TY - JOUR
T1 - Vascular Cognitive Impairment and cognitive decline; a longitudinal study comparing different types of vascular brain injury - The TRACE-VCI study
AU - Boomsma, Jooske M. F.
AU - Exalto, Lieza G.
AU - Barkhof, Frederik
AU - Leeuwis, Anna E.
AU - Prins, Niels D.
AU - Scheltens, Philip
AU - Teunissen, Charlotte E.
AU - Weinstein, Henry C.
AU - Biessels, Geert Jan
AU - van der Flier, Wiesje M.
AU - On-behalf-of-the-TRACE-VCI-study-group, null
N1 - Funding Information: The TRACE-VCI study was supported by Vidi grant 917.11.384 and Vici grand 918.16.616 from ZonMw, The Netherlands, Organisation for Health Research and Development and grant 2010T073 from the Dutch Heart Association to Geert Jan Biessels. Geert Jan Biessels, WIesje van der Flier and Lieza Exalto are recipients of Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation (CVON 2018-28 Heart Brain Connection). Research of the Alzheimer center, Vrije Universiteit Amsterdam, Amsterdam UMC is part of the neurodegeneration research program of the Amsterdam Neuroscience. The Alzheimer Center, Vrije Universiteit Amsterdam, Amsterdam UMC, is supported by Stichting Alzheimer Nederland and Stichting Vrije Universiteit Amsterdam, Amsterdam UMC fonds. The clinical database structure was developed with funding from Stichting Dioraphte. Frederik Barkhof is supported by the National Institute for Health Research (NIHR) and University College London Hospitals NHS Foundation Trust (UCLH) biomedical research center, London, United Kingdom. Funding Information: Members of the TRACE-VCI study group (in alphabetical order, per department) VU University Medical Center, Amsterdam, The Netherlands: Alzheimer Center and Department of neurology: M.R. Benedictus, J. Bremer, W.M. van der Flier, A.E. Leeuwis, J. Leijenaar, I.S. van Maurik, N.D. Prins, P. Scheltens, B.M. Tijms. Department of Radiology and Nuclear Medicine: F. Barkhof, M.P. Wattjes. Department of Clinical Chemistry: C.E. Teunissen. Department of Medical Psychology: T. Koene. University Medical Center Utrecht, Utrecht, The Netherlands: Department of Neurology: E. van den Berg, G.J. Biessels, J.M.F. Boomsma, L.G. Exalto, D.A. Ferro, C.J.M. Frijns, O.N. Groeneveld, R. Heinen, N.M van Kalsbeek, J.H. Verwer. Department of Radiology/Image Sciences Institute: J. de Bresser, H.J. Kuijf. Department of Geriatrics: H.L. Koek. Hospital Diakonessenhuis, Zeist, The Netherlands: Department of Neurology: C.M. Pleizier. E.M. Vriens. Department of Geriatrics: M.E. Hamaker, R.A. Faaij. Onze Lieve Vrouwe Gasthuis (OLVG) West, Amsterdam, The Netherlands: Department of Neurology: J.M.F. Boomsma, H.C. Weinstein. National Institute for Health Research (NIHR) and University College London Hospitals NHS Foundation Trust (UCLH) biomedical research center, London, United Kingdom: Department of Radiology: F. Barkhof. Publisher Copyright: © 2022 The Author(s)
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Background: Little is known about the trajectories of cognitive decline in relation to different types of vascular brain injury in patients presenting at a memory clinic with Vascular Cognitive Impairment (VCI). Methods: We included 472 memory clinic patients (age 68 (±8.2) years, 44% female, MMSE 25.9 (±2.8), 210 (44.5%) dementia) from the prospective TRACE-VCI cohort study with possible VCI, defined as cognitive complaints and vascular brain injury on MRI and at least 1 follow-up cognitive assessment (follow-up time 2.5 (±1.4) years, n = 1172 assessments). Types of vascular brain injury considered lacune(s) (≥1; n = 108 patients (23%)), non-lacunar infarct(s) (≥1; n = 54 (11%)), white matter hyperintensities (WMH) (none/mild versus moderate/severe (n = 211 patients (45%)) and microbleed(s) (≥1; n = 202 patients (43%)). We