An integrated investigation of vascular cognitive impairment in population based studies across Europe.
Lead Research Organisation:
University of Cambridge
Department Name: Public Health and Primary Care
Abstract
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Technical Summary
With increases in the prevalence of dementia a preventative strategy is urgently needed. Identification of modifiable risk factors is a priority. Apart from age, vascular disease (VD) is the second largest single identifiable risk factor for dementia and the only one currently treatable. Although the acute effect of VD on cognitive performance has been identified long term risk is poorly understood, especially at the population level.
Numerous concepts have been developed in an attempt to identify patients at risk of dementia. the most widely used is mild cognitive impairment (MCI). This defines a transitional state between ‘normal‘ ageing and pathological decline, focusing on memory dysfunction. whether this concept is equally applicable to the early stages of cognitive decline in the context of VD is not known, particularly as studies indicate that memory is typically preserved in these individuals. A recent consensus meeting agreed on the term mild vascular cognitive impairment (mVCI) to refer to individuals with early cognitive deficits typically associated with attention and executive performance in the context of VD. However, there is no formal agreed definition or diagnostic criteria for MCI or mVCI and their relation to dementia is unclear.
With improvements in the ability to quantify the overall burden of VD and the effect on the brain through increased access to neuropathological resources and advances in non-invasive techniques (i.e. imaging), what is needed is a more precise understanding of which risk factors lead to disease initioation, progression and prognosis using a life course epidemiological approach. This project will examine the association between vascular risk factors and different functional and anatomical markers of brain disease pooled across studies including: memory/non-memory domains of congnitive function; MRI measures of white matter lesions, regional brain atrophy, cerebrovascular disease; and neuropathological markers of dementia and its sub-types, including Alzheimer‘s Disease and vascular dementia. In addition, the relation between diet, physical health, cardiovascular health and cognitive decline will also be investigated across mid to late life. Understanding the interrelationships between vascular health, lifestyle (i.e. diet and physical activity), cognitive decline and dementia will have an impact on prevention and treatment strategies.
Numerous concepts have been developed in an attempt to identify patients at risk of dementia. the most widely used is mild cognitive impairment (MCI). This defines a transitional state between ‘normal‘ ageing and pathological decline, focusing on memory dysfunction. whether this concept is equally applicable to the early stages of cognitive decline in the context of VD is not known, particularly as studies indicate that memory is typically preserved in these individuals. A recent consensus meeting agreed on the term mild vascular cognitive impairment (mVCI) to refer to individuals with early cognitive deficits typically associated with attention and executive performance in the context of VD. However, there is no formal agreed definition or diagnostic criteria for MCI or mVCI and their relation to dementia is unclear.
With improvements in the ability to quantify the overall burden of VD and the effect on the brain through increased access to neuropathological resources and advances in non-invasive techniques (i.e. imaging), what is needed is a more precise understanding of which risk factors lead to disease initioation, progression and prognosis using a life course epidemiological approach. This project will examine the association between vascular risk factors and different functional and anatomical markers of brain disease pooled across studies including: memory/non-memory domains of congnitive function; MRI measures of white matter lesions, regional brain atrophy, cerebrovascular disease; and neuropathological markers of dementia and its sub-types, including Alzheimer‘s Disease and vascular dementia. In addition, the relation between diet, physical health, cardiovascular health and cognitive decline will also be investigated across mid to late life. Understanding the interrelationships between vascular health, lifestyle (i.e. diet and physical activity), cognitive decline and dementia will have an impact on prevention and treatment strategies.
