Mixed brain lesions mediate the association between cardiovascular risk burden and cognitive decline in old age: A population-based study

作者：Wang Rui^*; Fratiglioni Laura; Kalpouzos Gregoria; Lovden Martin; Laukka Erika J; Bronge Lena; Wahlund Lars Olof; Backman Lars; Qiu Chengxuan^*

来源：Alzheimer's and Dementia, 2017, 13(3): 247-256.

DOI：10.1016/j.jalz.2016.06.2363

• Framingham general cardiovascular risk score
• Magnetic resonance imaging
• Cerebral small-vessel disease
• Cognitive decline
• Aging
• Population study

Introduction: The underlying pathological mechanisms linking cardiovascular burden to cognitive decline remain unclear.
Methods: We investigated the associations of the Framingham general cardiovascular risk score (FGCRS), apolipoprotein E (APOE) 64, and brain structure with the Mini-Mental State Examination (MMSE) decline using the 9-year follow-up data from Swedish National Study on Aging and Care in Kungsholmen (n = 2189, age >= 60) and the embedded magnetic resonance imaging (MRI) (n = 448) studies. Volumes of white matter hyperintensities (WMHs), total gray matter, ventricles, and hippo campus were assessed in the MRI sample.
Results: A higher FGCRS was associated with faster MMSE decline in young-old people (60-72 years) but not in old-old (>= 78 years). Larger volumes of cerebral WMHs and ventricles and smaller volumes of total gray matter and hippocampus were all associated with accelerated MMSE decline (P <.01); these associations were stronger among APOE epsilon 4 carriers than noncarriers. Simultaneously entering multiple brain lesion markers as mediators in the model substantially attenuated the association between FGCRS and MMSE decline.
Discussion: The effect of cardiovascular risk burden on cognitive deterioration in old age is largely mediated by mixed brain lesions.

• 出版日期2017-3