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    Aspirin for the prevention of cognitive decline in the elderly: Rationale and design of a neuro-vascular imaging study (ENVIS-ion)

    Access Status
    Open access via publisher
    Authors
    Reid, Christopher
    Storey, E.
    Wong, T.
    Woods, R.
    Tonkin, A.
    Wang, J.
    Kam, A.
    Janke, A.
    Essex, R.
    Abhayaratna, W.
    Budge, M.
    Date
    2012
    Type
    Journal Article
    
    Metadata
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    Citation
    Reid, C. and Storey, E. and Wong, T. and Woods, R. and Tonkin, A. and Wang, J. and Kam, A. et al. 2012. Aspirin for the prevention of cognitive decline in the elderly: Rationale and design of a neuro-vascular imaging study (ENVIS-ion). BMC Neurology. 12 (3).
    Source Title
    BMC Neurology
    DOI
    10.1186/1471-2377-12-3
    School
    Department of Health Policy and Management
    URI
    http://hdl.handle.net/20.500.11937/11371
    Collection
    • Curtin Research Publications
    Abstract

    Background: This paper describes the rationale and design of the ENVIS-ion Study, which aims to determine whether low-dose aspirin reduces the development of white matter hyper-intense (WMH) lesions and silent brain infarction (SBI). Additional aims include determining whether a) changes in retinal vascular imaging (RVI) parameters parallel changes in brain magnetic resonance imaging (MRI); b) changes in RVI parameters are observed with aspirin therapy; c) baseline cognitive function correlates with MRI and RVI parameters; d) changes in cognitive function correlate with changes in brain MRI and RVI and e) whether factors such as age, gender or blood pressure influence the above associations. Methods/Design: Double-blind, placebo-controlled trial of three years duration set in two Australian academic medical centre outpatient clinics. This study will enrol 600 adults aged 70 years and over with normal cognitive function and without overt cardiovascular disease. Subjects will undergo cognitive testing, brain MRI and RVI at baseline and after 3 years of study treatment. All subjects will be recruited from a 19,000-patient clinical outcome trial conducted in Australia and the United States that will evaluate the effects of aspirin in maintaining disability-free longevity over 5 years. The intervention will be aspirin 100 mg daily versus matching placebo, randomized on a 1:1 basis. Discussion: This study will improve understanding of the mechanisms at the level of brain and vascular structure that underlie the effects of aspirin on cognitive function. Given the limited access and high cost of MRI, RVI may prove useful as a tool for the identification of individuals at high risk for the development of cerebrovascular disease and cognitive decline.

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