Vascular Risk Research Articles (Page 2)

Dietary glycocalyx mimetic reduces vascular risk in Type2 diabetes: evidence from urinary peptidomic classifiers in a South-Asian Surinamese Cohort.

Circle of Willis Configuration Is Not Associated with Early Neurological Deterioration in Lacunar Stroke.

Leukoaraiosis is a common imaging marker of cerebral small vessel disease. There is now increasing evidence shows the relationship between leukoaraiosis and cognitive impairment, high risk of death after stroke. The aim of this study was to analyze the risk factors clinically associated with the development of leukoaraiosis, and to explore clinical biomarkers that may predict leukoaraiosis. Inpatients were continuously recruited from July 2014 to October 2020. After admission, the cranial MRI examination was evaluated, and the severity of leukoaraiosis were evaluated and graded. Vascular risk factors and relevant clinical data were collected. Univariate analysis was used to analyze the parameters, and multivariate logistic regression analysis was used to analyze the statistically significant parameters. The analysis results were plotted as ROC curve to find out the diagnostic accuracy of the model. 1) 327 patients meeting the study criteria were included. Univariate analysis showed that 13 factors were statistically significantly (p < 0.05). 2) Multivariate logistic regression model showed that age (Age 1 [OR, 14.315; 95% CI, 6.662-30.757; p = 0.000], Age 2 [OR, 53.062; 95% CI, 15.661-179.783; p = 0.000]), elevated systolic blood pressure (SBP 1 (OR, 2.927; 95% CI, 1.224-7.003; p = 0.016), SBP 3 (OR, 15.109; 95% CI, 1.380-165.385; p = 0.026)), ischemicstroke (OR, 5.990; 95% CI, 2.594-13.846; p = 0.000), and FT4 (OR, 4.836; 95% CI, 2.086-11.216; p = 0.000) were independent risk factors for leukoaraiosis. 3) The ROC curve indicated the accuracy of diagnosis on leukoaraiosis is 0.906, and the positive rate and negative rate are both 85.2%. 1) Our findings support age, systolic blood pressure, ischemic stroke, and FT4 level serving as factors affecting the development of leukoaraiosis. 2) The model of "age, systolic blood pressure, ischemicstroke, FT4" may have relatively ideal sensitivity and specificity in predicting the development of leukoaraiosis.

A 67-year-old woman with myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis presented with progressive cognitive decline and was diagnosed with amnestic mild cognitive impairment. Brain magnetic resonance imaging (MRI) revealed chronic infarcts consistent with cerebral small vessel disease. Although conventional vascular risk factors were present, they were insufficient to fully account for the imaging and clinical findings. This case suggests that MPO-ANCA-associated vasculitis should be considered in the differential diagnosis of patients presenting with vascular cognitive impairment, particularly in the presence of systemic inflammatory features.

ABSTRACTINTRODUCTIONNeighborhood deprivation increases dementia risk, although mechanisms remain unclear. We tested a framework in which modifiable risk factors and cerebral small vessel disease (SVD) mediate the link between neighborhood deprivation and cognition.METHODSIn 585 cognitively healthy midlife adults (ages 40–59), neighborhood deprivation was derived from postcodes, cognition was assessed using the COGNITO, lifestyle risk factors were measured using clinical assessments, and SVD (white matter hyperintensities, lacunes, microbleeds, perivascular spaces) was assessed on 3T magnetic resonance imaging. Multivariate analyses examined association pathways among these variables.RESULTSNeighborhood deprivation was associated with poorer cognition (r = 0.36, p < 0.001), greater prevalence of modifiable risk factors (r = 0.36, p < 0.001), and greater SVD burden (β = 0.18, p = 0.008). Serial mediation showed that the effects of deprivation on cognition were indirect, possibly operating via lifestyle risk and SVD, explaining 20% of the total effect, whereas SVD alone explained 28%.DISCUSSIONNeighborhood disadvantage relates to poorer cognition, possibly mediated through vascular risk factors and cerebrovascular disease.HighlightsNeighborhood deprivation linked to poorer cognition in healthy midlife adultsDeprivation linked to small vessel disease (SVD) and modifiable risk factors (chiefly cardiovascular risk)Association between deprivation and cognition mediated by modifiable risk and SVDMediation was exclusive to hypertensive SVD, but not cerebral amyloid angiopathy (CAA)‐related SVD

