Dataset Information

Association of mild and complex multimorbidity with structural brain changes in older adults: A population-based study.

ABSTRACT:

Introduction

We quantified the association of mild (ie, involving one or two body systems) and complex (ie, involving ≥3 systems) multimorbidity with structural brain changes in older adults.

Methods

We included 390 dementia-free participants aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen who underwent brain magnetic resonance imaging at baseline and after 3 and/or 6 years. Using linear mixed models, we estimated the association between multimorbidity and changes in total brain tissue, ventricular, hippocampal, and white matter hyperintensities volumes.

Results

Compared to non-multimorbid participants, those with complex multimorbidity showed the steepest reduction in total brain (β*time -0.03, 95% CI -0.05, -0.01) and hippocampal (β*time -0.05, 95% CI -0.08, -0.03) volumes, the greatest ventricular enlargement (β*time 0.03, 95% CI 0.01, 0.05), and the fastest white matter hyperintensities accumulation (β*time 0.04, 95% CI 0.01, 0.07).

Discussion

Multimorbidity, particularly when involving multiple body systems, is associated with accelerated structural brain changes, involving both neurodegeneration and vascular pathology.

Highlights

Multimorbidity accelerates structural brain changes in cognitively intact older adults These brain changes encompass both neurodegeneration and cerebrovascular pathology The complexity of multimorbidity is associated with the rate of brain changes' progression.

SUBMITTER: Valletta M

PROVIDER: S-EPMC10984455 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Publications

Association of mild and complex multimorbidity with structural brain changes in older adults: A population-based study.

Valletta Martina M Vetrano Davide Liborio DL Calderón-Larrañaga Amaia A Kalpouzos Grégoria G Canevelli Marco M Marengoni Alessandra A Laukka Erika J EJ Grande Giulia G

Alzheimer's & dementia : the journal of the Alzheimer's Association 20240103 3

<h4>Introduction</h4>We quantified the association of mild (ie, involving one or two body systems) and complex (ie, involving ≥3 systems) multimorbidity with structural brain changes in older adults.<h4>Methods</h4>We included 390 dementia-free participants aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen who underwent brain magnetic resonance imaging at baseline and after 3 and/or 6 years. Using linear mixed models, we estimated the association between multimorbidity an ...[more]

PMID: 38170758

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Project description:Background/objectivesDue to the high costs and excess mortality associated with multimorbidity, there is a need to develop approaches for delaying its progression. High blood pressure (BP) is a common chronic condition and a risk factor for many additional chronic conditions, making it an ideal target for intervention. The purpose of this analysis was to determine the association between the level of sustained BP control and the progression of multimorbidity.DesignRetrospective cohort study.SettingAntihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) linked to Medicare claims.ParticipantsA total of 6,591 ALLHAT participants with Medicare who had systolic BP (SBP) measurements at eight or more study visits.MeasurementsSBP control was categorized as lower than 140 mm Hg at less than 50%, 50% to less than 75%, 75% to less than 100%, and 100% of visits. Multimorbidity progression was defined by the number of incident chronic conditions, including arthritis, asthma, atrial fibrillation, cancer, chronic kidney disease, chronic obstructive pulmonary disease, coronary heart disease, dementia, depression, diabetes mellitus, heart failure, hyperlipidemia, osteoporosis, and stroke. Recurrent event survival analysis was used to calculate rate ratios (RRs) for the association of sustained SBP control with progression of multimorbidity.ResultsRates of incident conditions per 10 person-years (95% CIs) were 5.2 (5.1-5.4), 4.7 (4.5-4.8), 4.4 (4.2-4.5), and 4.0 (3.8-4.2) for participants with SBP control at less than 50%, 50% to less than 75%, 75% to less than 100%, and 100% of visits, respectively, over a median follow-up of 9.0 years. Compared with participants with SBP control at less than 50% of visits, adjusted RRs (95% CIs) for multimorbidity progression were 0.90 (0.86-0.95), 0.85 (0.81-0.89), and 0.77 (0.72-0.82) for those with SBP control at 50% to less than 75%, 75% to less than 100%, and 100% of visits, respectively.ConclusionsSustaining BP control may be an effective approach to slow multimorbidity progression and may reduce the population burden of multimorbidity.

Dataset Information

Association of mild and complex multimorbidity with structural brain changes in older adults: A population-based study.

Introduction

Methods

Results

Discussion

Highlights

Publications

Association of mild and complex multimorbidity with structural brain changes in older adults: A population-based study.

Similar Datasets

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