ORCID Profile
0000-0002-8168-8593
Current Organisation
University of California, Irvine
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Publisher: Wiley
Date: 19-10-2017
DOI: 10.1016/J.JALZ.2017.09.007
Abstract: Progress in understanding and management of vascular cognitive impairment (VCI) has been h ered by lack of consensus on diagnosis, reflecting the use of multiple different assessment protocols. A large multinational group of clinicians and researchers participated in a two-phase Vascular Impairment of Cognition Classification Consensus Study (VICCCS) to agree on principles (VICCCS-1) and protocols (VICCCS-2) for diagnosis of VCI. We present VICCCS-2. We used VICCCS-1 principles and published diagnostic guidelines as points of reference for an online Delphi survey aimed at achieving consensus on clinical diagnosis of VCI. Six survey rounds comprising 65-79 participants agreed guidelines for diagnosis of VICCCS-revised mild and major forms of VCI and endorsed the National Institute of Neurological Disorders-Canadian Stroke Network neuropsychological assessment protocols and recommendations for imaging. The VICCCS-2 suggests standardized use of the National Institute of Neurological Disorders-Canadian Stroke Network recommendations on neuropsychological and imaging assessment for diagnosis of VCI so as to promote research collaboration.
Publisher: Springer Science and Business Media LLC
Date: 13-06-2022
Publisher: Springer Science and Business Media LLC
Date: 21-04-2016
Publisher: Wiley
Date: 12-2022
DOI: 10.1002/ALZ.12828
Abstract: There are limited data on prevalence of dementia in centenarians and near‐centenarians (C/NC), its determinants, and whether the risk of dementia continues to rise beyond 100. Participant‐level data were obtained from 18 community‐based studies ( N = 4427) in 11 countries that included in iduals ≥95 years. A harmonization protocol was applied to cognitive and functional impairments, and a meta‐analysis was performed. The mean age was 98.3 years (SD = 2.67) 79% were women. After adjusting for age, sex, and education, dementia prevalence was 53.2% in women and 45.5% in men, with risk continuing to increase with age. Education (OR 0.95 .92–0.98) was protective, as was hypertension (odds ratio [OR] 0.51 .35–0.74) in five studies. Dementia was not associated with diabetes, vision and hearing impairments, smoking, and body mass index (BMI). Among the exceptional old, dementia prevalence remains higher in the older participants. Education was protective against dementia, but other factors for dementia‐free survival in C/NC remain to be understood.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-12-2019
DOI: 10.1212/WNL.0000000000008732
Abstract: High blood pressure is one of the main modifiable risk factors for dementia. However, there is conflicting evidence regarding the best antihypertensive class for optimizing cognition. Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using comprehensive meta-analysis including reanalysis of original participant data. To identify suitable studies, MEDLINE, Embase, and PsycINFO and preexisting study consortia were searched from inception to December 2017. Authors of prospective longitudinal human studies or trials of antihypertensives were contacted for data sharing and collaboration. Outcome measures were incident dementia or incident cognitive decline (classified using the reliable change index method). Data were separated into mid and late-life ( years) and each antihypertensive class was compared to no treatment and to treatment with other antihypertensives. Meta-analysis was used to synthesize data. Over 50,000 participants from 27 studies were included. Among those aged years, with the exception of diuretics, we found no relationship by class with incident cognitive decline or dementia. Diuretic use was suggestive of benefit in some analyses but results were not consistent across follow-up time, comparator group, and outcome. Limited data precluded meaningful analyses in those ≤65 years of age. Our findings, drawn from the current evidence base, support clinical freedom in the selection of antihypertensive regimens to achieve blood pressure goals. The review was registered with the international prospective register of systematic reviews (PROSPERO), registration number CRD42016045454.
Publisher: Wiley
Date: 10-12-2016
DOI: 10.1016/J.JALZ.2016.10.007
Abstract: Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates and in turn prevalence estimates, research, and treatment. The Vascular Impairment of Cognition Classification Consensus Study (VICCCS) involved participants (81% academic researchers) from 27 countries in an online Delphi consensus study. Participants reviewed previously proposed concepts to develop new guidelines. VICCCS had a mean of 122 (98-153) respondents across the study and a 67% threshold to represent consensus. VICCCS redefined VCI including classification of mild and major forms of VCI and subtypes. It proposes new standardized VCI-associated terminology and future research priorities to address gaps in current knowledge. VICCCS proposes a consensus-based updated conceptualization of VCI intended to facilitate standardization in research.
Location: United States of America
No related grants have been discovered for Maria Corrada-Bravo.