopathological understanding of the damage associated to NPS is important for knowing and identifying the limits between healthy and pathological aging and recognize the utility of NPS as a risk factor for dementia.
P1-264
THE ROLE OF SEX IN POSTOPERATIVE COGNITIVE AND FUNCTIONAL DECLINE
Katie J. Schenning, Charles F. Murchison, Nora Mattek, Jeffrey Kaye, Joseph F. Quinn, Oregon Health & Science University, Portland, OR, USA. Contact e-mail: [email protected]
Figure 1. Association between higher Mediterranean score, lower diffusivity values (mean, axial and radial diffusivities) and higher fractional anisotropy in older subjects from the Bordeaux sample of the Three-City study (N¼146). The figure represents areas of the WM skeleton where each 1-point increase of the MeDi score was significantly associated with lower diffusivity (i.e. mean, axial and radial diffusivities) and higher fractional anisotropy values, after adjustment for age, gender, education and APOE4 allele carrier status. TBSS results were displayed at p<0.05, TFCE-corrected and overlaid on the MNI template. R ¼ right side.
P1-263
THE ROLE OF NEUROPSYCHIATRIC SYMPTOMS AS PREDICTORS OF DEMENTIA
Gilberto Isaac Acosta-Castillo1,2, Guilherme L. Borges3, Ana Luisa SosaOrtiz1, 1Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 2National Autonomous University of Mexico, Mexico City, Mexico; 3National Institute of Psychiatry, Mexico City, Mexico. Contact e-mail: [email protected] Background: Dementia manifestations are localized in three areas:
cognition, functionality and neuropsychiatric symptoms (NPS). The main interest for the study of NPS is related to its impact; identification and management in patients with dementia and in those who are at risk for the future development of dementia. Methods: This study explores the correlation between NPS and incident dementia in a three years follow-up general population study. We included 1,355 subjects, aged 65 years and older. Several instruments were used for having all the elements for operationalize dementia clinical diagnoses. Results: A total follow-up time of 4,168.6 person years was achieved. The average follow-up was 3.1 years with a median of 3.1 and an interquartile range of 3.0 to 3.2 years. Different strategies were explored to identify NPS related to increased risk for dementia. The associated risk to the develop dementia was estimated by modeling the cumulative incidence with Poisson’s model, socio-demographic, clinical and cognitive variables were adjusted in order to conduct a multivariate model analyses to test the effect of NPS.in the develop of dementia. Conclusions: The results showed a positive correlation between some of the NPS studied (delusions,
Background: Older adults receive >1/3 of the over 40 million anesthetics delivered yearly in the US, and these individuals are at the highest risk for deleterious postoperative neurocognitive outcomes. While women have an increased risk of developing AD, the role of sex in postoperative cognitive decline is unknown. We hypothesized that exposure to general anesthesia (GA) and surgery in older adults is associated with an accelerated deterioration of cognition, function, and brain volumes, and that this decline is more pronounced in women. Methods: We performed a retrospective, cohort analysis in two natural history studies of cognitive aging, the Oregon Brain Aging Study (n¼304) and the Intelligent Systems for Assessing Aging Changes (n¼223). After controlling for age, years of education, and Cumulative Illness Rating Scale, we used mixed-effects models to assess the relationship between exposure to GA/surgery and longitudinal change in measures of cognition, function, and brain volumes (Table 1). Exposure to GA/surgery was modeled as both a dichotomous categorical factor as well as a continuous variable indicating the number of exposure events to evaluate the Table 1 Outcome Measures Dementia
Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), CDR sum of boxes (CDR-SB) Cognitive Consortium to Establish a Registry for AD Word List Delayed Recall (CERAD) Delayed Word List, Animal Category Fluency, Trail Making Test B, Digit Symbol Test, Logical Memory Delayed Recall Functional Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Functional Activities Questionnaire (FAQ) Neuroimaging Total brain volume, Intracranial volume, Hippocampal volume, White matter hyperintensity volume, Ventricular volume Table 2 Participant Characteristics
Mean Age (years) Female (%) Mean Education (years) Cumulative Illness Rating Scale Presence of an APOE4 allele (%)*
Exposed (n¼182 )
Unexposed (n¼345)
p-value
80.0 (SD¼7.4) 61% 15.1 (SD¼2.7) 20.2 (SD¼3.3)
83.9 (SD¼7.0) 68% 14.8 (SD¼2.7) 20.5 (SD¼3.5)
<0.0001 0.10 0.33 0.56
23%
22%
*29 ISAAC participants are missing APOE genotype data.
0.68