To explore the relation between (changes in) cerebrovascular function and the change in cognitive function in older adults with and without MCI across follow-up.
ID
Source
Brief title
Condition
- Central nervous system vascular disorders
- Cognitive and attention disorders and disturbances
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The change in cerebrovascular and cognitive function between the
post-intervention measurements from the previous studies and the measurements
from this follow-up study. Cognitive function will be assessed by comprehensive
neuropsychological testing involving the tests listed in the protocol of the
study in which each individual participated in (either NL54544.091.15 or
NL19014.091.07). Cerebrovascular function measures will consist of cerebral
autoregulation and cerebral vasomotor reactivity.
Secondary outcome
The (change in) physical fitness will be assessed using a submaximal
incremental cycling test, hand grip strength test, 30 second chair stand test,
and a physical activity questionnaire (LAPAQ).
Other study parameters include clinical data on progression of cognitive
impairment (new onset of MCI, changes in severity of MCI, progression to
Alzheimer*s disease or dementia) or development of other diseases or comorbid
conditions.
Background summary
Cardio- and cerebrovascular diseases remain one of the leading causes of
morbidity and mortality in the modern world, with coronary artery disease and
cerebrovascular accidents as the top manifestations. Atherosclerosis is the
underlying pathological mechanism for these diseases, and poses a diagnostic
challenge due to its long asymptomatic phase characterized by progressive
endothelial dysfunction eventually leading to the development of
atherosclerotic plaques. In line with the process and development of coronary
artery disease, endothelial dysfunction has also been implicated in early
cognitive changes and is associated with mild cognitive impairment in older
adults, as well as increased severity of cognitive impairment in patients at
increased risk for dementia.
Mild cognitive impairment (MCI) represents a transition state between typical
age-related cognitive changes and progressive cognitive decline, possibly
leading to Alzheimer*s disease (AD). Older adults diagnosed with MCI progress
to AD at a much higher rate than healthy age-matched peers. However, a portion
of those diagnosed with MCI remain stable and do not develop AD, which poses an
additional prognostic challenge in this vulnerable population. Past year,
increasing evidence has linked changes in cerebrovascular function and/or
cerebral perfusion to the process of cognitive decline. For example, MCI
patients show impairments in cerebrovascular function when compared to
age-matched healthy peers, and may decline at a higher rate such that these two
groups exhibit different trajectories of both cognitive and cerebrovascular
decline. More specifically, aging and MCI status have been linked to impaired
cerebrovascular properties, such as the dilator/constrictor response to changes
in blood pressure (cerebral autoregulation, CA) and to changes in PaCO2
(vasomotor reactivity CVMR).
An important limitation of previous work is that it had a cross-sectional
design, making it difficult to link older age and/or MCI to changes in
cerebrovascular function or cerebral blood flow. Past years, we have performed
studies in older subjects and those with MCI, including comprehensive
assessment of cerebrovascular and cognitive function. By repeating these
measurements, the time between follow-up measurements allow us to provide
unique insight and examine the longitudinal relationship between (changes in)
cognitive and cerebrovascular function in older adults with and without MCI.
Since comprehensive assessment was performed, we can tightly control our
outcomes for potential factors known to influence cerebrovascular and/or
cognitive function (e.g. physical fitness, physical activity patterns).
Study objective
To explore the relation between (changes in) cerebrovascular function and the
change in cognitive function in older adults with and without MCI across
follow-up.
Study design
Observational follow-up.
Study burden and risks
Possible disadvantages/burden associated with participation:
- Placed measurement equipment can be experienced as uncomfortable.
- Discomfort when placing the hand in ice water.
- Fatigue during and after the incremental cycling test.
Philips van Leydenlaan 15
Nijmegen 6525 EX
NL
Philips van Leydenlaan 15
Nijmegen 6525 EX
NL
Listed location countries
Age
Inclusion criteria
- Participated in one of our previous two studies (NL19014.091.07 or
NL54544.091.15);
- Informed consent;
- Adequate visual and auditory acuity to allow neuropsychological testing;
- Caregiver/informant available (applicable to cognitively impaired patients).
Exclusion criteria
- Participants currently enrolled in any investigational drug study.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL71569.091.19 |