BackgroundBlood pressure variability (BPV) is associated with neurodegeneration and cognitive decline independent of average pressure. The effect of parasympathetic central autonomic network (CAN) impairment on this relationship has not been assessed.ObjectiveDetermine whether parasympathetic CAN network function affects the relationship between BPV and neurodegenerative markers.Methods100 independently living older adults (55-89 years) underwent continuous blood pressure monitoring, neuropsychological testing, venipuncture, and brain MRI. Hippocampal volumes and entorhinal cortex thicknesses were assessed. Functional connectivity within a parasympathetic cardiovascular control network was used as a measure of parasympathetic CAN function. Plasma glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) were used as measures of glial and neuronal injury, respectively.ResultsElevated BPV was associated with left hippocampal atrophy (p = 0.03) and elevated plasma GFAP (p = 0.005) independent of age, sex, vascular risk factor burden, total intracranial volume (when applicable) and average blood pressure. These relationships were not mediated by parasympathetic central autonomic network impairment. Instead, parasympathetic CAN impairment conferred a vulnerability to elevated BPV. In participants with decreased parasympathetic CAN connectivity elevated BPV was associated with left entorhinal cortex atrophy (p = 0.0001), elevated plasma GFAP (p = 0.0001), elevated plasma NfL (p = 0.001), and memory impairment (p = 0.007).ConclusionsFindings suggest elevated beat-to-beat BPV is directly related to brain injury, and this effect is not mediated by CAN dysfunction. Instead, CAN impairment may confer a susceptibility to glial and neuronal injury in older adults with elevated beat-to-beat blood pressure variability. Mechanisms underlying increased susceptibility to BPV elevation in those with CAN dysfunction warrants further study.

Schizophrenia is increasingly recognized as a disorder not only of early neurodevelopment but also of accelerated brain aging. Structural brain aging is characterized by neuronal loss, synaptic degeneration, and cortical atrophy, with particular vulnerability in the medial temporal lobe and hippocampal formation. Vascular brain aging contributes through both overt cerebrovascular events and insidious small vessel disease, compounded by modifiable risk factors such as hypertension and metabolic dysfunction. Functional brain aging, reflected in altered connectivity, intersects with the pathophysiology of schizophrenia, highlighting the dynamic interplay between disease processes and age-related decline across the lifespan. Effective management strategies should therefore include early detection of neurodegenerative changes, integrated care models bridging psychiatric and dementia services, multi-domain lifestyle interventions targeting vascular risk, and emerging neuromodulation approaches. While therapeutic evidence remains preliminary, these strategies underscore the importance of preserving cognitive reserve and promoting brain health in patients with schizophrenia as they age.

Background: Diabetes mellitus (DM) and hypertension (HTN) are key drivers of microvascular retinal damage. Coexisting diabetic retinopathy (DR) and hypertensive retinopathy (HR) synergistically exacerbate retinal pathology, increasing the risk of irreversible vision loss. This Case Report details the management of severe proliferative diabetic retinopathy (PDR) and high-grade hypertensive retinopathy. Methods: A 55-year-old male with a 12-year history of poorly controlled type 2 DM (HbA1c 9.1%) and chronic HTN (≈170/100 mmHg) presented with progressive bilateral vision loss. Managed at Dr. Jawahar Lal Rohtagi Memorial Eye Hospital, Kanpur, from 2018 to 2025, his ophthalmic evaluation showed best-corrected visual acuity of 6/18 OD and 6/24 OS. Dilated fundus examination, fundus photography, and fluorescein angiography confirmed active PDR with high-risk neovascularization and Grade III hypertensive retinopathy, characterized by severe arteriolar narrowing, arterio-venous nicking, haemorrhages, and cotton-wool spots. Spectral-domain optical coherence tomography verified centre-involving diabetic macular oedema (DME) with elevated central retinal thickness. Results: A multidisciplinary approach was employed, including intensified insulin therapy for glycaemic control, an optimized antihypertensive regimen (ACE inhibitor, calcium channel blocker, diuretic), and ocular interventions. Pan-retinal photocoagulation addressed PDR, while intravitreal ranibizumab injections treated DME. Over 7 years, stabilization of proliferative changes, reduction of DME and systemic improvements preserved functional vision. Conclusion: Coexisting PDR and HR require urgent, coordinated intervention. Evidence-based ocular therapies (anti-VEGF, PRP) and rigorous systemic control of glycaemia and blood pressure are critical for vision preservation and mitigating vascular risks.

