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UBC Theses and Dissertations

The relationship between white matter lesion volume with vascular stiffness, mobility and cognitive performance in older adults with vascular cognitive impairment Al Keridy, Walid Ahmed


Background: Sub-cortical ischemic vascular cognitive impairment (SIVCI) is the most prevalent form of Vascular Cognitive Impairment (VCI). Previous studies have shown that Carotid-Femoral Pulse Wave Velocity (CF-PWV), cognitive function, mobility performance and blood pressure are related to White Matter Lesions (WMLs) volume, but whether these associations exist in those with mild SIVCI is unclear. Thus, in this study of older adults with mild SIVCI, I examined four questions: 1) What is the association between total, deep and periventricular WMLs volume on Magnetic Resonance Imaging (MRI) with CF-PWV? 2) What are the associations between total, deep and periventricular WMLs volume and measures of global cognitive function and executive function? 3) What is the association between total, deep and periventricular WMLs volume with mobility performance? 4) What is the association between total, deep and periventricular WMLs volume with systolic and diastolic blood pressure? Methods: The data of 34 participants diagnosed with mild SIVCI were used for this cross-sectional analysis. Measures of interest included global cognitive function tests, such as Alzheimer’s disease Assessment Scale Cognitive Subscale (ADAS-cog) and Montreal Cognitive Assessment (MoCA). Executive functions were assessed with paper Stroop test, Trails Making Tests (A&B) and animal fluency. Mobility performance was assessed with the Time Up and Go test (TUG) and usual gait speed. CF-PWV was measured using the Complior System (ALAM Medical, France). WMLs volume was quantified for the total, deep and periventricular WMLs with a semi-automated technique. Results: We did not find an association between total or periventricular WMLs volume with CF-PWV, executive function, global cognitive function, mobility performance or blood pressure. Deep WMLs volume was associated with Trails B-A and animal category fluency but not associated with measures of global cognitive function. Deep WMLs volume was significantly associated with diastolic blood pressure. Conclusion: In this exploratory analysis, deep WMLs volume is associated with executive function and diastolic blood pressure. While systolic hypertension has been strongly linked to large vessel stroke events which are commonly complicated by post stroke cognitive impairment and dementia, our findings provide possible mechanistic insight to previous studies that found association between diastolic blood pressure and cognitive decline.

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