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VIENNA — The presence of brain infarcts at age 60 strongly predicts later stroke and dementia, while the presence of white matter hyperintensities is related to a wider variety of outcomes, including stroke, cognitive decline, dementia, and death.
The relationships suggest that each imaging abnormality could be used as a risk marker for the various disorders, Dr. Stephanie Debette said at the International Conference on Alzheimer's Disease.
“The association of large-volume white matter hyperintensities with incident dementia and amnestic MCI [mild cognitive impairment] suggests that it could be a useful quantitative intermediate marker for risk factors of early-stage cognitive impairment and dementia, whereas brain infarcts may be a more appropriate intermediate marker for stroke,” said Dr. Debette of Boston University. “These imaging measures could potentially serve as intermediate end points in prevention trials.”
The study cohort consisted of 2,229 subjects (mean age 62 years) in the Framingham Heart Study Offspring Cohort who underwent brain MRI and neuropsychological testing between 1999 and 2005. Of these, 1,694 returned for a second neuropsychological assessment an average of 6 years later.
At baseline, 2% had evidence of an ischemic stroke and 0.3% had clinical dementia. Excess white matter hyperintensity volume was present in 14%, and 11% showed at least one brain infarct.
After 6 years, 7 subjects had developed dementia; 32 had experienced an ischemic stroke; and 187 had developed new-onset MCI, 94 cases of which were amnestic. During follow-up, 97 of the subjects died.
Two multivariate analyses that controlled for age, sex, and vascular risk factors revealed significant associations between the MRI markers, neurocognitive outcomes, stroke, and death.
Subjects with a large volume of white matter hyperintensities at baseline were significantly more likely than were those without a large volume of lesions to experience stroke and dementia (hazard ratio 2.0), amnestic mild MCI (HR 1.75), and death (HR 1.77). This association was particularly strong with cardiovascular death (HR 3.5).
Subjects with at least one brain infarct at baseline were significantly more likely to develop MCI of the executive function type (HR 2.3). Baseline brain infarcts also significantly predicted stroke (HR 3.0) and dementia (HR 9.0).
'These imaging measures could potentially serve as intermediate end points in prevention trials.'
Source DR. DEBETTE
VIENNA — The presence of brain infarcts at age 60 strongly predicts later stroke and dementia, while the presence of white matter hyperintensities is related to a wider variety of outcomes, including stroke, cognitive decline, dementia, and death.
The relationships suggest that each imaging abnormality could be used as a risk marker for the various disorders, Dr. Stephanie Debette said at the International Conference on Alzheimer's Disease.
“The association of large-volume white matter hyperintensities with incident dementia and amnestic MCI [mild cognitive impairment] suggests that it could be a useful quantitative intermediate marker for risk factors of early-stage cognitive impairment and dementia, whereas brain infarcts may be a more appropriate intermediate marker for stroke,” said Dr. Debette of Boston University. “These imaging measures could potentially serve as intermediate end points in prevention trials.”
The study cohort consisted of 2,229 subjects (mean age 62 years) in the Framingham Heart Study Offspring Cohort who underwent brain MRI and neuropsychological testing between 1999 and 2005. Of these, 1,694 returned for a second neuropsychological assessment an average of 6 years later.
At baseline, 2% had evidence of an ischemic stroke and 0.3% had clinical dementia. Excess white matter hyperintensity volume was present in 14%, and 11% showed at least one brain infarct.
After 6 years, 7 subjects had developed dementia; 32 had experienced an ischemic stroke; and 187 had developed new-onset MCI, 94 cases of which were amnestic. During follow-up, 97 of the subjects died.
Two multivariate analyses that controlled for age, sex, and vascular risk factors revealed significant associations between the MRI markers, neurocognitive outcomes, stroke, and death.
Subjects with a large volume of white matter hyperintensities at baseline were significantly more likely than were those without a large volume of lesions to experience stroke and dementia (hazard ratio 2.0), amnestic mild MCI (HR 1.75), and death (HR 1.77). This association was particularly strong with cardiovascular death (HR 3.5).
Subjects with at least one brain infarct at baseline were significantly more likely to develop MCI of the executive function type (HR 2.3). Baseline brain infarcts also significantly predicted stroke (HR 3.0) and dementia (HR 9.0).
'These imaging measures could potentially serve as intermediate end points in prevention trials.'
Source DR. DEBETTE
VIENNA — The presence of brain infarcts at age 60 strongly predicts later stroke and dementia, while the presence of white matter hyperintensities is related to a wider variety of outcomes, including stroke, cognitive decline, dementia, and death.
The relationships suggest that each imaging abnormality could be used as a risk marker for the various disorders, Dr. Stephanie Debette said at the International Conference on Alzheimer's Disease.
“The association of large-volume white matter hyperintensities with incident dementia and amnestic MCI [mild cognitive impairment] suggests that it could be a useful quantitative intermediate marker for risk factors of early-stage cognitive impairment and dementia, whereas brain infarcts may be a more appropriate intermediate marker for stroke,” said Dr. Debette of Boston University. “These imaging measures could potentially serve as intermediate end points in prevention trials.”
The study cohort consisted of 2,229 subjects (mean age 62 years) in the Framingham Heart Study Offspring Cohort who underwent brain MRI and neuropsychological testing between 1999 and 2005. Of these, 1,694 returned for a second neuropsychological assessment an average of 6 years later.
At baseline, 2% had evidence of an ischemic stroke and 0.3% had clinical dementia. Excess white matter hyperintensity volume was present in 14%, and 11% showed at least one brain infarct.
After 6 years, 7 subjects had developed dementia; 32 had experienced an ischemic stroke; and 187 had developed new-onset MCI, 94 cases of which were amnestic. During follow-up, 97 of the subjects died.
Two multivariate analyses that controlled for age, sex, and vascular risk factors revealed significant associations between the MRI markers, neurocognitive outcomes, stroke, and death.
Subjects with a large volume of white matter hyperintensities at baseline were significantly more likely than were those without a large volume of lesions to experience stroke and dementia (hazard ratio 2.0), amnestic mild MCI (HR 1.75), and death (HR 1.77). This association was particularly strong with cardiovascular death (HR 3.5).
Subjects with at least one brain infarct at baseline were significantly more likely to develop MCI of the executive function type (HR 2.3). Baseline brain infarcts also significantly predicted stroke (HR 3.0) and dementia (HR 9.0).
'These imaging measures could potentially serve as intermediate end points in prevention trials.'
Source DR. DEBETTE