Vascular and Metabolic Risk Factors, Carotid Atherosclerosis and Vascular Cognitive Impairment in a First Nations Population
The objectives of the thesis were to examine the associations between vascular and metabolic risk factors, carotid atherosclerosis and cognitive function in a Canadian First Nations population. Eligible individuals were ≥18 years and with First Nations status who had undergone cognitive function ass...
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ftunivtoronto:oai:localhost:1807/19267 2023-05-15T16:15:41+02:00 Vascular and Metabolic Risk Factors, Carotid Atherosclerosis and Vascular Cognitive Impairment in a First Nations Population Fergenbaum, Jennifer Young, Kue Dalla Lana School of Public Health NO_RESTRICTION http://hdl.handle.net/1807/19267 en_ca eng http://hdl.handle.net/1807/19267 Epidemiology 0766 Thesis ftunivtoronto 2020-06-17T11:14:10Z The objectives of the thesis were to examine the associations between vascular and metabolic risk factors, carotid atherosclerosis and cognitive function in a Canadian First Nations population. Eligible individuals were ≥18 years and with First Nations status who had undergone cognitive function assessment by the Clock Drawing Test (CDT) and the Trail Making Test Parts A and B. Parts A and B were combined into an executive function score (TMT-exec). Anthropometric, vascular and metabolic risk factors were assessed by interview, clinical examinations and blood tests. Doppler ultrasonography assessed carotid atherosclerosis (carotid stenosis, plaque volume). For the 190 individuals with TMT-exec scores, obese individuals were at a 4-fold increased risk for lowered cognitive performance compared to those who were not obese (odds ratio [OR]: 3.77, 95% confidence interval [CI]: 1.46-9.72). Those having an increased waist circumference also had 5 times the risk compared to those without an increased waist circumference (OR: 5.41, 95% CI: 1.83-15.99). Individuals having the metabolic syndrome were at a 4-fold increased risk compared to those without the metabolic syndrome (OR: 3.67, 95% CI: 1.34-10.07). No other cardiovascular risk factors were associated and no associations were shown for the CDT. For TMT-exec only, individuals with elevated levels of left (LCS) and total carotid stenosis (TCS) were less likely to demonstrate lowered cognitive performance (LCS, OR: 0.47, 95% CI: 0.24-0.96; TCS, OR: 0.40, 95% CI: 0.20-0.80). In structural equation modeling, for every 1-unit change in the anthropometric factor in kg/m2, there was a 0.86-fold decrease in the percent of TCS (p<0.05). The etiology of VCI is vascular and is affected by non-traditional risk factors such as obesity. The health effects of obesity beyond traditional disease endpoints warrants further study. Mild-moderate levels of carotid stenosis are not detrimental to cognitive functioning and may additionally include acting as a mediator. PhD Thesis First Nations University of Toronto: Research Repository T-Space |
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University of Toronto: Research Repository T-Space |
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ftunivtoronto |
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English |
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Epidemiology 0766 |
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Epidemiology 0766 Fergenbaum, Jennifer Vascular and Metabolic Risk Factors, Carotid Atherosclerosis and Vascular Cognitive Impairment in a First Nations Population |
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Epidemiology 0766 |
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The objectives of the thesis were to examine the associations between vascular and metabolic risk factors, carotid atherosclerosis and cognitive function in a Canadian First Nations population. Eligible individuals were ≥18 years and with First Nations status who had undergone cognitive function assessment by the Clock Drawing Test (CDT) and the Trail Making Test Parts A and B. Parts A and B were combined into an executive function score (TMT-exec). Anthropometric, vascular and metabolic risk factors were assessed by interview, clinical examinations and blood tests. Doppler ultrasonography assessed carotid atherosclerosis (carotid stenosis, plaque volume). For the 190 individuals with TMT-exec scores, obese individuals were at a 4-fold increased risk for lowered cognitive performance compared to those who were not obese (odds ratio [OR]: 3.77, 95% confidence interval [CI]: 1.46-9.72). Those having an increased waist circumference also had 5 times the risk compared to those without an increased waist circumference (OR: 5.41, 95% CI: 1.83-15.99). Individuals having the metabolic syndrome were at a 4-fold increased risk compared to those without the metabolic syndrome (OR: 3.67, 95% CI: 1.34-10.07). No other cardiovascular risk factors were associated and no associations were shown for the CDT. For TMT-exec only, individuals with elevated levels of left (LCS) and total carotid stenosis (TCS) were less likely to demonstrate lowered cognitive performance (LCS, OR: 0.47, 95% CI: 0.24-0.96; TCS, OR: 0.40, 95% CI: 0.20-0.80). In structural equation modeling, for every 1-unit change in the anthropometric factor in kg/m2, there was a 0.86-fold decrease in the percent of TCS (p<0.05). The etiology of VCI is vascular and is affected by non-traditional risk factors such as obesity. The health effects of obesity beyond traditional disease endpoints warrants further study. Mild-moderate levels of carotid stenosis are not detrimental to cognitive functioning and may additionally include acting as a mediator. PhD |
author2 |
Young, Kue Dalla Lana School of Public Health |
format |
Thesis |
author |
Fergenbaum, Jennifer |
author_facet |
Fergenbaum, Jennifer |
author_sort |
Fergenbaum, Jennifer |
title |
Vascular and Metabolic Risk Factors, Carotid Atherosclerosis and Vascular Cognitive Impairment in a First Nations Population |
title_short |
Vascular and Metabolic Risk Factors, Carotid Atherosclerosis and Vascular Cognitive Impairment in a First Nations Population |
title_full |
Vascular and Metabolic Risk Factors, Carotid Atherosclerosis and Vascular Cognitive Impairment in a First Nations Population |
title_fullStr |
Vascular and Metabolic Risk Factors, Carotid Atherosclerosis and Vascular Cognitive Impairment in a First Nations Population |
title_full_unstemmed |
Vascular and Metabolic Risk Factors, Carotid Atherosclerosis and Vascular Cognitive Impairment in a First Nations Population |
title_sort |
vascular and metabolic risk factors, carotid atherosclerosis and vascular cognitive impairment in a first nations population |
publishDate |
|
url |
http://hdl.handle.net/1807/19267 |
genre |
First Nations |
genre_facet |
First Nations |
op_relation |
http://hdl.handle.net/1807/19267 |
_version_ |
1766001457977360384 |