White Matter Lesions on Brain Magnetic Resonance Imaging Scan and 5-Year Cognitive Decline: The Honolulu-Asia Aging Study
White Matter Lesions on Brain Magnetic Resonance Imaging Scan and 5-Year Cognitive Decline: The Honolulu-Asia Aging Study
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DOI：
10.1111/j.1532-5415.2011.03490.x
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发表时间：
2011-08-01
影响因子：
6.3
通讯作者：
Masaki, Kamal
中科院分区：
文献类型：
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作者：
Inaba, Michiko;White, Lon;Masaki, Kamal
目的：研究老年日裔美国男性的白色病变（WML）和5年认知能力下降。产品设计：纵向队列研究。在夏威夷的檀香山进行的一项基于人群的研究。参与者：来自檀香山-亚洲老龄化研究（哈斯）的74 - 95岁日裔美国男性，他们没有普遍的痴呆症，在第五次哈斯检查时接受了一次脑MRI扫描（1994-1996），并在5年后返回进行认知测试（N = 267）。WML分为存在（3-9级，38.2%）或不存在（1-2级，61.8%）。使用认知能力筛查工具（CASI）测量认知功能，5年认知功能下降定义为CASI评分下降12分或更多（1个标准差）。结果：基线时MRI显示有WML的男性在5年时比没有WML的男性更有可能经历认知功能下降（22.4% vs 34.4%，P = 0.03）。使用多元logistic回归，调整年龄，教育，载脂蛋白（Apo）E4等位基因，MRI上的大或小梗死，基线CASI评分和高血压，WML患者更有可能发展为5年认知能力下降（比值比= 2.00，95%置信区间= 1.10-3.65，P = 0.02）。这种关联是更强的男性谁是认知完整和免费的ApoE 4基因型和临床中风在basel.CONCLUSION：存在WMLs的MRI显着相关的5年认知能力下降的老年日裔美国男性的几率较高。WML的存在可能有助于识别有患痴呆症风险的人，这些人可能从早期干预中受益。J Am Geriatr Soc 59：1484-1489，2011.
OBJECTIVES: To study white matter lesions (WMLs) and 5-year cognitive decline in elderly Japanese-American men. DESIGN: Longitudinal cohort study.SETTING: Population-based study in Honolulu, Hawaii.PARTICIPANTS: Japanese-American men aged 74 to 95 from the Honolulu-Asia Aging Study (HAAS) who were free of prevalent dementia, underwent a protocol brain MRI scan at the fifth HAAS examination (1994-1996), and returned for cognitive testing 5 years later (N = 267).MEASUREMENTS: WMLs were dichotomized as present (grade 3-9, 38.2%) or absent (grade 1-2, 61.8%). Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI), and 5-year cognitive decline was defined as a drop in CASI score of 12 points or more (1 standard deviation).RESULTS: Men with WMLs on MRI at baseline were significantly more likely to experience cognitive decline at 5 years than those without (22.4% vs 34.4%, P = .03). Using multiple logistic regression, adjusting for age, education, apolipoprotein (Apo) E4 allele, large or small infarcts on MRI, baseline CASI score, and hypertension, those with WMLs were significantly more likely to develop 5-year cognitive decline (odds ratio = 2.00, 95% confidence interval = 1.10-3.65, P = .02). This association was stronger in men who were cognitively intact and free of the ApoE4 genotype and clinical stroke at baseline.CONCLUSION: Presence of WMLs on MRI was significantly associated with higher odds of 5-year cognitive decline in older Japanese-American men. Presence of WMLs may help identify people at risk for developing dementia, who may benefit from early intervention. J Am Geriatr Soc 59:1484-1489, 2011.