Mild cognitive deterioration with subcortical features: Prevalence, clinical characteristics, and association with cardiovascular risk factors in community-dwelling older persons (the InCHIANTI study)

Cristina Geroldi, Luigi Ferrucci, Stefania Bandinelli, Chiara Cavazzini, Orazio Zanetti, Jack M. Guralnik, Giovanni B. Frisoni

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To identify subjects with minimal or mild nonamnestic cognitive impairment with parkinsonian stance and gait and investigate vascular correlates of this condition. DESIGN: First wave of an epidemiological longitudinal study (InCHIANTI) on factors predicting loss of mobility in older persons. SETTING: The Chianti geographic area (Tuscany, Italy). PARTICIPANTS: Five hundred fifty-six subjects aged 70 to 90 with Mini-Mental State Examination (MMSE) scores greater than 23 of 30, of the 1,260 persons aged 65 and older randomly selected from the population registry of Greve in Chianti and Bagno a Ripoli, two small towns near Florence. METHODS: Low cognitive performance (LCP) was defined as an age- and education-adjusted MMSE below the 50th percentile for the InCHIANTI population. Subcortical features were plastic rigidity on neurological examination (parkinsonism), gait disturbance (small-step gait or parkinsonian gait), and dysexecutive features. Two hundred forty-three participants had high cognitive performance, 166 had LCP without subcortical features, and 75 had LCP with subcortical features. Vascular risk factors were hypertension, atrial fibrillation or pathological findings on electrocardiogram (ECG), low serum high-density lipoprotein (HDL) or high low-density lipoprotein cholesterol, diabetes mellitus, obesity, and heavy smoking. RESULTS: Three main vascular risk factors were significantly more prevalent in LCP with subcortical features: hypertension (P = .02), atrial fibrillation or ECG changes (P = .04), and low HDL cholesterol (P = .001). LCP with subcortical features was significantly associated with cerebrovascular risk factors (P = .001). CONCLUSION: Gait disturbance and nonamnestic cognitive symptoms might be the consequence of subcortical vascular damage.

Original languageEnglish
Pages (from-to)1064-1071
Number of pages8
JournalJournal of the American Geriatrics Society
Volume51
Issue number8
DOIs
Publication statusPublished - Aug 1 2003

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Independent Living
Gait
LDL Cholesterol
Atrial Fibrillation
HDL Cholesterol
Blood Vessels
Electrocardiography
Hypertension
Neurobehavioral Manifestations
Neurologic Examination
Parkinsonian Disorders
HDL Lipoproteins
Italy
Population
Plastics
Longitudinal Studies
Registries
Epidemiologic Studies
Diabetes Mellitus
Obesity

Keywords

  • Cognitive impairment
  • Parkinsonism
  • Subcortical features
  • Vascular risk factor

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

@article{27d5bb3aaacf493f98f932b07916c8d0,
title = "Mild cognitive deterioration with subcortical features: Prevalence, clinical characteristics, and association with cardiovascular risk factors in community-dwelling older persons (the InCHIANTI study)",
abstract = "OBJECTIVES: To identify subjects with minimal or mild nonamnestic cognitive impairment with parkinsonian stance and gait and investigate vascular correlates of this condition. DESIGN: First wave of an epidemiological longitudinal study (InCHIANTI) on factors predicting loss of mobility in older persons. SETTING: The Chianti geographic area (Tuscany, Italy). PARTICIPANTS: Five hundred fifty-six subjects aged 70 to 90 with Mini-Mental State Examination (MMSE) scores greater than 23 of 30, of the 1,260 persons aged 65 and older randomly selected from the population registry of Greve in Chianti and Bagno a Ripoli, two small towns near Florence. METHODS: Low cognitive performance (LCP) was defined as an age- and education-adjusted MMSE below the 50th percentile for the InCHIANTI population. Subcortical features were plastic rigidity on neurological examination (parkinsonism), gait disturbance (small-step gait or parkinsonian gait), and dysexecutive features. Two hundred forty-three participants had high cognitive performance, 166 had LCP without subcortical features, and 75 had LCP with subcortical features. Vascular risk factors were hypertension, atrial fibrillation or pathological findings on electrocardiogram (ECG), low serum high-density lipoprotein (HDL) or high low-density lipoprotein cholesterol, diabetes mellitus, obesity, and heavy smoking. RESULTS: Three main vascular risk factors were significantly more prevalent in LCP with subcortical features: hypertension (P = .02), atrial fibrillation or ECG changes (P = .04), and low HDL cholesterol (P = .001). LCP with subcortical features was significantly associated with cerebrovascular risk factors (P = .001). CONCLUSION: Gait disturbance and nonamnestic cognitive symptoms might be the consequence of subcortical vascular damage.",
keywords = "Cognitive impairment, Parkinsonism, Subcortical features, Vascular risk factor",
author = "Cristina Geroldi and Luigi Ferrucci and Stefania Bandinelli and Chiara Cavazzini and Orazio Zanetti and Guralnik, {Jack M.} and Frisoni, {Giovanni B.}",
year = "2003",
month = "8",
day = "1",
doi = "10.1046/j.1532-5415.2003.51353.x",
language = "English",
volume = "51",
pages = "1064--1071",
journal = "Journal of the American Geriatrics Society",
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TY - JOUR

