ORCID Profile
0000-0002-1397-4272
Current Organisation
University of Aberdeen
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 08-06-2020
DOI: 10.1002/GPS.5355
Publisher: Bentham Science Publishers Ltd.
Date: 04-2013
DOI: 10.2174/1567205011310040001
Abstract: There is good epidemiological evidence that vascular disease predisposes to cognitive decline and dementia. The impact of vascular disease on dementia is likely to increase further because of the poor diagnosis and management of vascular risk factors, the increase in life expectancy, and the improved survival following major cardiovascular events, e.g. acute stroke. It is estimated that the adequate management of vascular risk factors, with pharmacological and/or nonpharmacological interventions, might result in a 50% reduction in the forecasted dementia prevalence. The exact mechanisms by which vascular risk factors and vascular disease adversely affect brain function remain unclear, but it is hypothesized that endothelial dysfunction plays an important role. Reduced synthesis and availability of endothelial nitric oxide (NO) may contribute to the development of dementia by at least two mechanisms: (1) favoring the onset and progression of atherosclerosis, vasoconstriction, and impaired cerebral blood flow regulation and (2) reduced neuroprotection.Several studies have shown that asymmetric dimethylarginine (ADMA), an endogenous methylated form of the amino acid L-arginine, inhibits NO synthesis and favors oxidative stress and vascular damage. Unlike NO, ADMA concentrations are relatively stable and can be accurately measured in plasma. There is good evidence that higher plasma ADMA concentrations favor atherosclerosis and independently predict adverse cardiovascular and cerebrovascular outcomes in several patient groups. ADMA might represent a unifying pathophysiological pathway linking the presence of vascular risk factors with the onset and progression of cognitive decline and dementia. This review discusses the biological role of ADMA, its potential contribution to the onset and progression of dementia through vascular disease and atherosclerosis, the available evidence linking ADMA with cognitive impairment and dementia, and the strategies to characterize the predictive role of ADMA in cognitive impairment in epidemiological studies. Therapeutic implications and suggestions for future research directions are also discussed.
Publisher: Elsevier BV
Date: 07-2022
Publisher: Massachusetts Medical Society
Date: 19-07-2100
Publisher: Elsevier BV
Date: 02-2022
Publisher: Elsevier BV
Date: 10-2020
Publisher: Bentham Science Publishers Ltd.
Date: 31-01-2014
DOI: 10.2174/15672050113106660178
Abstract: This study measured serum concentrations of vascular risk factors, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) in a representative s le of older community-dwelling adults and determined their associations with objective and subjective memory impairment. Data on clinical, lifestyle, and demographic characteristics, serum ADMA, SDMA, and L-arginine (measured using LC-MS/MS) were collected from a population-based s le of older Australian adults from the Hunter Community Study. Objective memory was measured with the Audio Recorded Cognitive Screen (ARCS) neuropsychological battery and subjective memory impairment was measured using the Memory Complaint Questionnaire (MAC-Q). Multivariate analysis revealed that SDMA and diabetes were significantly associated with objective memory impairment (Adjusted Odd ratio (AOR) = 3.90 95% CI. 1.21 - 12.52 for fourth quartile (Q4) of SDMA. ADMA, SDMA, education, number of general practitioner visits and atrial fibrillation were all significantly associated with subjective memory impairment. (AOR = 1.82 95% CI. 1.04 - 3.18 for Q4 ADMA. Higher serum SDMA was associated with objective and subjective memory impairment while higher serum ADMA was associated with subjective memory impairment.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Elsevier BV
Date: 02-2021
Publisher: Elsevier BV
Date: 05-2021
Publisher: Public Library of Science (PLoS)
Date: 15-05-2013
Publisher: Massachusetts Medical Society
