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P1‐420: ASSOCIATION BETWEEN NEUROPSYCHIATRIC DISORDERS AND CEREBRAL SMALL VESSEL DISEASE IN AN ASIAN NON‐DEMENTED MEMORY CLINIC PATIENT COHORT
Author(s) -
Kan Cheuk Ni,
Gyanwali Bibek,
Chong Eddie,
Hilal Saima,
Venketasubramanian Narayanaswamy,
Chen Christopher,
Xu Xin
Publication year - 2019
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 - 10.1016/j.jalz.2019.06.1025
Subject(s) - apathy , dementia , memory clinic , cohort , medicine , hyperintensity , cohort study , quality of life (healthcare) , prospective cohort study , magnetic resonance imaging , disease , psychiatry , radiology , nursing
assessed using a detailed neuropsychological battery administered at baseline; months 1, 2, and 6; and every 6 months thereafter until 36 months. Using the General Cognitive Performance composite as the outcomemeasure, we performed a linear mixed effects model to examine cognitive change at months 1 and 2, and cognitive decline (slope) from months 2-36, controlling for age, sex, and education. We examined main effects of AD signature atrophy and the interaction of AD signature atrophy and delirium on LTCD. Results: Thinner AD Signature cortical thickness was associated with steeper post-operative cognitive slopes (b1⁄4-1.78, p1⁄4.040, Figure1). When the interaction of AD Signature and delirium was added to the model, there was a trend for steeper slopes in those with both thinner AD Signature cortex and delirium (b1⁄4-3.11, p1⁄4.13, Figure2). The effect size for the difference in slope between the groupwith the most atrophy (based on tertiles) and delirium vs. the group with the least atrophy and no delirium was large (Cohen’s d 1⁄41.10). There were no significant differences at baseline, month 1 or 2. Conclusions: AD-related atrophy is associated with steeper slopes of post-operative cognitive decline. Delirium further accelerates this decline, such that patients with the greatest AD-related atrophy and delirium experience the greatest decline. These findings support a relationship between preclinical/prodromal AD, delirium, and post-operative cognitive decline.