The Prevalence and Severity of White Matter Lesions, Their Relationship with Age, Ethnicity, Gender, and Cardiovascular Disease Risk Factors: The ARIC Study

Liao, Duanping; Cooper, Lawton S.; Cai, Jianwen; Toole, James F.; Bryan, Nick; Burke, Gregory L.; Shahar, Eyal; Nieto, Javier; Mosley, Thomas H.; Heiss, Gerardo

doi:10.1159/000368814

Cited by 389 publications

(341 citation statements)

References 9 publications

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“…Clinically, white matter disease is found most often in association with old age, arterial hypertension, diabetes mellitus, heart disease, and cardiovascular risk factors (Bots et al, 1993;de Leeuw et al, 2001;Liao et al, 1997). Experimental animal studies have reproduced some aspects of human WML (Pantoni & Garcia, 1997) and implicate leaks in the blood brain barrier as part of the cause of age-related cognitive decline originating from WML (Kemper, Blatt, Killiany, & Moss, 2001).…”

Section: Brain White Matter Abnormalitiesmentioning

confidence: 99%

Cerebral white matter abnormalities and lifetime cognitive change: A 67-year follow-up of the Scottish Mental Survey of 1932.

Deary¹,

Leaper²,

Murray³

et al. 2003

Psychology and Aging

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Cerebral white matter abnormalities relate to cognitive functioning in elders. We examine whether this association is (a) independent of mental ability in youth and (b) related to general and/or specific mental abilities. We retested 83 participants of the Scottish Mental Survey of 1932 on a battery of mental tests. Their brains were scanned by magnetic resonance imaging. Three independent ratings (Fazekas) were made of periventricular, and subcortical and deep white matter abnormalities. Structural equation models showed that, irrespective of brain location, white matter abnormalities contributed about 14% of cognitive function variance in old age. Some of this effect might be due to hypertension. This contribution is independent of mental function in early life and is associated with general cognitive ability.People who retain their cognitive functions in old age tend to have higher quality of life and live longer (Korten et al., 1999; National Research Council, 2000). Therefore, it is important to discover the factors that contribute to individual differences in cognitive functioning among the elderly. Ideally, researchers should establish the extent to which putative determinants of differences in cognitive aging are independent of prior cognitive ability differences, but cognitive data from youth are rarely available for aging cohorts. We discovered a population-wide cohort of individuals who took a validated mental test under standardized conditions in 1932 at 11 years of age (Scottish Council for Research in Education, 1933;Deary, Whalley, Lemmon, Crawford, & Starr, 2000). A measure of early life cognitive ability was available, therefore, for many individuals who were in their late 70s at the time of this investigation.In the present study, we examined the contribution of brain white matter lesions (WML) to cognitive ability differences in old age. Brain white matter abnormalities are important in the study of psychology and aging: (a) They are common, even in people with no dementia or other neurocognitive disorders; (b) they appear to be associated with other factors related to cognitive aging (such as hypertension and other illnesses, e.g., diabetes, that have an impact on vascular function); and (c) they are related to cognitive functioning in old age. In this article, we enquire whether (a) any association between WML and cognitive ability in old age is independent of cognitive ability in youth; (b) WML relate to specific or general cognitive abilities; and (c) hypertension underlies both differences in WML and cognitive function in old age. Brain White Matter AbnormalitiesIn this section, the phenomenon of brain WML is described, and causes of WML are discussed. One possible cause of both WML and cognitive aging is hypertension, which we examine in the present study.White matter abnormalities are frequently observed on T2 weighted magnetic resonance imaging (T2W MRI) of the brain, particularly in adults over the age of 60. They are alternatively referred to as lesions or hyperintensities, which is...

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Section: Brain White Matter Abnormalitiesmentioning

confidence: 99%

Cerebral white matter abnormalities and lifetime cognitive change: A 67-year follow-up of the Scottish Mental Survey of 1932.

Deary¹,

Leaper²,

Murray³

et al. 2003

Psychology and Aging

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“…14,15 Although correlations between arterial hypertension and cognitive decline are not yet fully understood, with many controversial results, 16,17 studies have indicated that individuals with arterial hypertension are more likely to be affected by a decline in cognitive capacity. 18,19 Most studies 14,15,18,19 indicate that Systemic Arterial Hypertension (SAH) is associated with the decline of cognitive function, given that high arterial pressure is one of the risk factors for strokes, leading to the development of vascular dementia. Therefore, physiologically, multiple heart attacks can cause dementia, depending on the volume of the brain affected, whether the attacks are local or bilateral, and the presence of white matter lesions in areas of demyelination and narrowing of the vessel lumen, which are associated with both SAH and cognitive dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Associação entre declínio cognitivo e qualidade de vida de idosos hipertensos

Chaves

Santos

Alves

et al. 2015

Rev. bras. geriatr. gerontol.

