Dementia incidence and predictors in cerebral amyloid angiopathy patients without intracerebral hemorrhage
Dementia incidence and predictors in cerebral amyloid angiopathy patients without intracerebral hemorrhage
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DOI：
10.1177/0271678x17700435
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发表时间：
2018-02-01
影响因子：
6.3
通讯作者：
Viswanathan, Anand
中科院分区：
文献类型：
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作者：
Xiong, Li;Boulouis, Gregoire;Viswanathan, Anand
脑淀粉样血管病（CAA）是老年人认知障碍的常见原因。本研究旨在探讨CAA患者中无脑出血（ICH）的痴呆的预测因素。共纳入158名来自中风服务或记忆诊所的非痴呆患者，他们符合可能CAA的修改后的波士顿标准。在基线时，评估神经影像学标志物，包括脑叶微出血（脑微出血（CMB））、白色高信号（WMH）、皮质浅表铁质沉着症（cSS）、磁共振成像（MRI）-可见半卵圆中心血管周围间隙（CSO-PVS）、腔隙和内侧颞叶萎缩（MTA）。根据CMB数量、WMH严重程度、cSS存在和程度以及CSO-PVS严重程度，通过累积评分计算CAA的小血管疾病（SVD）总体负担。1年时估计的累积痴呆发生率为14%（95%置信区间（CI）：5%-23%），5年时为73%（95% CI：55%，84%）。年龄（风险比（HR）1.05/年，95% CI：1.01-1.08，p=0.007），存在MCI状态（HR 3.40，95% CI：1.97-6.92，p
Cerebral amyloid angiopathy (CAA) is a common cause of cognitive impairment in older individuals. This study aimed to investigate predictors of dementia in CAA patients without intracerebral hemorrhage (ICH). A total of 158 non-demented patients from the Stroke Service or the Memory Clinic who met the modified Boston Criteria for probable CAA were included. At baseline, neuroimaging markers, including lobar microbleeds (cerebral microbleeds (CMBs)), white matter hyperintensities (WMH), cortical superficial siderosis (cSS), magnetic resonance imaging (MRI)-visible centrum semiovale perivascular spaces (CSO-PVS), lacunes, and medial temporal atrophy (MTA) were assessed. The overall burden of small vessel disease (SVD) for CAA was calculated by a cumulative score based on CMB number, WMH severity, cSS presence and extent and CSO-PVS severity. The estimated cumulative dementia incidence at 1 year was 14% (95% confidence interval (CI): 5%-23%), and 5 years 73% (95% CI: 55%, 84%). Age (hazard ratio (HR) 1.05 per year, 95% CI: 1.01-1.08, p=0.007), presence of MCI status (HR 3.40, 95% CI: 1.97-6.92, p