Major psychiatric disorder, including schizophrenia, bipolar disorder, and major depressive disorder, has been individually associated with increased risk of stroke. However, few studies have directly compared the stroke risk across these diagnostic groups within a unified cohort framework while accounting for stroke subtypes and relevant confounders. Using Taiwan's National Health Insurance Research Database, we identified 30,945 patients with schizophrenia, 30,360 with bipolar disorder, 30,447 with major depressive disorder, and 91,752 age-matched controls without psychiatric illness between 2001 and 2009. Participants were followed until death or the end of 2011. Cox regression models were used to estimate the hazard ratio (HR) for ischemic and hemorrhagic stroke, adjusting for potential confounding factors. Sensitivity analyses were conducted by excluding stroke events occurring within the first 1 or 3 years of psychiatric diagnosis. All three psychiatric groups exhibited significantly higher risks of ischemic and hemorrhagic stroke compared with controls. Stroke risk remained consistently elevated across age and sex strata for all psychiatric groups. Greater cumulative exposure to antidepressants was associated with reduced stroke risk across all three disorders; antipsychotics showed protective associations in schizophrenia and bipolar disorder, non-lithium mood stabilizers were protective only in bipolar disorder, and lithium showed no significant association with stroke risk. Schizophrenia, bipolar disorder, and major depressive disorder are independently associated with increased stroke risk. These findings highlight the need for integrated vascular risk monitoring in psychiatric care.

Vascular cognitive impairment (VCI) describes cerebrovascular disease (CeVD)-associated cognitive disorders regardless of pathogenesis, ranging from a prodrome to dementia. Heterogeneity in the etiology and severity of CeVD, and significant co-occurrence with Alzheimer's disease (AD) pathology has hampered investigations. Research into VCI is especially relevant in Asia, where cognitive impairment and dementia, often due to VCI, grows due to rapidly aging populations and high prevalence of vascular risk factors. This manuscript reviewed the rationale, unique positioning, design, methodology, and findings from the HARMONISATION study, a prospective observational study of VCI and AD in multi-ethnic Asians. HARMONISATION aimed to discover and validate novel biomarkers as effective diagnostic and prognostic tools, and translate findings into improved patient care, disease management and treatment-utilizing comprehensive multimodal clinical, neuroimaging, retinal, and blood biomarker data to address critical research gaps such as the etiology and clinical importance of mixed dementia, relationships between AD and CeVD pathology, and challenges of heterogenous CeVD pathology. HARMONIZATION recruited and deeply phenotyped 700 older multi-ethnic Asians with no cognitive impairment, mild cognitive impairment, and dementia for up to 5 years of follow-up. It has yielded developments in biomarker identification, validation, interactions and analysis methods; disease mechanisms and progression; clinical prognostics for VCI and AD; improved patient care and management; and enabled future development of novel interventions in Asians, and globally. An ongoing extension study will allow up to 10 years follow-up to further explore specific modifiable processes of VCI and the contributions of vascular events to cognitive impairment.