T1 - Mild cognitive deterioration with subcortical features

T2 - Prevalence, clinical characteristics, and association with cardiovascular risk factors in community-dwelling older persons (the InCHIANTI study)

AU - Geroldi, Cristina

AU - Ferrucci, Luigi

AU - Bandinelli, Stefania

AU - Cavazzini, Chiara

AU - Zanetti, Orazio

AU - Guralnik, Jack M.

AU - Frisoni, Giovanni B.

PY - 2003/8/1

Y1 - 2003/8/1

N2 - OBJECTIVES: To identify subjects with minimal or mild nonamnestic cognitive impairment with parkinsonian stance and gait and investigate vascular correlates of this condition. DESIGN: First wave of an epidemiological longitudinal study (InCHIANTI) on factors predicting loss of mobility in older persons. SETTING: The Chianti geographic area (Tuscany, Italy). PARTICIPANTS: Five hundred fifty-six subjects aged 70 to 90 with Mini-Mental State Examination (MMSE) scores greater than 23 of 30, of the 1,260 persons aged 65 and older randomly selected from the population registry of Greve in Chianti and Bagno a Ripoli, two small towns near Florence. METHODS: Low cognitive performance (LCP) was defined as an age- and education-adjusted MMSE below the 50th percentile for the InCHIANTI population. Subcortical features were plastic rigidity on neurological examination (parkinsonism), gait disturbance (small-step gait or parkinsonian gait), and dysexecutive features. Two hundred forty-three participants had high cognitive performance, 166 had LCP without subcortical features, and 75 had LCP with subcortical features. Vascular risk factors were hypertension, atrial fibrillation or pathological findings on electrocardiogram (ECG), low serum high-density lipoprotein (HDL) or high low-density lipoprotein cholesterol, diabetes mellitus, obesity, and heavy smoking. RESULTS: Three main vascular risk factors were significantly more prevalent in LCP with subcortical features: hypertension (P = .02), atrial fibrillation or ECG changes (P = .04), and low HDL cholesterol (P = .001). LCP with subcortical features was significantly associated with cerebrovascular risk factors (P = .001). CONCLUSION: Gait disturbance and nonamnestic cognitive symptoms might be the consequence of subcortical vascular damage.

AB - OBJECTIVES: To identify subjects with minimal or mild nonamnestic cognitive impairment with parkinsonian stance and gait and investigate vascular correlates of this condition. DESIGN: First wave of an epidemiological longitudinal study (InCHIANTI) on factors predicting loss of mobility in older persons. SETTING: The Chianti geographic area (Tuscany, Italy). PARTICIPANTS: Five hundred fifty-six subjects aged 70 to 90 with Mini-Mental State Examination (MMSE) scores greater than 23 of 30, of the 1,260 persons aged 65 and older randomly selected from the population registry of Greve in Chianti and Bagno a Ripoli, two small towns near Florence. METHODS: Low cognitive performance (LCP) was defined as an age- and education-adjusted MMSE below the 50th percentile for the InCHIANTI population. Subcortical features were plastic rigidity on neurological examination (parkinsonism), gait disturbance (small-step gait or parkinsonian gait), and dysexecutive features. Two hundred forty-three participants had high cognitive performance, 166 had LCP without subcortical features, and 75 had LCP with subcortical features. Vascular risk factors were hypertension, atrial fibrillation or pathological findings on electrocardiogram (ECG), low serum high-density lipoprotein (HDL) or high low-density lipoprotein cholesterol, diabetes mellitus, obesity, and heavy smoking. RESULTS: Three main vascular risk factors were significantly more prevalent in LCP with subcortical features: hypertension (P = .02), atrial fibrillation or ECG changes (P = .04), and low HDL cholesterol (P = .001). LCP with subcortical features was significantly associated with cerebrovascular risk factors (P = .001). CONCLUSION: Gait disturbance and nonamnestic cognitive symptoms might be the consequence of subcortical vascular damage.

KW - Cognitive impairment

KW - Parkinsonism

KW - Subcortical features

KW - Vascular risk factor

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