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  • Decarli, Charles  (2)
  • Rajan, Kumar B  (2)
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  • 1
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S3 ( 2023-06)
    Abstract: White matter hyperintensity (WMH), assessed by magnetic resonance imaging (MRI), is a marker of cerebrovascular disease. Neurofilament light chain (NFL), assessed in the blood, is a biomarker of neurodegeneration. While both measures, WMH and NFL, are associated with cognitive impairment, we aimed to evaluate which of the two measurements is most advantageous in determining the risk of cognitive impairment. Method We conducted this investigation in Chicago Health and Aging Project (CHAP), a prospective population‐based cohort study in the United States. The study included 1,323 participants with data on NFL serum concentrations and 923 who underwent an MRI scan and had data on WMH volumes. NFL was measured using an ultrasensitive immunoassay, single‐molecule array technology. MRI scans of the brain were acquired using 1.5‐T systems. Global cognitive function was created as a composite measure of 4 neuropsychological tests, standardized and averaged to z‐scores. Linear mixed‐effects models were used to examine associations of the NFL, WMH, and cognitive decline adjusting for age, sex, race, education, and APOE e4. Result Of 1,323 participants, 808 (61%) were African Americans, and 38% were men, with an average age of 78.5 years. WMH and NFL were associated with faster cognitive decline in a multivariable‐adjusted model. Individuals in the third tertile of WMH had a faster cognitive decline by 0.029 (95%CI ‐0.052, ‐0.006) units per year compared to the first tertile. Also, compared to the first tertile of NFL, individuals in the third tertile had a faster cognitive decline by 0.029 (95%CI ‐0.046, ‐0.011) units per year. The stratified analysis by the tertiles of WMH showed that NFL was associated with a cognitive decline only in participants in the lowest tertile of WMH (‐0.089; 95%CI ‐0.159, ‐0.02). Similarly, when we stratified analysis by the tertiles of the NFL, we found a significant association of WMH with cognitive decline only participants in the lowest tertile of the NFL (‐0.052; 95%CI ‐0.008, ‐0.024). Conclusion While both biomarkers, NFL and WMH, are associated with cognitive decline, our findings suggest that within individuals with low values of NFL, WMH may identify people with a faster rate of decline in cognitive functioning.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
    Location Call Number Limitation Availability
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  • 2
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S8 ( 2023-06)
    Abstract: Subjective memory complaints (SMCs) are associated with a faster cognitive decline and dementia; whether this relationship results from irreversible structural brain alterations, such as white matter hyperintensities (WMH), requires investigation. We aimed to determine the association of SMCs with WMH and cognitive decline and investigate the role of WMH on the relationship between SMCs and cognitive decline. Method We studied 917 participants (63% African Americans and 60% women) from the population‐based Chicago Health and Aging Project (CHAP), who responded to questions about SMCs, underwent magnetic resonance imaging of the brain, and had valid cognitive data on two or more visits during the follow‐up period. SMCs were obtained by self‐report questionnaire, and based on frequency and severity of concerns, we categorized participants into three groups: not concerned, moderately concerned, and very concerned. Result Of 917 participants eligible for the study, 158 (17.2%) had no SMCs concerns, 671 (73.2%) had moderate concerns, and 88 (9.6%) were very concerned. SMCs were associated with larger WMH volumes and faster cognitive decline. Compared to participants with no concerns, those very concerned had 0.833 (95%CI 0.203, 1.463) units higher WMH volumes and 174% faster cognitive decline (‐0.049; 95%CI ‐0.076, ‐0.022). The association between SMCs and cognitive decline was statistically significant only among individuals with large WMH volumes; that is, very concerned individuals with large WMH volumes had 428% faster cognitive decline annually (‐0.077; 95%CI ‐0.144, ‐0.011) than participants with no concerns. In participants with low volumes of WMH, SMCs were not associated with a faster cognitive decline ( P ‐value = 0.595). Conclusion Our study suggests that SMCs, frequently reported by the elderly, are an important sign of cognitive impairment, especially in people with brain atrophies, such as large WMH volumes.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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