Functional magnetic resonance imaging (fMRI) is commonly used to investigate the neural bases of aging and psychological disorders. However, the BOLD signal captured by fMRI is affected by many factors that are non-neural in origin. We tested how vascular health risks, which often go unmeasured in neuroimaging studies, and aging interact to modify the shape and/or timing of the HRF, which then affect the differences in patterns of brain activity in a task-evoked memory encoding paradigm. Adult participants (aged 20–74) answered questions about their health and underwent two fMRI tasks: viewing a flashing checkerboard and a memory encoding task. Aging and vascular risk had the largest impacts on the maximum peak value of the HRF. Using a subject-specific HRF resulted in a dampening of brain activity in task-positive and task-negative regions. Across three vascular risk factors, using a subject-specific HRF resulted in more consistent brain regions that reached significance and larger effect sizes compared with the canonical HRF. These findings serve as a cautious tail when interpreting task-evoked fMRI activity, especially in populations experiencing alterations to brain vasculature including many older adults and people with neurocognitive disorders like Alzheimer’s disease and related dementias.

In this cross-sectional observational study, we investigated whether recreational exercise (RE) influences systemic inflammation in Hashimoto’s thyroiditis (HT) across different disease severity groups. We analyzed 403 participants from the Croatian Biobank of Patients with HT (CRO-HT), including 173 controls and 230 HT patients (euthyroid, levothyroxine [LT4]-treated, and hypothyroid). Serum levels of 92 inflammatory proteins were measured using the Olink® Target 96 Inflammation panel, and exercise status was assessed via structured questionnaires. Linear regression revealed distinct protein associations depending on thyroid status. In controls, RE was associated with reduced MMP-10 and FGF-5, reflecting cardiovascular and muscle benefits. In euthyroid patients, RE was associated with decreased CXCL9 and TRAIL, implicating reduced type 1 inflammation and vascular risk. LT4-treated patients showed increases in IL-15RA and IL-24 with RE, suggesting improved muscle metabolism and anti-inflammatory effects. In hypothyroid patients, RE was associated with reduced CCL20 and increased HGF, while changes in TRANCE and TWEAK indicated mixed effects on bone and immune regulation. Notably, RE was associated with reduced CXCL9 and CCL20, two proteins previously linked to HT risk. Overall, RE is associated with distinct changes in inflammatory profiles across HT disease severity groups, with the most favourable responses observed in LT4-treated patients, suggesting synergy with hormone therapy.

White matter hyperintensity, a key imaging biomarker for brain health, has prognostic implications for stroke. Using a multicenter MRI dataset of 9179 stroke patients plus the UK Biobank (n = 36,210 low/high risk controls), we employ Subtype and Stage Inference modeling and identify three distinct white matter hyperintensity progression subtypes: fronto-parietal, radial, and temporo-occipital. Longitudinal validation confirms classification stability. The fronto-parietal subtype shows delayed onset and more hypertension, while the temporo-occipital subtype has more atrial fibrillation and coronary heart disease. The fronto-parietal and radial subtypes are linked to small vessel stroke, while the temporo-occipital subtype is linked to cardioembolism. The fronto-parietal subtype has higher 1-year ischemic stroke recurrence, while the temporo-occipital subtype shows a higher incidence of early neurological deterioration by symptomatic hemorrhagic transformation and worse 3-month outcomes. Beyond capturing progression, demographics, and vascular risks, and improving post-stroke outcome prediction, this subtyping–staging model also holds potential for stroke prediction.

Rationale:Percutaneous vertebroplasty (PVP) is an effective and minimally invasive treatment for osteoporotic vertebral compression fractures. Although generally safe, rare but life-threatening vascular complications may occur, particularly in frail elderly patients.Patient concerns:A 90-year-old woman with a history of chronic obstructive pulmonary disease, cardiac insufficiency, and type II respiratory failure presented with severe thoracolumbar pain refractory to conservative treatment.Diagnoses:Imaging confirmed T10 and L1 osteoporotic compression fractures with severe osteoporosis (T-score − 4.5). Two hours after PVP, she developed nausea and diarrhea, followed by hypotension (73/40 mm Hg) and hemoglobin decline (Δ45 g/L). Computed tomography angiography confirmed retroperitoneal hematoma due to lumbar artery rupture.Interventions:The patient underwent urgent superselective embolization via digital subtraction angiography and transfusion therapy, followed by intensive care monitoring.Outcomes:Hemostasis was successfully achieved. She was discharged on postoperative day 14, with recovery to baseline activities of daily living at the 3-month follow-up.Lessons:This case highlights that fracture-induced displacement of lumbar arteries and transverse process hypoplasia increase vascular injury risk during PVP, atypical gastrointestinal symptoms may serve as early warning signs of retroperitoneal hemorrhage, and tailored preoperative vascular imaging and staged surgical strategies should be considered in frail patients undergoing multilevel PVP.