assessed cognitive functioning at baseline and follow-up, including the Rey Auditory Verbal Learning Test (RAVLT), Trail Making Test (TMT) A and B, category naming task and MMSE. The association of different types of vascular brain injury with cognitive decline was evaluated with linear mixed models, including one type of vascular brain injury (dichotomized), time and vascular brain injury*time, adjusted for sex, age, dementia status (yes/no), education (Verhage scale) and medial temporal lobe atrophy (MTA) score (dichotomized as ≥ 1.5). Results: Across the population, performance declined over time on all tests. Linear mixed models showed that lacune(s) were associated with worse baseline TMTA (Beta(SE)) (8.3 (3.8), p = .03) and TMTB (25.6 (10.3), p = .01), albeit with a slower rate of decline on MMSE, RAVLT and category naming. By contrast, patients with non-lacunar infarct(s) showed a steeper rate of decline on TMTB (29.6 (7.7), p = .00), mainly attributable to patients with dementia (62.9 (15.5), p = .00). Conclusion: Although different types of vascular brain injury have different etiologies and different patterns, they show little differences in cognitive trajectories depending on type of vascular brain injury.
AB - Background: Little is known about the trajectories of cognitive decline in relation to different types of vascular brain injury in patients presenting at a memory clinic with Vascular Cognitive Impairment (VCI). Methods: We included 472 memory clinic patients (age 68 (±8.2) years, 44% female, MMSE 25.9 (±2.8), 210 (44.5%) dementia) from the prospective TRACE-VCI cohort study with possible VCI, defined as cognitive complaints and vascular brain injury on MRI and at least 1 follow-up cognitive assessment (follow-up time 2.5 (±1.4) years, n = 1172 assessments). Types of vascular brain injury considered lacune(s) (≥1; n = 108 patients (23%)), non-lacunar infarct(s) (≥1; n = 54 (11%)), white matter hyperintensities (WMH) (none/mild versus moderate/severe (n = 211 patients (45%)) and microbleed(s) (≥1; n = 202 patients (43%)). We assessed cognitive functioning at baseline and follow-up, including the Rey Auditory Verbal Learning Test (RAVLT), Trail Making Test (TMT) A and B, category naming task and MMSE. The association of different types of vascular brain injury with cognitive decline was evaluated with linear mixed models, including one type of vascular brain injury (dichotomized), time and vascular brain injury*time, adjusted for sex, age, dementia status (yes/no), education (Verhage scale) and medial temporal lobe atrophy (MTA) score (dichotomized as ≥ 1.5). Results: Across the population, performance declined over time on all tests. Linear mixed models showed that lacune(s) were associated with worse baseline TMTA (Beta(SE)) (8.3 (3.8), p = .03) and TMTB (25.6 (10.3), p = .01), albeit with a slower rate of decline on MMSE, RAVLT and category naming. By contrast, patients with non-lacunar infarct(s) showed a steeper rate of decline on TMTB (29.6 (7.7), p = .00), mainly attributable to patients with dementia (62.9 (15.5), p = .00). Conclusion: Although different types of vascular brain injury have different etiologies and different patterns, they show little differences in cognitive trajectories depending on type of vascular brain injury.
KW - Cognitive decline
KW - Cognitive trajectories
KW - Vascular Cognitive Impairment
KW - Vascular brain injury
UR - http://www.scopus.com/inward/record.url?scp=85127469364&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.cccb.2022.100141
DO - https://doi.org/10.1016/j.cccb.2022.100141
M3 - Article
C2 - 36324410
SN - 2666-2450
VL - 3
JO - Cerebral Circulation - Cognition and Behavior
JF - Cerebral Circulation - Cognition and Behavior
M1 - 100141
ER -