Cerebral Small Vessel Disease and Motoric Cognitive Risk Syndrome: Results from the Kerala-Einstein Study.
Cerebral Small Vessel Disease and Motoric Cognitive Risk Syndrome: Results from the Kerala-Einstein Study.
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DOI：
10.3233/jad-150523
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Verghese J
中科院分区：
文献类型：
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作者：
Wang N;Allali G;Kesavadas C;Noone ML;Pradeep VG;Blumen HM;Verghese J
脑小血管疾病对认知能力下降的影响，尤其是在非白种人群体中，尚不明确。我们研究了印度老年人脑小血管疾病与运动认知风险综合征（MCR）之间的关系，MCR 是最近描述的一种痴呆前期综合征。一项横断面研究对印度南部喀拉拉邦-爱因斯坦研究的 139 名参与者（平均年龄 66.6 ± 5.4 岁，33.1% 女性）进行了检查。不了解临床信息的评估者确定了脑小血管疾病（腔隙性梗塞和脑微出血（CMB））和 MRI 上白质高信号的存在。 MCR 的定义是，没有痴呆或行动障碍的老年人存在认知问题和步态缓慢。三十八名 (27.3%) 参与者符合 MCR 标准。腔隙性梗塞和 CMB 的总体患病率分别为 49.6% 和 9.4%。即使在调整了血管危险因素和白质高信号后，额叶的腔隙性梗塞与 MCR 无关，但与 MCR 无关（调整后的比值比 (aOR)：4.67，95% CI：1.69-12.94）。额叶腔隙性梗塞与步态缓慢（aOR：3.98，95％CI：1.46-10.79）和记忆测试表现不佳（β：-1.24，95％CI：-2.42至-0.05）相关，但与认知问题或非记忆测试无关。未发现 CMB 与 MCR、个人 MCR 标准或认知测试相关。额叶腔隙性梗塞与印度老年人的 MCR 相关，可能是由于导致步态缓慢和记忆功能差。
The contribution of cerebral small vessel disease to cognitive decline, especially in non-Caucasian populations, is not well established. We examined the relationship between cerebral small vessel disease and motoric cognitive risk syndrome (MCR), a recently described pre-dementia syndrome, in Indian seniors. 139 participants (mean age 66.6 ± 5.4 y, 33.1% female) participating in the Kerala-Einstein study in Southern India were examined in a cross-sectional study. The presence of cerebral small vessel disease (lacunar infarcts and cerebral microbleeds (CMB)) and white matter hyperintensities on MRI was ascertained by raters blinded to clinical information. MCR was defined by the presence of cognitive complaints and slow gait in older adults without dementia or mobility disability. Thirty-eight (27.3%) participants met MCR criteria. The overall prevalence of lacunar infarcts and CMB was 49.6% and 9.4%, respectively. Lacunar infarcts in the frontal lobe, but no other brain regions, were associated with MCR even after adjusting for vascular risk factors and presence of white matter hyperintensities (adjusted Odds Ratio (aOR): 4.67, 95% CI: 1.69–12.94). Frontal lacunar infarcts were associated with slow gait (aOR: 3.98, 95% CI: 1.46–10.79) and poor performance on memory test (β: −1.24, 95% CI: −2.42 to −0.05), but not with cognitive complaints or non-memory tests. No association of CMB was found with MCR, individual MCR criterion or cognitive tests. Frontal lacunar infarcts are associated with MCR in Indian seniors, perhaps, by contributing to slow gait and poor memory function.