Retinal vascular occlusion (RVO), a common eye condition, has been hypothesized as a potential indicator of neurodegenerative risk. This systematic review and meta-analysis aimed to quantitatively assess the association between RVO and the subsequent development of dementia. A comprehensive search of major databases was conducted to identify cohort studies investigating the association between RVO and dementia. Data on hazard ratios (HRs) and odds ratios (ORs) for all-cause dementia, Alzheimer's disease, and vascular dementia were extracted. Pooled effect estimates were calculated using a random-effects model. Six cohort studies with a pooled sample size of 4,638,720 participants were included. The pooled odds ratio for developing dementia in patients with RVO was 1.54 (95% CI (0.95, 2.47), p = 0.08; I² = 62%). The pooled hazard ratio for all-cause dementia was 1.04 (95% CI (0.92, 1.16), p = 0.56; I² = 93%). For Alzheimer's disease, the pooled HR was 1.01 (95% CI (0.91, 1.13), p = 0.83; I² = 78%). Notably, the pooled hazard ratio for vascular dementia showed a statistically significant increased risk in patients with RVO at 1.15 (95% CI (1.04, 1.28), p = 0.008; I² = 40%). This meta-analysis suggests a significant association between RVO and increased vascular dementia risk, highlighting RVO as a potential marker for vascular-related cognitive decline, warranting further investigation.

Disclosure: R. Trivedi: None. S. Chrysafides: None. N. Rahman: None. A. Lim: None. A.F. Firek: None. I. Munir: None. A. Yang: None. M. Firek: None.Background: PCOS is the most common endocrine disorder present in women of reproductive age and is characterized by various degrees of insulin resistance placing them at risk for dyslipidemia, hypertension, diabetes, and nonalcoholic steatohepatitis. Importantly, these metabolic determinants may increase the risk for future atherosclerotic and venous thrombotic events such as myocardial infarction, stroke, and heart failure. Traditionally therapy for PCOS has largely been targeted at cosmetic therapies and lifestyle modifications, the purpose of this study is to explore metabolic and vascular risks of PCOS for adverse health outcomes and overall risk for general hospitalizations. Method: This study compared vascular health consequences of women with PCOS to women without PCOS utilizing deidentified National Inpatient Sample (NIS) data for hospital admissions from 2016-2022. We analyzed a total of 205,960 women hospitalized aged 18-80 with a concomitant diagnosis of PCOS. Data was separated by age categories (18 to 30, 30 to 40, 40 to 50, and 50 to 80) and by reason for hospitalization (thrombotic, atherosclerotic and cerebrovascular disease). These populations were compared to women without PCOS who were hospitalized for the same reasons in the same time span. Within these groups, we compared the incidence of new ischemic events including myocardial infarction (MI), stroke, peripheral vascular disease (PVD), and death during hospitalization. Results: When compared to women without PCOS, a significantly greater percentage of women with PCOS who were hospitalized for thrombotic, atherosclerotic, and cerebrovascular disease were below the age of 50 (92.59% vs 27.03% for thrombotic, 74.21% vs 11.49% for atherosclerotic, and 86.06% vs 12.18% for cerebrovascular diseases, p<0.05). When analyzing MI, PVD, and stroke in thrombotic populations, women with PCOS had an increase in incidence of stroke (14.81% vs 11.97%). Additionally, women with PCOS in the atherosclerotic population had a comparable overall incidence of MI when compared to without PCOS group (91.82% vs 94.13%). Although the incidence of MI and PVD were lower in both thrombotic and atherosclerotic groups with PCOS, death rates during hospitalization were comparable (2.90% vs 2.47% and 3.54% vs 3.14% respectively). Conclusion: Women with PCOS are at increased relative risk for acute overall hospitalizations and vascular events compared to women without PCOS. Despite being at a significantly younger age on average, women with PCOS face equivalent mortality from these vascular events compared to women without PCOS. Our findings support expanding guidelines to recognize PCOS as a condition with increased vascular risk and to consider early and aggressive interventions for risk reduction.Presentation: Saturday, July 12, 2025

