Deans' stroke musings: Association of cardiovascular health level in older age with cognitive decline and incident dementia

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, September 2, 2018

Association of cardiovascular health level in older age with cognitive decline and incident dementia

By cherry picking participants it will now require repeated research for patients like us.
https://www.mdlinx.com/journal-summaries/cardiovascular-health-level-dementia-older-adults/2018/08/24/7542485/?

JAMA — Samieri C, et al. | August 24, 2018

Researchers explored the link between cardiovascular health level (defined using the 7-item tool from the American Heart Association [AHA]) and risk of dementia and cognitive decline in older persons. They observed that increased numbers of optimal cardiovascular health metrics and a higher cardiovascular health score were related to a lower risk of dementia and lower rates of cognitive decline. Promoting cardiovascular health as a means to prevent risk factors correlated with cognitive decline and dementia was supported in this analysis.

Methods

Study participants in this population-based cohort study were persons aged 65 years or older from Bordeaux, Dijon, and Montpellier, France, without history of cardiovascular diseases or dementia at baseline who had repeated in-person neuropsychological testing (January 1999–July 2016) and systematic detection of incident dementia (date of final follow-up, July 26, 2016).
Main exposures were the number of the AHA’s Life’s Simple 7 metrics at recommended optimal level (nonsmoking, body mass index < 25, regular physical activity, eating fish twice a week or more and fruits and vegetables at least 3 times a day, cholesterol < 200 mg/dL [untreated], fasting glucose < 100 mg/dL [untreated], and blood pressure < 120/80 mm Hg [untreated]; score range, 0-7) and a global cardiovascular health score (range, 0-14; poor, intermediate, and optimal levels of each metric assigned a value of 0, 1, and 2, respectively).
Main outcomes and measures were incident dementia validated by an expert committee and change in a composite score of global cognition (in standard units, with values indicating distance from population means, 0 equal to the mean, and +1 and -1 equal to 1 SD above and below the mean).

Results

At baseline, among 6,626 study participants (mean age, 73.7 years; 4,200 women [63.4%]), 2,412 (36.5%), 3,781 (57.1%), and 433 (6.5%) had 0 to 2, 3 to 4, and 5 to 7 health metrics at optimal levels, respectively.
Seven hundred forty-five study participants had incident adjudicated dementia over a mean follow-up duration of 8.5 (range, 0.6-16.6) years.
The absolute differences in incident dementia rates for 2, 3, 4, 5, and 6 to 7 metrics were, respectively, -0.26 (95% CI, -0.48 to -0.04), -0.59 (95% CI, -0.80 to -0.38), -0.43 (95% CI, -0.65 to -0.21), -0.93 (95% CI, -1.18 to -0.68), and -0.96 (95% CI, -1.37 to -0.56) per 100 person-years compared with the incidence rate of dementia of 1.76 (95% CI, 1.38-2.15) per 100 person-years among those with 0 or 1 health metrics at optimal levels.
The hazard ratios for dementia were 0.90 (95% CI, 0.84-0.97) per additional optimal metric and 0.92 (95% CI, 0.89-0.96) per additional point on the global score in multivariable models.
The study results showed that the gain in global cognition related to each additional optimal metric at baseline was 0.031 (95% CI, 0.009-0.053) standard units at inclusion, 0.068 (95% CI, 0.045-0.092) units at year 6, and 0.072 (95% CI, 0.042-0.102) units at year 12.

Read the full article on JAMA