Total Cerebral Small Vessel Disease Burden Is Related to Worse Performance on the Mini-Mental State Examination and Incident Dementia: A Prospective 5-Year Follow-Up
Total Cerebral Small Vessel Disease Burden Is Related to Worse Performance on the Mini-Mental State Examination and Incident Dementia: A Prospective 5-Year Follow-Up
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DOI：
10.3233/jad-181135
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发表时间：
2019-01-01
影响因子：
4
通讯作者：
Chen, Xingdong
中科院分区：
文献类型：
--
作者：
Jiang, Yanfeng;Wang, Yingzhe;Chen, Xingdong
个体脑血管疾病（CSVD）可导致认知能力下降。然而，心血管疾病总负担与普通人群认知能力下降之间的关系尚不清楚。我们的目的是确定CSVD总评分是否与一般人群的认知表现改变和痴呆发生率相关。在以人群为基础的纵向泰州影像学研究中，556名无神经系统疾病的参与者在基线时接受了脑MRI和神经心理测试。共有456名参与者接受了平均（标准差）4.6年（0.6年）的认知表现随访。总CSVD评分（范围0-4）通过以下标记物的存在分配1分来计算：腔隙、白质高、脑微出血和血管周围间隙。采用Beta回归评估CSVD总负担与MMSE评分变化之间的关系。使用Fisher精确检验研究了流行的CSVD与痴呆的关系。262例（47.1%）存在csvd。CSVD总评分与MMSE评分下降显著相关（p = 0.001）。与没有CSVD的受试者相比，有4种CSVD标记物的受试者MMSE评分下降幅度更大（β值：-0.53,95% CI: -0.86至-0.21;p = 0.001）。在随访期间，共有15名参与者患上了痴呆症。基线时超过三个CSVD标记物的存在与痴呆风险显著增加相关（p = 0.020）。在中国的一般人群中，总CSVD负担似乎与MMSE评分下降和痴呆发生率有关。
Individual cerebral small vessel disease (CSVD) may cause cognitive decline. However, the association between total burden of CSVD and cognitive deterioration in the general population remains unclear. We aimed to determine whether total CSVD score is associated with cognitive performance change and incident dementia in the general population. In the longitudinal population-based Taizhou Imaging Study, 556 participants free of neurological disorders underwent brain MRI and neuropsychological testing at baseline. A total of 456 participants were followed up for cognitive performance for a mean (standard deviation) of 4.6 (0.6) years. Total CSVD score (range 0-4) was calculated by assigning 1 point for the presence of each of the following markers: lacune, white matter hyperintensity, cerebral microbleed, and perivascular space. Beta regression was used to evaluate the association between total CSVD burden and MMSE score change. The association of prevalent CSVD with incident dementia was studied using Fisher's exact test. CSVDs were present in 262 individuals (47.1%). The total CSVD score was significantly associated with MMSE score decline (p = 0.001). Compared to those with no CSVD, participants with 4 CSVD markers had a steeper decline in MMSE score (beta : -0.53, 95% CI: -0.86 to -0.21; p = 0.001). A total of 15 participants developed dementia during follow-up. The presence of more than three CSVD markers at baselinewas associated with a significantly higher risk of dementia (p = 0.020). Total CSVD burden appears to be associated with MMSE score decline and incident dementia in a general population in China.