TY - JOUR
T1 - Slowing
T2 - A Vascular Geriatric Syndrome?
AU - van de Schraaf, Sara A. J.
AU - Rhodius-Meester, Hanneke F. M.
AU - Aben, Laurien
AU - Sizoo, Eefje M.
AU - Peters, Mike J. L.
AU - Trappenburg, Marijke C.
AU - Hertogh, Cees M. P. M.
AU - Klein, Martin
AU - Muller, Majon
N1 - Funding Information: The authors thank Peter Alders, Greetje Asma, Gerda Bolink, Anouk Burger, Elske Gieteling, Bart Homan, Rosa de Jager, Emma Kleipool, Gooke Lagaay, Petra Moens, Astrid Verburg-Bakker, Barbara Verhaar, and Kathelijn Versteeg for their efforts and contribution to the Amsterdam Aging Cohort. H.R.-M. performs contract research for Combinostics; all funding is paid to her institution. The other authors declare no conflicts of interest. Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - Objectives: This study aimed to investigate the interrelation between slowing in walking, thinking and mood, and their relationship with cerebral small vessel disease (CSVD) in a geriatric population. Design: Cross-sectional study. Setting and Participants: 566 geriatric outpatients from the Amsterdam Aging Cohort (49% female; age 79 ±6 years), who visited the Amsterdam UMC geriatric outpatient memory clinic. Methods: Patients underwent a comprehensive geriatric assessment, brain imaging, and a neuropsychological assessment as part of medical care. Three slowing aspects were investigated: gait speed, processing speed, and apathy symptoms (higher scores indicating more advanced slowing). We visually rated CSVD [white matter hyperintensities (WMHs), strategic lacunes, and microbleeds] on brain imaging. Results: Regression analyses showed that slowing in walking (gait speed) was associated with slowing in thinking [processing speed; β = 0.35, 95% confidence interval (CI) 0.22, 0.48] and slowing in mood (apathy symptoms; β = 0.21, 95% CI 0.13, 0.30), independent of important confounders. Large confluent areas of WMH (Fazekas 3) were associated with all slowing aspects: gait speed (β = 0.49, 95% CI 0.28, 0.71), processing speed (β = 0.36, 95% CI 0.19, 0.52) and apathy symptoms (β = 0.30, 95% CI 0.09, 0.51). In addition, in patients with more slowing aspects below predefined cutoffs, severe WMH was more common. Presence of ≥3 microbleeds was associated with apathy symptoms (β = 0.39, 95% CI 0.12, 0.66), whereas lacunes were not associated with slowing. Conclusions and Implications: This study provides evidence that slowing in walking, thinking, and mood are closely related and associated with CSVD. This phenotype or geriatric syndrome could be helpful to identify and characterize patients with CSVD.
AB - Objectives: This study aimed to investigate the interrelation between slowing in walking, thinking and mood, and their relationship with cerebral small vessel disease (CSVD) in a geriatric population. Design: Cross-sectional study. Setting and Participants: 566 geriatric outpatients from the Amsterdam Aging Cohort (49% female; age 79 ±6 years), who visited the Amsterdam UMC geriatric outpatient memory clinic. Methods: Patients underwent a comprehensive geriatric assessment, brain imaging, and a neuropsychological assessment as part of medical care. Three slowing aspects were investigated: gait speed, processing speed, and apathy symptoms (higher scores indicating more advanced slowing). We visually rated CSVD [white matter hyperintensities (WMHs), strategic lacunes, and microbleeds] on brain imaging. Results: Regression analyses showed that slowing in walking (gait speed) was associated with slowing in thinking [processing speed; β = 0.35, 95% confidence interval (CI) 0.22, 0.48] and slowing in mood (apathy symptoms; β = 0.21, 95% CI 0.13, 0.30), independent of important confounders. Large confluent areas of WMH (Fazekas 3) were associated with all slowing aspects: gait speed (β = 0.49, 95% CI 0.28, 0.71), processing speed (β = 0.36, 95% CI 0.19, 0.52) and apathy symptoms (β = 0.30, 95% CI 0.09, 0.51). In addition, in patients with more slowing aspects below predefined cutoffs, severe WMH was more common. Presence of ≥3 microbleeds was associated with apathy symptoms (β = 0.39, 95% CI 0.12, 0.66), whereas lacunes were not associated with slowing. Conclusions and Implications: This study provides evidence that slowing in walking, thinking, and mood are closely related and associated with CSVD. This phenotype or geriatric syndrome could be helpful to identify and characterize patients with CSVD.
KW - Slowing
KW - apathy
KW - cerebral small vessel disease
KW - gait speed
KW - geriatric patients
KW - processing speed
UR - http://www.scopus.com/inward/record.url?scp=85114236178&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jamda.2021.07.031
DO - https://doi.org/10.1016/j.jamda.2021.07.031
M3 - Article
C2 - 34454919
SN - 1525-8610
VL - 23
SP - 47-53.e2
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 1
ER -