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Association of Dementia Risk With Focal Epilepsy and Modifiable Cardiovascular Risk Factors
This cross-sectional study examines data from the UK Biobank to explore the association between focal epilepsy compared with stroke or migraine and the risk of developing dementia and how that risk is affected by modifiable cardiovascular risk factors.
Source: JAMA Neurology - March 27, 2023 Category: Neurology Source Type: research

Association of Vascular Risk Factors and Genetic Factors With Penetrance of Variants Causing Monogenic Stroke
This cohort study examines data from UK Biobank participants who had whole-exome sequencing to determine the frequency of pathogenic variants in the 3 most common monogenic cerebral small vessel diseases and their associations with prevalent and incident stroke and dementia.
Source: JAMA Neurology - October 27, 2022 Category: Neurology Source Type: research

Association of Ischemic Stroke Incidence, Severity, and Recurrence With Dementia in the ARIC Cohort Study
This cohort study evaluates the association between risk of dementia and incident ischemic stroke by stroke severity and recurrence.
Source: JAMA Neurology - January 24, 2022 Category: Neurology Source Type: research

Prevention of Dementia —Thinking Beyond the Age and Amyloid Boxes
It is increasingly recognized that the declines in brain structure and function in persons with no clinical brain disease that we call brain aging and the 2 brain diseases that most frequently affect older adults (dementia and stroke) are the theoretically predictable consequences of a lifetime of injury that overcomes genetically and environmentally determined reserve and resilience, a concept encapsulated in the shorthand phrase life-course illness. Despite this insight, details of the various factors that adversely affect the brain health of older adults (and clarity on which times during life have the greatest effect a...
Source: JAMA Neurology - November 4, 2019 Category: Neurology Source Type: research

Potential New Horizons for the Prevention of Cerebrovascular Diseases and Dementia
In this issue ofJAMA Neurology, Spence et al discuss the effect of pioglitazone, an insulin-sensitizing agent that has been shown to reduce the risk of recurrent stroke and myocardial infarction in patients with insulin resistance, in patients with prediabetes. Prediabetes was defined according to the American Diabetes Association criteria, ie, a hemoglobin A1c level of 5.7% to 6.4% or a fasting plasma glucose level of 100 to 125 mg/dL. Data were taken from the Insulin Resistance Intervention after Stroke (IRIS) study, an international randomized clinical trial performed in patients with previous stroke or transient ischem...
Source: JAMA Neurology - February 7, 2019 Category: Neurology Source Type: research

Birth in a High Stroke Mortality State, Race, and Risk of Dementia
This cohort study examines the risk of dementia in individuals who are born in the Stroke Belt but later reside in California.
Source: JAMA Neurology - July 31, 2017 Category: Neurology Source Type: research

Association Between CV Risk Factors and Familial Alzheimer Disease
This cohort study investigates associations between coronary risk factors, stroke, and late-onset Alzheimer dementia in patients with familial disease.
Source: JAMA Neurology - August 15, 2016 Category: Neurology Source Type: research

Proton Pump Inhibitors and Dementia Incidence
To the Editor I read with interest the article by Gomm and colleagues, which examined the association between the use of proton pump inhibitors (PPIs) and incident dementia in elderly individuals in a prospective study. The authors adopted time-dependent Cox regression analysis, and the time-dependent covariates were polypharmacy and the comorbidities of depression, diabetes, ischemic heart disease, and stroke. Age and sex were also used as confounding factors. The hazard ratio of PPIs for incident dementia was 1.44 (95% CI, 1.36-1.52), and the authors recommended randomized clinical trials to confirm the causal associatio...
Source: JAMA Neurology - June 20, 2016 Category: Neurology Source Type: research

Dementia After Intracerebral Hemorrhage
As acute management of intracerebral hemorrhage (ICH) has improved, more patients survive ICH but are left with significant deficits. In the past, primary evaluations of outcomes after ICH have focused on mortality and levels of functional dependence, with a relatively modest number of patients experiencing true functional independence after ICH or returning to their previous level of functioning. Cognitive outcomes after ICH have thus not been a primary focus of either treatment or natural history studies of ICH, despite their known importance after ischemic stroke and their importance in predicting return to previous functioning.
Source: JAMA Neurology - June 13, 2016 Category: Neurology Source Type: research

Cerebral Microbleeds, Cognition and Therapeutic Implications
A recent major clinical advance in magnetic resonance imaging (MRI) of the brain is the development of paramagnetic-sensitive sequences such as T2-weighted gradient-recalled echo and susceptibility-weighted images for the detection of cerebral microbleeds (CMBs). On brain MRI, CMBs are small (≤5 to 10 mm in diameter), round, dark-signaled lesions that consist of extravasation of blood components through fragile microvascular walls that neuropathologically represent hemosiderin-laden macrophages. Magnetic resonance imaging–detected CMBs are common in elderly individuals, coexist with ischemic stroke and intracerebral he...
Source: JAMA Neurology - June 6, 2016 Category: Neurology Source Type: research

Microbleeds, Mortality, and Stroke in Alzheimer Disease The MISTRAL Study
Conclusions and RelevanceIn patients with AD, the presence of nonlobar microbleeds was associated with an increased risk for cardiovascular events and cardiovascular mortality. Patients with lobar microbleeds had an increased risk for stroke and stroke-related mortality, indicating that these patients should be treated with the utmost care.
Source: JAMA Neurology - March 23, 2015 Category: Neurology Source Type: research