Cerebral Small Vessel Disease, Risk Factors, and Cognition in Tenants of Precarious Housing

BACKGROUND AND PURPOSE:We aim to describe the burden, characteristics, and cognitive associations of cerebral small vessel disease in a Canadian sample living with multimorbidity in precarious housing. METHODS:Participants received T1, T2-fluid-attenuated inversion recovery, and susceptibility-weigh...

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Published in:Stroke (1970) 2020-11, Vol.51 (11), p.3271-3278
Main Authors: Zhou, Lily W, Panenka, William J, Al-Momen, Ghadeer, Gicas, Kristina M, Thornton, Allen E, Jones, Andrea A, Woodward, Melissa, Heran, Manraj K.S, Vertinsky, A Talia, Su, Wayne, Barr, Alasdair M, MacEwan, G William, Lang, Donna J, Rauscher, Alexander, Honer, William G, Field, Thalia S
Format: Article
Language:English
Subjects:
Adult
Attention
British Columbia - epidemiology
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - epidemiology
Cerebral Small Vessel Diseases - diagnostic imaging
Cerebral Small Vessel Diseases - epidemiology
Cholesterol, LDL
Cognition
Cognitive Dysfunction - epidemiology
Cognitive Dysfunction - physiopathology
Decision Making
Female
Glycated Hemoglobin A - metabolism
Heart Disease Risk Factors
Homeless Persons - statistics & numerical data
Housing - statistics & numerical data
Humans
Hypercholesterolemia - epidemiology
Hypertension - epidemiology
Inhibition, Psychological
Magnetic Resonance Imaging
Male
Memory
Middle Aged
Overweight - epidemiology
Risk Factors
Smoking - epidemiology
Stroke, Lacunar - diagnostic imaging
Stroke, Lacunar - epidemiology
Substance Abuse, Intravenous - epidemiology
Young Adult
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Summary:BACKGROUND AND PURPOSE:We aim to describe the burden, characteristics, and cognitive associations of cerebral small vessel disease in a Canadian sample living with multimorbidity in precarious housing. METHODS:Participants received T1, T2-fluid-attenuated inversion recovery, and susceptibility-weighted imaging 3T magnetic resonance imaging sequences and comprehensive clinical, laboratory, and cognitive assessments. Cerebral small vessel disease burden was characterized using a modified Small Vessel Disease (mSVD) score. One point each was given for moderate-severe white matter hyperintensities, ≥1 cerebral microbleeds, and ≥1 lacune. Multivariable regression explored associations between mSVD score, risk factors, and cognitive performance. RESULTS:Median age of the 228 participants (77% male) was 44.7 years (range, 23.3–63.2). In n=188 participants with consistent good quality magnetic resonance imaging sequences, mSVD scores were 0 (n=127, 68%), 1 (n=50, 27%), and 2 (n=11, 6%). Overall, one-third had an mSVD ≥1 n=61 (32%); this proportion was unchanged when adding participants with missing sequences n=72/228 (32%). The most prevalent feature was white matter hyperintensities 53/218 (24%) then cerebral microbleed 16/191 (8%) and lacunes 16/228 (7%). Older age (odds ratio, 1.10 [95% CI, 1.05–1.15], P
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.120.030446