White Matter Hyperintensity Predicts the Risk of Incident Cognitive Decline in Community Dwelling Elderly

被引：6
作者：
Ding, Ding [1 ,2 ]
Xiong, Yunyun [3 ]
Zhao, Qianhua [1 ,2 ]
Guo, Qihao [1 ,2 ]
Chu, Shuguang [2 ,4 ]
Chu, Winnie W. C. [5 ]
Luo, Jianfeng [6 ]
Liang, Xiaoniu [1 ,2 ]
Zheng, Li [1 ,2 ]
Hong, Zhen [1 ,2 ]
Wong, Lawrence K. S. [6 ,7 ]
Mok, Vincent C. T. [7 ]
机构：
[1] Fudan Univ, WHO Collaborating Ctr Res & Training Neurosci, Huashan Hosp, Inst Neurol, Shanghai, Peoples R China
[2] Fudan Univ, Huashan Hosp, Natl Clin Res Ctr Aging & Med, Shanghai, Peoples R China
[3] Nanjing Univ, Sch Med, Jinling Hosp, Dept Neurol, Nanjing, Jiangsu, Peoples R China
[4] Fudan Univ, Huashan Hosp, Dept Radiol, Shanghai, Peoples R China
[5] Chinese Univ Hong Kong, Dept Radiol & Organ Imaging, Shatin, Hong Kong, Peoples R China
[6] Fudan Univ, Sch Publ Hlth, Dept Biostat, Shanghai, Peoples R China
[7] Chinese Univ Hong Kong, Lui Che Woo Inst Innovat Med, Therese Pei Fong Chow Res Ctr Prevent Dementia, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China
来源：
JOURNAL OF ALZHEIMERS DISEASE | 2018年 / 61卷 / 04期
基金：
中国国家自然科学基金;
关键词：
Cognitive decline; dementia; mild cognitive impairment; small vessel disease; white matter hyperintensity; SMALL-VESSEL DISEASE; ALZHEIMERS-DISEASE; PREVALENCE; IMPAIRMENT; LESIONS; MRI; DEMENTIA; AGE; SHANGHAI; PEOPLE;
D O I：
10.3233/JAD-170876
中图分类号：
Q189 [神经科学];
学科分类号：
071006 ;
摘要：
Background: Unlike western countries, data on white matter hyperintensity ( WMH) in community dwelling elderly in Asian population is very limited. Objective: To examine the relation between baseline WMH burden and the risk of incident cognitive decline in a community-based cohort with Chinese-dwelling elderly. Methods: We prospectively evaluated the incident cognitive decline for 226 participants in the Shanghai Aging Study. Baseline WMH severity was visually rated by the age-related white matter changes (ARWMC) scale based on MRI. Cox proportional hazards regression model was used to estimate the relative risk (RR) of total ARWMC scale, global ARWMC score, presence of lacune and microbleed, for incident cognitive decline by adjusting potential confounders. Results: Forty subjects were identified with incident cognitive decline (new onset 34 mild cognitive impairment and 6 dementia) during a median duration of 6 years follow-up. The incidence of cognitive decline was 3.0 (95% confidence interval [CI] 2.2-4.1) per 100 person-years. Increasing total ARWMC scale [RR1.21 (95% CI 1.06-1.39), p = 0.004)], confluent WMH [RR3.16 (95% CI 1.50-6.64), p = 0.002), and presence of lacunes [RR 2.73 (95% CI 1.21-6.15)] at baseline were independent predictors of incident cognitive decline. Conclusion: Our study demonstrated that confluent WMH may increase the risk of incident cognitive decline by 3 folds in community dwelling subjects. Small vessel disease may cause heavy burden of cognitive impairment in the elderly in China.
引用
收藏
页码：1333 / 1340
页数：8
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