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Objective: To evaluate the association between cognitive decline and quality of life in hypertensive elderly persons. Methods: A quantitative, cross-sectional, analytical study involving 125 hypertensive elderly individuals of both genders attending the HIPERDIA Program in São Luís, in the state of Maranhao, was performed. The Mini Mental State Exam (MMSE) was used to evaluate cognitive decline and quality of life was assessed using the Medical Outcomes Study 36 Short-Form Health Survey (SF-36). The normality of the data was verified by the Shapiro-Wilk test. The Mann-Whitney test was also applied (quality of life). The association between cognitive decline and quality of life was evaluated using Spearman's coefficient. Results: The prevalence of cognitive decline was 20.8% and there was a predominance of elderly persons with a low educational level (45.83%). Hypertensive elderly individuals with cognitive decline had a poorer quality of life than those without cognitive decline. A positive association between cognitive function and quality of life was observed for the following domains: functional capacity (r=0.222; p=0.01), pain (r=0.1871; p=0.04), and emotional aspects (r=0.3136; p=0.0005). Conclusion: The results of this study suggest that cognitive decline directly affects the quality of life of the elderly by limiting the capacity to perform activities of daily living, especially if associated with painful medical conditions and emotional disturbances.

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“…[3][4][5][6][7][8][9] Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels have been inversely related to cognitive performance level. 2,10,11 Moreover, DBP and SBP levels in midlife have been inversely associated with performance levels on cognitive tests administered at later ages.…”

mentioning

confidence: 99%

Blood Pressure-Related Cognitive Decline

Elias

Elias²,

Robbins³

et al. 2004

Hypertension

178

117

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Abstract-Systolic and diastolic blood pressures have been inversely related to cognitive performance in prospective and cross-sectional studies. However, in large, community-based samples, these findings have been limited to older adults. In this 20-year longitudinal study, we examined the relationship between baseline blood pressure and cognitive decline for 529 participants using 2 age groups (18 to 46 years and 47 to 83 years). Cognitive performance was measured over multiple examinations with the Wechsler Adult Intelligence Scale from which 4 scores were derived by factor analysis. A 2-stage growth curve method of analysis was used to model cognitive change. Results indicated that higher levels of baseline systolic blood pressure, diastolic blood pressure, mean arterial pressure, and blood pressure categories as defined by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure were significantly associated with decline in Visualization/Fluid abilities in both younger and older age groups. Young adults are as susceptible to blood pressure-related longitudinal decline in cognitive performance as are older adults. Key Words: blood pressure Ⅲ age Ⅲ arterial hypertension Ⅲ cognition Ⅲ prospective studies Ⅲ risk factors H ypertension is related to poorer cognitive performance in adults, 1,2 and hypertension-related changes in the brain are well-documented. 3-9 Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels have been inversely related to cognitive performance level. 2,10,11 Moreover, DBP and SBP levels in midlife have been inversely associated with performance levels on cognitive tests administered at later ages. 9,[12][13][14] It is important to determine whether baseline BP values are associated with accelerated cognitive change with advancing age. Longitudinal designs are methodologically superior to cross-sectional designs because BP level can be related to intra-individual decline in cognitive functioning. 15,16 Most of the longitudinal studies using large, community-based samples have involved only midlife or older individuals. [17][18][19][20] Recently, Knopman et al studied persons ranging in age from 47 to 70 years and found that hypertension was related to cognitive decline from baseline to 6-year follow-up, but only for persons aged 58 to 70 years. 21 In contrast to longitudinal findings, cross-sectional studies indicate that younger adult hypertensive individuals may be more vulnerable to BP-related decrement in cognitive functioning than older hypertensive individuals. 10,22 This phenomenon may be an artifact of cross-sectional designs. 1,2,10 However, the possibility that younger adult hypertensive individuals exhibit greater cognitive decline than older hypertensive individuals has not been tested with a longitudinal design that included persons younger than 47 years of age. The major objective of the present study was to compare older and younger adults with respect to BP-associated cognitive decline using a prospective longit...

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The Prevalence and Severity of White Matter Lesions, Their Relationship with Age, Ethnicity, Gender, and Cardiovascular Disease Risk Factors: The ARIC Study

Cited by 389 publications

References 9 publications

Cerebral white matter abnormalities and lifetime cognitive change: A 67-year follow-up of the Scottish Mental Survey of 1932.

Cerebral white matter abnormalities and lifetime cognitive change: A 67-year follow-up of the Scottish Mental Survey of 1932.

Associação entre declínio cognitivo e qualidade de vida de idosos hipertensos

Blood Pressure-Related Cognitive Decline

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