Vascular aging and cognitive decline The Rotterdam study Francesco - - PowerPoint PPT Presentation

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Vascular aging and cognitive decline The Rotterdam study Francesco - - PowerPoint PPT Presentation

Sep 11, 2022 181 likes •739 views

Vascular aging and cognitive decline The Rotterdam study Francesco Mattace Raso, MD PhD Geriatric Medicine, Department of Internal Medicine The Ugly The good The Bad The good The Bad The Ugly Rotterdam, Ommoord The Rotterdam Study is a

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Vascular aging and cognitive decline

The Rotterdam study

Francesco Mattace Raso, MD PhD Geriatric Medicine, Department of Internal Medicine

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The good The Ugly The Bad

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The good The Bad The Ugly

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Rotterdam, Ommoord

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The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases.

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The Rotterdam Study

  • Invitation to participate
  • Data collection
  • Data storage
  • Analyses
  • Writing manuscripts
  • Publications
  • Thesis
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Possible causes of dementia

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Causes of cognitive decline

  • Diabetes
  • Metabolic disorders
  • Vascular disorders
  • Atherosclerosis
  • Arteriosclerosis
  • Vascular aging
  • Diabetes
  • Metabolic disorders
  • Vascular disorders
  • Atherosclerosis
  • Arteriosclerosis
  • Vascular aging
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What do we know about vascular aging?

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Aging and increase of IMT

Age 8 Age 52 Age 85

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Age and carotid IMT

Nagai, Circulation, 1998

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Progression of Carotid IMT

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Vascular Structure and Function

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European Network for Non-Invasive Investigation of Large Arteries

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Reference Values for Arterial Stiffness' Collaboration Eur Heart J. 2010

Aging and aPWV

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aPWV according to BP and age categories

Reference Values for Arterial Stiffness' Collaboration Eur Heart J. 2010

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aPWV according to BP and age categories

Reference Values for Arterial Stiffness' Collaboration Eur Heart J. 2010

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Atherosclerosis and dementia

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Selwaness M et al Hypertension 2013

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Apnea e valori pressori

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Association Between PWV (per Increase in SD) and Various Plaque Components (n=1979 Carotid Plaques)

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Fazekas scale for WM lesions

0: None or a single punctate WMH lesion 1: Multiple punctate lesions 2: Beginning confluency of lesions (bridging) 3: Large confluent lesions

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Strategic Infarctions

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Aortic stiffness and cerebral small vessel disease

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Arterial stiffness and blood pressure regulation the short-term effects

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Blood Pressure regulation

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Baroreflex sensitivity (BRS) and age

  • BRS: the slope of the regression line between changes of SBP and the related lengthening or shortening
  • in the R-R interval, occurring over spontaneous sequences of three or more consecutive beats
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Carotid IMT, Aortic Stiffness and BRS

Gianaros PJ et al Am J Hypertens 2002 Mattace-Raso F et al, J Hypertension 2007

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Arterial stiffness and orthostatic hypotension

  • Mattace-Raso F et al, J Hypertension 2006
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Conclusions

  • Vascular aging should no longer be considered an

innocent expression

  • Vascular aging is associated with the risk of CVD
  • Vascular aging is associated with cognitive

decline

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f.mattaceraso@erasmusmc.nl