Abstract Background and Aims Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in patients with chronic kidney disease on dialysis (CKD-5D). These patients are at a very high vascular risk (VR) and yet do not always achieve optimal control of cardiovascular risk factors (CVRFs). Our goal is to assess, in a large sample of CKD-5D patients in Spain, the degree of control over CVRFs (hypertension, diabetes, and dyslipidemia) and the factors involved. Method A multicenter, interventional, prospective study conducted under routine clinical practice conditions. Patients undergoing hemodialysis were randomly selected from 20 dialysis centers across Spain. The study was approved by the Ethics Committee. According to international guideline criteria, control targets were defined as follows: for hypertension (HTN), blood pressure (BP) &amp;lt;140/80 mmHg for patients &amp;gt;65 years and &amp;lt;130/80 mmHg for those &amp;lt;65 years; for dyslipidemia, LDL-c targets of &amp;lt;70 mg/dL for high VR and &amp;lt;55 mg/dL for very high VR; and for diabetes, HbA1c &amp;lt;7% or &amp;lt;8% in patients ≥80 years. Results A total of 504 patients were included (347 men, 157 women); among them, 471 (93.4%) were hypertensive, 238 (47.2%) diabetic, and 397 (78.7%) dyslipidemic. A total of 207 patients (41%) were simultaneously hypertensive, dyslipidemic, and diabetic. The percentage of CVRF control was as follows: hypertension, 218 patients (43.2%); diabetes, 155 patients (65.1%); and dyslipidemia, 198 patients (49.8%). Only 38 patients (7.5%) achieved control of all three CVRFs simultaneously. In 5.4% (27 patients), none of the factors (HTN, diabetes, or dyslipidemia) were controlled. Among diabetic patients, 16% had all three factors controlled, while 11.3% had all CVRFs uncontrolled. Conclusion Among the population of CKD-5D patients treated in Spain, the control of cardiovascular risk factors is remarkably low. A total of 92.5% of patients are not meeting control targets as defined by international vascular risk guidelines, and only 7.5% achieve these objectives. Active pharmacological intervention by clinicians aimed at managing these factors could improve the prognosis for these patients.

Abstract Background and Aims Moderately elevated albumin excretion in the urine, semiquantified by the urine albumin-creatinine ratio (uACR), has been shown to increase the risk for vascular or renal end-points in patients with diabetes mellitus, arterial hypertension, high cardiovascular risk, or even the general population. The mechanisms behind this relation are still under debate. Pulse wave velocity (PWV) is a marker of arterial stiffness, which includes endothelial function. In patients with renal disease, a relation between uACR and enhanced PWV was described. Until now such relation has not been extensively studied in an average risk, low morbidity cohort. Method We cross-sectionally studied individuals participating in a local subcohort of the German National Cohort (NAKO), a large population-based cohort that recruited participants aged 19–74 years. Urinary albumin-creatinine ratio was determined from a spontaneously voided sample and pulse wave velocity was measured using a plethysmographic device (Vascular ExplorerTM) with cuffs at the upper arm and the ankle. The PWV was compared between categories auf uACR (0–&amp;lt;30 mg/g, 30–&amp;lt;300 mg/g and 300+ mg/g) by ANOVA. Further, a multivariate linear model corrected for age, BMI, eGFR, and HbA1c was analyzed. Results Complete data sets were available from 4,798 individuals of the local cohort, 51% male, age 50.3 ± 12.9 years, body mass index 26.9 ± 4.9 (mean ± SD). Among these participants, 207 (4.3%) reported a history of cardiac disease, 112 (2.3%) of peripheral artery disease, 353 of diabetes mellitus (7.4%), and 117 (2.4%) of kidney disease, 4.048 (84.3%) reported none of these conditions. The average uACR was 17.6 ± 152.9 mg/g with 341 (7.1%) participants showing a value above 30 mg/g. The average eGFR was 99.0 ± 15.2 ml/min with 65 (1.4%) participants showing eGFR &amp;lt;60 ml/min. The PWV was slightly higher in participants with uACR &amp;gt;30 mg/g than in those with uACR &amp;lt;30 mg/g (P &amp;lt; 0.001) (Fig. 1). The uACR was predictive for PWV in multivariate analysis correcting for typical vascular risk factors. Sensitivity analysis showed that this relation still held true after excluding individuals who reported a history of vascular, metabolic or renal disease. Conclusion Albuminuria is associated with elevated pulse wave velocity in a population-based cohort with low metabolic, vascular, and renal disease load. Further studies should address the role of low-level albuminuria in the absence of overt cardiovascular disease.

