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Cognitive performance and complex functionality in a population with mild cognitive impairment and vascular damage
Author(s) -
Guajardo Maria Elena,
Söderlund Maria Elvira,
Pagotto Vanina,
Schapira Marcelo,
Seinhart Daniel Bernardo,
Labos Edith
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.037151
Subject(s) - neurocognitive , medicine , hyperintensity , cognition , odds ratio , population , magnetic resonance imaging , psychology , cardiology , psychiatry , radiology , environmental health
Background Small vessel disease is a frequent cause of vascular damage, observed on magnetic resonance imaging and increased with age.(Pantoni, Poggesi & Inzitari,2007) One scale to assess vascular damage that correlates with cognitive measures is Fazekas scale.(Fazekas, Chawluk, et.al. 1987). Vascular damage can have an impact on cognitive and functional performance. Method Cross‐sectional study with prospective recruitment of patients 65 years or more, evaluated in the Geriatric Section, Italian Buenos Aires Hospital. Patients with MCI and brain MRI were included. All subjects were evaluated with a complete neurocognitive battery, and functional scales (complex activities of daily living: EFE). Patients were divided in 3 categories of vascular brain damage according to the MRI in Fazekas (F) group: 0‐1, 2 and 3. Bivariate analysis and multivariable analysis was performed. Odds ratio (OR) and confidence intervals 95% (CI) were informed. Result 346 patients were included, women 71.7%, mean age: 77.9 (ds 6.1). Fazekas (F) categories: F0‐1: 229 (66.2%), F 2: 79 (22.8 %) y F 3: 38 (11.0 %). Patients with hippocampus atrophy (HA)119 (46.1%).There were no differences in the presence of comorbidities between the 3 categories of Fazekas. Patients with F3 were older (table1). In cognitive profile, patients with F3 showed greater impairment in executive functions and episodic memory than patients with F2 and F0‐1 (table2); in functional profile, patients with F3 showed greater impairment in complex functionality than patients with F2 and F 0‐1 (table 2). Fazekas categories were an independent factor associated with the impairment of the EFE (F3 OR 2.53 CI1.05‐6.11 p= 0.039 ) (Figure 1) and with the free memory delayed recall impairment (F3 OR: 2.84 CI 1.09‐7.43 p= 0.033) (Figure 2) Conclusion The results obtained show a functional cognitive profile in patients with MCI and its associations with vascular damage. Severe vascular damage was independently associated with: 1) the deterioration of complex activities of daily living as a manifestation of executive impairment and 2) the deterioration of free memory delayed recall by compromise executive control processes that is critical for to maintain, code and retrieve long time memories.