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4 results on '"Cremers, L.G.M."'

2. Hemoglobin and anemia in relation to dementia risk and accompanying changes on brain MRI

Author

Wolters, F.J., Zonneveld, H.I., Licher, S., Cremers, L.G.M., Ikram, M.K., Koudstaal, P.J., Vernooij, M.W., Ikram, M.A., Buchem, M.A. van, Biessels, G.J., Rocca, H.P.B. la, Craen, A.J. de, Flier, W.M. van der, Kappelle, L.J., Mooijaart, S.P., Niessen, W., Oostenbrugge, R. van, Roos, A. de, Rossum, A.C. van, Daemen, M.J., Heart Brain Connection, Epidemiology, Neurology, Radiology & Nuclear Medicine, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H02 Cardiomyopathy, RS: CARIM - R2.02 - Cardiomyopathy, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: Carim - B05 Cerebral small vessel disease, and RS: CARIM - R3.03 - Cerebral small vessel disease

Subjects
Male, Serum, Comorbidity, Rotterdam Study, Hemoglobins, Risk Factors, Neural Pathways, HYPERVISCOSITY, GENERAL-POPULATION, education.field_of_study, Hazard ratio, Brain, Anemia, ASSOCIATION, Middle Aged, Magnetic Resonance Imaging, White Matter, PREVALENCE, COMMUNITY, CARDIOVASCULAR-DISEASE, Female, Alzheimer's disease, HEMATOCRIT, Brain Infarction, medicine.medical_specialty, Population, Neuroimaging, Article, Alzheimer Disease, Internal medicine, medicine, Dementia, Humans, Cerebral perfusion pressure, education, OLDER, business.industry, medicine.disease, ROTTERDAM, CEREBRAL-BLOOD-FLOW, Neurology (clinical), Hemoglobin, business
Abstract

ObjectiveTo determine the long-term association of hemoglobin levels and anemia with risk of dementia, and explore underlying substrates on brain MRI in the general population.MethodsSerum hemoglobin was measured in 12,305 participants without dementia of the population-based Rotterdam Study (mean age 64.6 years, 57.7% women). We determined risk of dementia and Alzheimer disease (AD) (until 2016) in relation to hemoglobin and anemia. Among 5,267 participants without dementia with brain MRI, we assessed hemoglobin in relation to vascular brain disease, structural connectivity, and global cerebral perfusion.ResultsDuring a mean follow-up of 12.1 years, 1,520 individuals developed dementia, 1,194 of whom had AD. We observed a U-shaped association between hemoglobin levels and dementia (p = 0.005), such that both low and high hemoglobin levels were associated with increased dementia risk (hazard ratio [95% confidence interval (CI)], lowest vs middle quintile 1.29 [1.09–1.52]; highest vs middle quintile 1.20 [1.00–1.44]). Overall prevalence of anemia was 6.1%, and anemia was associated with a 34% increased risk of dementia (95% CI 11%–62%) and 41% (15%–74%) for AD. Among individuals without dementia with brain MRI, similar U-shaped associations were seen of hemoglobin with white matter hyperintensity volume (p = 0.03), and structural connectivity (for mean diffusivity, p < 0.0001), but not with presence of cortical and lacunar infarcts. Cerebral microbleeds were more common with anemia. Hemoglobin levels inversely correlated to cerebral perfusion (p < 0.0001).ConclusionLow and high levels of hemoglobin are associated with an increased risk of dementia, including AD, which may relate to differences in white matter integrity and cerebral perfusion.

Published
2019

3. Structural disconnectivity and the risk of dementia in the general population

Author

Cremers, L.G.M. (Lotte), Wolters, F.J. (Frank), Groot, M. de, Ikram, M.K. (Kamran), Lugt, A. (Aad) van der, Niessen, W.J. (Wiro), Vernooij, M.W. (Meike), Ikram, M.A. (Arfan), Cremers, L.G.M. (Lotte), Wolters, F.J. (Frank), Groot, M. de, Ikram, M.K. (Kamran), Lugt, A. (Aad) van der, Niessen, W.J. (Wiro), Vernooij, M.W. (Meike), and Ikram, M.A. (Arfan)

Abstract

Objective The disconnectivity hypothesis postulates that partial loss of connecting white matter fibers between brain regions contributes to the development of dementia. Using diffusion MRI to quantify global and tract-specific white matter microstructural integrity, we tested this hypothesis in a longitudinal population-based study. Methods Global and tract-specific fractional anisotropy (FA) and mean diffusivity (MD) were obtained in 4,415 people without dementia (mean age 63.9 years, 55.0% women) from the prospective population-based Rotterdam Study with brain MRI between 2005 and 2011. We modeled the association of these diffusion measures with risk of dementia (follow-up until 2016) and with changes on repeated cognitive assessment after on average 5.4 years, adjusting for age, sex, education, macrostructural MRI markers, depressive symptoms, cardiovascular risk factors, and APOE genotype. Results During a median follow-up of 6.8 years, 101 participants had incident dementia, of whom 83 had clinical Alzheimer disease (AD). Lower global values of FA and higher values of MD were associated with an increased risk of dementia (adjusted hazard ratio [95% confidence interval (CI)] per SD increase for MD 1.79 [1.44–2.23] and FA 0.65 [0.52–0.80]). Similarly, lower global values of FA and higher values of MD related to more cognitive decline in people without dementia (difference in global cognition per SD increase in MD [95% CI] was −0.04 [−0.07 to −0.01]). Associations were most profound in the projection, association, and limbic system tracts. Conclusions Structural disconnectivity is associated with an increased risk of dementia and more pronounced cognitive decline in the general population.

Published
2020
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4. Structural Brain Connectivity in Aging and Neurodegeneration

Author

Cremers, L.G.M. (Lotte) and Cremers, L.G.M. (Lotte)

Abstract

As our life expectancy rises, the prevalence of common age-related brain diseases such as cognitive decline, dementia and neurovascular disease will increase. Effective preventive and curative interventions are scarce, whilst causative factors remain largely unknown. The role of cerebral white matter in age-related diseases has been established. However, macrostructural white matter changes, which are visible on a conventional MRI, constitute only the tip of the iceberg of the white matter pathology that have occurred

Published
2018

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