Cerebral small vessel disease burden and longitudinal cognitive decline from age 73 to 82: the Lothian Birth Cohort 1936.
Cerebral small vessel disease burden and longitudinal cognitive decline from age 73 to 82: the Lothian Birth Cohort 1936.
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DOI：
10.1038/s41398-021-01495-4
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发表时间：
2021-07-06
影响因子：
6.8
通讯作者：
Deary IJ
中科院分区：
文献类型：
--
作者：
Hamilton OKL;Cox SR;Okely JA;Conte F;Ballerini L;Bastin ME;Corley J;Taylor AM;Page D;Gow AJ;Muñoz Maniega S;Redmond P;Valdés-Hernández MDC;Wardlaw JM;Deary IJ
加工速度减慢被认为是脑小血管疾病(SVD)认知能力下降的一个显著特征；然而，尚不清楚SVD与加工减慢的关联是否可能是由于它与总体认知能力下降的关联。我们量化了1936年洛锡安出生队列中540名成员(年龄：72.6 ± 0.7岁；47%女性)的核磁共振可见的SVD总负担。使用潜伏期生长曲线模型，我们测试了平均年龄73岁的SVD总负担与一般认知能力、处理速度、言语记忆和视觉空间能力变化之间的关系，这些变化是在73岁、76岁、79岁和82岁测量的。协变量包括年龄、性别、血管风险和儿童认知能力。在完全调整的模型中，SVD负担越重，一般认知能力(标准化β：−0.201；95%CI：[−0.36，−0.04]；pFDR = 0.022)和加工速度(−0.222；[−0.40，−0.04]；pFDR = 0.022)的下降幅度更大。SVD负担可以解释一般认知能力和处理速度下降的4%到5%的差异。在考虑了加工速度和一般认知能力测试之间的协方差后，只有奇异值分解与一般认知能力的较大下降之间的关联仍然显著，在FDR校正之前(−0.222；[−0.39，−0.06]；p = 0.008；p FDR = 0.085)。我们的发现不支持奇异值分解与处理速度下降有特定联系的观点，独立于一般认知能力的下降(这捕捉到认知能力各领域共有的差异)。SVD负担和一般认知能力下降之间的联系支持SVD是一种弥漫性、全脑疾病的概念，并建议监测SVD相关认知变化的试验应该在整体、一般认知下降的背景下考虑特定领域的变化。
Slowed processing speed is considered a hallmark feature of cognitive decline in cerebral small vessel disease (SVD); however, it is unclear whether SVD’s association with slowed processing might be due to its association with overall declining general cognitive ability. We quantified the total MRI-visible SVD burden of 540 members of the Lothian Birth Cohort 1936 (age: 72.6 ± 0.7 years; 47% female). Using latent growth curve modelling, we tested associations between total SVD burden at mean age 73 and changes in general cognitive ability, processing speed, verbal memory and visuospatial ability, measured at age 73, 76, 79 and 82. Covariates included age, sex, vascular risk and childhood cognitive ability. In the fully adjusted models, greater SVD burden was associated with greater declines in general cognitive ability (standardised β: −0.201; 95% CI: [−0.36, −0.04]; pFDR = 0.022) and processing speed (−0.222; [−0.40, −0.04]; pFDR = 0.022). SVD burden accounted for between 4 and 5% of variance in declines of general cognitive ability and processing speed. After accounting for the covariance between tests of processing speed and general cognitive ability, only SVD’s association with greater decline in general cognitive ability remained significant, prior to FDR correction (−0.222; [−0.39, −0.06]; p = 0.008; pFDR = 0.085). Our findings do not support the notion that SVD has a specific association with declining processing speed, independent of decline in general cognitive ability (which captures the variance shared across domains of cognitive ability). The association between SVD burden and declining general cognitive ability supports the notion of SVD as a diffuse, whole-brain disease and suggests that trials monitoring SVD-related cognitive changes should consider domain-specific changes in the context of overall, general cognitive decline.
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DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
Hu, Li-tze;Bentler, Peter M.
通讯作者：
Bentler, Peter M.
影响因子：
4.6
作者：
Ballerini L;Lovreglio R;Valdés Hernández MDC;Ramirez J;MacIntosh BJ;Black SE;Wardlaw JM
通讯作者：
Wardlaw JM
影响因子：
4.2
作者：
Hamilton O;Cox SR;Ballerini L;Bastin ME;Corley J;Gow AJ;Muñoz Maniega S;Redmond P;Valdés Hernández MDC;Wardlaw JM;Deary IJ
通讯作者：
Deary IJ
影响因子：
9.9
作者：
Duering, Marco;Righart, Ruthger;Dichgans, Martin
通讯作者：
Dichgans, Martin
影响因子：
5.7
作者：
Deary, IJ;Simonotto, E;Wardlaw, JM
通讯作者：
Wardlaw, JM