Date: 25-02-2021
Publisher: Springer Science and Business Media LLC
Date: 18-07-2016
Publisher: Elsevier BV
Date: 2022
Publisher: Wiley
Date: 10-2012
Publisher: Elsevier BV
Date: 11-2013
Publisher: Informa UK Limited
Date: 02-2011
Abstract: Antimuscarinic drug prescribing scoring systems might better identify patients at risk of adverse drug reactions. The recently developed Anticholinergic Risk Scale (ARS) score is significantly associated with the number of antimuscarinic side effects in older outpatients. We sought to identify the clinical and demographic patient-level correlates of the ARS, including a modified version adjusted for daily dose, in elderly hospitalized patients. Clinical and demographic patient characteristics known to be associated with antimuscarinic prescribing, ARS and dose-adjusted ARS scores, and full medication exposure on admission were recorded in 362 consecutive patients (aged 83.6 ± 6.6 years) admitted to 2 geriatric units (NHS Gr ian, Aberdeen, Scotland, UK) between February 1, 2010 and June 30, 2010. Each year of increasing age was associated with reduced number of antimuscarinic drugs (incidence rate ratio [IRR], 0.963 95% confidence interval [CI], 0.948-0.980 P < 0.001), non-antimuscarinic drugs (IRR, 0.991 95% CI, 0.985-0.997 P = 0.006), and total number of drugs (IRR, 0.988 95% CI, 0.983-0.994 P < 0.001). Multivariate Poisson regression showed that increasing age and history of dementia were negatively associated with the ARS score (IRR, 0.97 95% CI, 0.94-0.99 P = 0.001 and IRR, 0.62 95% CI, 0.41-0.92 P = 0.019, respectively). By contrast, institutionalization (IRR, 1.32 95% CI, 1.00-1.74 P = 0.050), Charlson comorbidity index (IRR, 1.06 95% CI, 1.01-1.11 P = 0.015), and total number of non-antimuscarinic drugs (IRR, 1.13 95% CI, 1.08-1.18 P < 0.001) were all positively associated with the ARS score. Similar results were observed for the dose-adjusted ARS score. Institutionalization, comorbidities, and non-antimuscarinic polypharmacy show independent positive associations with the ARS and dose-adjusted ARS scores in older hospitalized patients. Increasing age and dementia are negatively associated with the ARS score.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.JAMDA.2011.03.006
Abstract: The anticholinergic risk scale (ARS) score is associated with the number of anticholinergic side effects in older outpatients. We tested the hypothesis that high ARS scores are negatively associated with "global" parameters of physical function (Barthel Index, primary outcome) and predict length of stay and in-hospital mortality (secondary outcomes) in older hospitalized patients. Prospective study in 2 acute geriatric units. Three hundred sixty-two consecutive patients (age 83.6 ± 6.6 years) admitted between February 1, 2010, and June 30, 2010. Clinical and demographic characteristics, Barthel Index, full medication exposure, and ARS score were recorded on admission. Data on length of stay and in-hospital mortality were obtained from electronic records. After adjustment for age, gender, dementia, institutionalization, Charlson Comorbidity Index, admission site, and number of nonanticholinergic drugs, a unit increase in ARS score was associated with a 29% reduction in the odds of being in a higher Barthel quartile than a lower quartile (odds ratio 0.71, 95% confidence interval [CI] 0.59-0.86, P = .001). The Barthel components mostly affected were bathing (P < .001), grooming (P < .001), dressing (P < .001), transfers (P =.005), mobility (P < .001), and stairs (P < .001). Higher ARS scores predicted in-hospital mortality among patients with hyponatremia (hazard ratio [HR] 3.66, 95% CI 1.70-7.89, P = .001) but not those without hyponatremia (HR 1.04, 95% CI 0.70-1.54, P = .86). The ARS score did not significantly predict length of stay (HR 1.02, 95% CI 0.88-1.17, P = .82). High ARS scores are negatively associated with various components of the Barthel Index and predict in-hospital mortality in the presence of hyponatremia among older patients. The ARS score may be useful in the acute setting to improve risk stratification.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Roy Soiza.