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Background Cerebral small vessel disease is associated with higher ratios of soluble‐epoxide hydrolase derived linoleic acid diols (12,13‐dihydroxyoctadecenoic acid [DiHOME] and 9,10‐DiHOME) to their parent epoxides (12(13)‐epoxyoctadecenoic acid [EpOME] and 9(10)‐EpOME); however, the relationship has not yet been examined in stroke. Methods and Results Participants with mild to moderate small vessel stroke or large vessel stroke were selected based on clinical and imaging criteria. Metabolites were quantified by ultra‐high‐performance liquid chromatography–mass spectrometry. Volumes of stroke, lacunes, white matter hyperintensities, magnetic resonance imaging visible perivascular spaces, and free water diffusion were quantified from structural and diffusion magnetic resonance imaging (3 Tesla). Adjusted linear regression models were used for analysis. Compared with participants with large vessel stroke (n=30), participants with small vessel stroke (n=50) had a higher 12,13‐DiHOME/12(13)‐EpOME ratio (β=0.251, P =0.023). The 12,13‐DiHOME/12(13)‐EpOME ratio was associated with more lacunes (β=0.266, P =0.028) but not with large vessel stroke volumes. Ratios of 12,13‐DiHOME/12(13)‐EpOME and 9,10‐DiHOME/9(10)‐EpOME were associated with greater volumes of white matter hyperintensities (β=0.364, P P P =0.011; β=0.314, P =0.006). In small vessel stroke, the 12,13‐DiHOME/12(13)‐EpOME ratio was associated with higher white matter free water diffusion (β=0.439, P =0.016), which was specific to the temporal lobe in exploratory regional analyses. The 9,10‐DiHOME/9(10)‐EpOME ratio was associated with temporal lobe atrophy (β=−0.277, P =0.031). Conclusions Linoleic acid markers of cytochrome P450/soluble‐epoxide hydrolase activity were associated with small versus large vessel stroke, with small vessel disease markers consistent with blood brain barrier and neurovascular‐glial disruption, and temporal lobe atrophy. The findings may indicate a novel modifiable risk factor for small vessel disease and related neurodegeneration.

Clinician-led memory interventions have been shown to increase knowledge, reduce anxiety, promote memory-strategy use, and increase brain-healthy lifestyle behaviours in older adults with normal age-related memory changes. A self-guided, e-learning version of the Baycrest Memory and Aging Program® was recently developed to increase accessibility to memory interventions. The objectives of the current study were to assess program feasibility (retention rate), acceptability (satisfaction), and participant-reported impact (memory concerns, behaviour change, goal attainment). As part of a larger study, participants were 139 healthy older adults (mean age: 73±7, 73% female). Ninety-two individuals completed the program (retention rate=66%). Anonymous feedback data indicated a high level of satisfaction with the program overall (98%), the pace and clarity of the learning modules (100%), and the organization and navigation of the interface (92%). Suggested improvements included offering more interaction with others and addressing minor platform glitches. There was a decrease in the level of concern about memory change, with 64% expressing concern at a level consistent with the Jessen et al. (2014) criteria for Subjective Cognitive Decline at baseline, and 23% expressing the same at post-test. The majority of participants reported increases in using memory-strategies (63-97%) and lifestyle-promoting behaviours (40-72%). All participants reported moderate to high satisfaction with personal goal attainment. Results support feasibility, acceptability, and impact of a self-guided e-learning adaptation of memory intervention. E-learning tools may be a promising avenue to deliver accessible brain health promotion in later life, especially in the context of the shift to virtual care during and beyond COVID-19.

Objectives Recent studies suggest that interindividual genetic differences in glial-dependent CSF flow through the brain parenchyma, known as glymphatic flow, may trigger compensatory changes in human sleep physiology. In animal models, brain perivascular spaces are a critical conduit for glymphatic flow. We tested the hypothesis that MRI-visible PVS volumes, a putative marker of perivascular dysfunction, are associated with compensatory differences in real-world human sleep behavior. Methods We analyzed data from 152 cerebrovascular disease patients from the Ontario Neurodegenerative Disease Research Initiative (ONDRI). PVS volumes were measured using 3T-MRI. Self-reported total sleep time, time in bed, and daytime dysfunction were extracted from the Pittsburgh Sleep Quality Index. Results Individuals with greater PVS volumes reported longer time in bed (+0.85 h per log10 proportion of intracranial volume (ICV) occupied by PVS, SE = 0.30, p = 0.006) and longer total sleep times (+0.70 h per log10 proportion of ICV occupied by PVS volume, SE = 0.33, p = 0.04), independent of vascular risk factors, sleep apnea, nocturnal sleep disturbance, depression, and global cognitive status. Further analyses suggested that the positive association between PVS volumes and total sleep time was mediated by greater time in bed. Moreover, despite having on average greater total sleep times, individuals with greater basal ganglia PVS volumes were more likely to report daytime dysfunction (OR 5.63 per log10 proportion of ICV occupied by PVS, 95% CI: 1.38–22.26, p = 0.018). Conclusions Individuals with greater PVS volumes spend more time in bed, resulting in greater total sleep time, which may represent a behavioral compensatory response to perivascular space dysfunction.

Age-related memory changes pose considerable concerns for aging adults, and can adversely affect their daily living and cause worry even when changes experienced are not clinically significant. The Memory and Aging Program® is a validated psychoeducation and memory strategy-training program that teaches the public about memory changes during aging and trains them to use evidence-based strategies to support brain health. The program has been offered in-person for over 20 years, and a self-guided eLearning version was recently developed to improve program accessibility. This study evaluated the self-reported impacts of memory changes in older adults who completed this eLearning against a control group. We randomized 202 older adults, without neurological or psychiatric diagnoses (71.6 years; 69 % female; 15.6 years of education), into the eLearning program or a control group that received no intervention. All participants reported their perceived impact of memory changes using the Memory Impact Questionnaire at pre-, post-, and 6-8 weeks follow-up. A significant reduction in negative impact of memory changes on daily living and a significant improvement in positive coping with memory changes relative to controls was observed at post-test (13.4 versus 2.5 points reduction and 7.4 versus 0.1 point improvement, respectively, both p < 0.05), but these did not persist at follow-up. The adoption of digital tools has hastened across all ages. Our study showed that self-guided digital tools, such as the eLearning Memory and Aging Program®, may be a promising avenue to help aging individuals reduce the impact of memory changes on daily living.