Association of cerebral small vessel disease burden with brain structure and cognitive and vascular risk trajectories in mid-to-late life.
Association of cerebral small vessel disease burden with brain structure and cognitive and vascular risk trajectories in mid-to-late life.
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DOI：
10.1177/0271678x211048411
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Suri S
中科院分区：
文献类型：
--
作者：
Jansen MG;Griffanti L;Mackay CE;Anatürk M;Melazzini L;Lange AG;Filippini N;Zsoldos E;Wiegertjes K;Leeuw FE;Singh-Manoux A;Kivimäki M;Ebmeier KP;Suri S
我们描述了总脑小血管疾病（SVD）负荷与大脑结构，血管危险因素的轨迹和中晚期认知功能的关系。参与者是来自多模态MRI的Whitehall II成像子研究的623名社区居民成年人（平均年龄69.96岁，SD = 5.18，79%为男性）。我们使用线性混合效应模型来研究SVD负担与长达25年的血管风险和认知能力回顾性轨迹的相关性。使用一般线性模型研究与灰质（GM）密度和白色（WM）微结构的并发关联，以及这些关联是否因认知状态而改变（蒙特利尔认知评估[莫卡]评分< 26与≥ 26）。老年人的重度SVD负担与整个中年期的平均动脉压较高（β = 3.36，95% CI [0.42-6.30]）、字母流畅性（β = −0.07，95% CI [−0.13-−0.01]）和语言推理（β = −0.05，95% CI [−0.11-−0.001]）的认知下降较快相关。此外，SVD负担与GM体积较低（占总GM的9.7%）和广泛的WM显微结构下降相关（FWE校正p < 0.05）。后一种关联在莫卡上表现出认知障碍的个体中最为明显（莫卡< 26; F3，608 = 2.14，p = 0.007）。这些发现强调了管理中年血管健康以保护老年大脑结构和认知功能的重要性。
We characterize the associations of total cerebral small vessel disease (SVD) burden with brain structure, trajectories of vascular risk factors, and cognitive functions in mid-to-late life. Participants were 623 community-dwelling adults from the Whitehall II Imaging Sub-study with multi-modal MRI (mean age 69.96, SD = 5.18, 79% men). We used linear mixed-effects models to investigate associations of SVD burden with up to 25-year retrospective trajectories of vascular risk and cognitive performance. General linear modelling was used to investigate concurrent associations with grey matter (GM) density and white matter (WM) microstructure, and whether these associations were modified by cognitive status (Montreal Cognitive Asessment [MoCA] scores of < 26 vs. ≥ 26). Severe SVD burden in older age was associated with higher mean arterial pressure throughout midlife (β = 3.36, 95% CI [0.42-6.30]), and faster cognitive decline in letter fluency (β = −0.07, 95% CI [−0.13–−0.01]), and verbal reasoning (β = −0.05, 95% CI [−0.11–−0.001]). Moreover, SVD burden was related to lower GM volumes in 9.7% of total GM, and widespread WM microstructural decline (FWE-corrected p < 0.05). The latter association was most pronounced in individuals who demonstrated cognitive impairments on MoCA (MoCA < 26; F3,608 = 2.14, p = 0.007). These findings highlight the importance of managing midlife vascular health to preserve brain structure and cognitive function in old age.
影响因子：
6.3
作者：
Akasaki M;Kivimäki M;Steptoe A;Nicholas O;Shipley MJ
通讯作者：
Shipley MJ