BackgroundEnlarged perivascular spaces of the basal ganglia (BG-EPVS), an emerging topic in cerebral small vessel disease, are known to be associated with executive dysfunction. However, their relationships with specific domains of executive function remain unclear.ObjectiveThis study aimed to clarify the association between BG-EPVS and cognitive function, as assessed by the Frontal Assessment Battery (FAB).MethodsWe performed a cross-sectional analysis using data from our prospective cohort study to investigate the association between gut microbiota and dementia. We enrolled patients who visited a memory clinic and collected information on demographics, risk factors, and cognitive function, as well as brain imaging data. EPVS severity in the basal ganglia and centrum semiovale was rated according to magnetic resonance imaging data. We examined the relationship between severe BG-EPVS and FAB scores, including on individual FAB subtests.ResultsWe analyzed 100 participants (mean age: 76 years, 47% women). Multivariable analyses showed that a lower FAB total score (< 13 points) was independently associated with severe BG-EPVS (odds ratio: 4.37, 95% confidence interval: 1.08-17.8). Among the FAB subtests, a lower score (< 2 points) on the similarities subtest was independently associated with severe BG-EPVS (odds ratio: 3.01, 95% confidence interval: 1.07-8.51). However, there was no significant association between EPVS in the centrum semiovale and the FAB score.ConclusionsIn this study, severe BG-EPVS were independently associated with a lower FAB score, particularly on the similarities subtest. Effective management of vascular risk factors for BG-EPVS in older adults is important for preventing cognitive decline.

Abstract Background and Aims Associations of glomerular hyperfiltration with vascular events and death have been reported, particularly in community populations, but have scarcely been investigated in patients with stroke. Method Centres from the Microbleed International Collaborative Network (MICON) contributed data on estimated glomerular filtration rate (eGFR), recurrent stroke events and death. Using Cox proportional hazards regression modelling, we investigated associations of glomerular hyperfiltration with recurrent ischaemic stroke (IS), symptomatic intracranial haemorrhage (ICrH), death and vascular death. Hyperfiltration was defined as eGFR greater than the age and gender-adjusted 95th percentile. Hypofiltration was defined as eGFR &amp;lt;60 ml/min/1.73 m2. Results 11,175 patients (mean age 70.7, 42% female) were included, 554 with hyperfiltration and 2815 with eGFR&amp;lt;60. Compared to normofiltration, the hyperfiltration group had similar event rates for recurrent IS (37 vs. 35 events per 1000 patient-years) and ICrH (8 vs. 7 events). The rates of death (147 vs. 61) and vascular death (27 vs. 11) were significantly higher in the hyperfiltration group. In multivariable Cox regression models there was no significant association of hyperfiltration with IS (aHR 0.91, 95% CI 0.59 to 1.38) or ICrH (aHR 0.91, 95% CI 0.37 to 2.27). Compared to normofiltration, hyperfiltration was independently associated with the risk of death from any cause (aHR 1.53, 95% CI 1.22 to 1.93) and the risk of vascular death (aHR 1.83, 95% CI 1.09 to 3.08). Conclusion In this large international stroke population, glomerular hyperfiltration was independently associated with 53% increased risk of death, and 83% increased risk of vascular death. Nephrology advisory bodies could recommend screening for hyperfiltration to detect increased vascular risk earlier and in younger age groups.