Biomedical subjects

Christiane Reitz

Publications and source records attributed to Christiane Reitz.

5 recordsLinked to original sources

PubMed2006

Relation of plasma thyroid-stimulating hormone levels to vascular lesions and atrophy of the brain in the elderly.

CONTEXT: Recent studies suggest that thyroid disease is associated with cardiovascular and peripheral vascular disease. However, little is known about the underlying pathophysiology and the relation with cerebrovascular disease or brain atrophy in the elderly. OBJECTIVE: To determine if plasma thyroid-stimulating hormone (TSH) levels are associated with vascular brain changes and cortical atrophy in the elderly. DESIGN: Community based, cross-sectional study. PARTICIPANTS AND SETTING: 268 participants of the Memory and Morbidity in Augsburg Elderly Study, 65-83 years of age and without contraindications for magnetic resonance imaging (MRI) of the brain. MAIN OUTCOME MEASURES: The presence of brain lesions and atrophy was determined using a standardized MRI protocol, an established rating scale and a single rater. Plasma TSH levels were assessed using standard laboratory methods. The association between plasma TSH levels and MRI findings was analyzed using logistic and linear regression models. RESULTS: Higher TSH levels within the normal clinical range were significantly associated with severer cortical atrophy (p = 0.04) and a higher proportion of infarct-like vascular lesions (p = 0.005) in men. These associations were independent of potential confounders, including thyroid hormone therapy, in multivariable regression analysis. No association between plasma TSH levels and both MRI outcomes were observed in women. In addition, neither in men nor in women was an association between TSH levels and white-matter lesions found. CONCLUSIONS: Increasing TSH levels even within the normal clinical range are associated with severer brain atrophy and infarct-like vascular lesions in elderly men.

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PubMed2006

Stroke and memory performance in elderly persons without dementia.

BACKGROUND: There are conflicting data showing that stroke is associated with a higher risk of dementia and a more severe decline in persons with cognitive impairment. However, it remains unclear if cerebrovascular disease is directly related to cognitive decline in the absence of cognitive impairment or dementia. OBJECTIVE: To examine the association between stroke and changes in cognitive function over time in elderly persons without dementia at baseline. DESIGN: The results of neuropsychological tests from several intervals over a 5-year period were clustered into domains of memory, abstract/visuospatial, and language in 1271 elderly persons without dementia or cognitive decline. Stroke was related to the slope of performance in each cognitive domain using generalized estimating equations. RESULTS: Memory performance declined over time, while abstract/visuospatial and language performance remained stable during the study period. Stroke was associated with a more rapid decline in memory performance, while there was no association between stroke and decline in abstract/visuospatial or language performance. The association between stroke and decline in memory performance was strongest for men and for persons without an APOEepsilon4 allele. A significant association between stroke and decline in abstract/visuospatial performance was also observed for persons without the APOEepsilon4 allele. CONCLUSION: A history of stroke is related to a progressive decline in memory and abstract/visuospatial performance, especially among men and those without an APOEepsilon4 allele.

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PubMed2006

Relation of cerebral small-vessel disease and brain atrophy to mild Parkinsonism in the elderly.

The association between cerebral small-vessel disease, brain atrophy, and the risk and severity of mild parkinsonian signs (MPS) remains unclear. The objective of this study is to examine the effect of lacunar brain infarcts, cerebral white matter lesions (WMLs), and cortical atrophy on the risk and severity of MPS. This study is a cross-sectional community-based cohort study comprising 268 subjects, 65 to 83 years of age, residing in the Augsburg region of southern Germany, and without contraindications for magnetic resonance imaging (MRI) of the brain. Main outcome measures. Subcortical and periventricular WMLs, lacunar brain infarcts, and cortical atrophy determined using a standardized MRI protocol developed for the Rotterdam Scan Study and an established rating scale. MPS, assessed in a standardized neurological examination and based on the Unified Parkinson's Disease Rating Scale motor scale. Lacunar brain infarcts and large subcortical white matter lesions were associated with an elevated risk of resting tremor. More severe cortical atrophy was related to an increased risk of rigidity and bradykinesia. In a linear regression analysis relating each individual MRI measurement with the severity of MPS, the number of lacunar brain infarcts and the degree of brain atrophy were correlated with the severity of resting tremor, whereas the size of subcortical and periventricular WMLs was correlated with the severity of rigidity. A higher degree of brain atrophy was associated with increased severity of either cardinal sign. In our study, presence and volume of lacunar brain infarcts, cerebral WMLs, and cortical atrophy were associated with the risk as well as severity of MPS. Determining the presence of these brain changes using brain imaging might contribute to identify persons at risk for MPS.

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PubMed2005

Effect of smoking and time on cognitive function in the elderly without dementia.

OBJECTIVE: To examine the association between smoking and changes in cognitive function over time in elderly persons without dementia. METHODS: The results of neuropsychological tests grouped into domains of memory, abstract-visuospatial, and language, from several intervals over a 5-year period in 791 elderly patients without dementia or cognitive impairment. Smoking history was categorized as never, current, or past smokers and related to the slope of performance in each cognitive domain using generalized estimating equations. RESULTS: Performance in all cognitive domains declined over time. Memory performance declined more rapidly among current smokers aged >75 years than in nonsmokers similar in age, including those who never smoked or had quit smoking. The effect was stronger among those without an APOE-epsilon4 allele. There was no association between smoking and performance in any cognitive domain in persons aged <75 years, and there was no association between past smoking and performance on any of the three cognitive factors at any time interval in either age group. CONCLUSION: Current smokers aged >75 years perform more poorly on cognitive tests and appear to decline in memory more rapidly than their peers who do not smoke, especially if they lack the APOE-epsilon4 allele. Smoking does not affect cognitive performance in those persons aged <75 years.

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PubMed2004

Relation of plasma lipids to Alzheimer disease and vascular dementia.

BACKGROUND: The relation between plasma lipid levels and Alzheimer disease (AD) and vascular dementia (VaD), and the impact of drugs to lower lipid levels remains unclear. OBJECTIVE: To investigate the relation between plasma lipid levels and the risk of AD and VaD and the impact of drugs to lower lipid levels on this relationship. DESIGN AND SETTING: Cross-sectional and prospective community-based cohort studies. PARTICIPANTS: Random sample of 4316 Medicare recipients, 65 years and older, residing in northern Manhattan, NY. MAIN OUTCOME MEASURES: Vascular dementia and AD according to standard criteria. RESULTS: Elevated levels of non-high-density lipoprotein (HDL-C) and low-density lipoprotein cholesterol (LDL-C) and decreased levels of HDL-C were weak risk factors for VaD in either cross-sectional or prospective analyses. Higher levels of total cholesterol were associated with a decreased risk of incident AD after adjustment for demographics, apolipoprotein E genotype, and cardiovascular risk factors. Treatment with drugs to lower lipid levels did not change the disease risk of either disorder. CONCLUSIONS: We found a weak relation between non-HDL-C, LDL-C, and HDL-C levels and the risk of VaD. Lipid levels and the use of agents to lower them do not seem to be associated with the risk of AD.

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