 |
 |

Cerebrovascular and Brain Morphologic Correlates of Mild Cognitive Impairment in the National Heart, Lung, and Blood Institute Twin Study
Charles DeCarli, MD;
Bruce L. Miller, MD;
Gary E. Swan, PhD;
Terry Reed, PhD;
Philip A. Wolf, MD;
Dorit Carmelli, PhD
Arch Neurol. 2001;58:643-647.
Objective To evaluate the relative risk (RR) of mild cognitive impairment (MCI)
associated with cerebrovascular risk factors and cerebrovascular-related brain
changes.
Design Mild cognitive impairment was determined for the subjects of the prospective
National Heart, Lung, and Blood Institute Twin Study. Quantitative measures
of brain, white matter hyperintensity, cerebral infarction, apolipoprotein
E genotype, and psychometric testing were obtained.
Results Subjects with MCI were older (73.5 ± 3.0 vs 72.1 ± 2.8
years), consumed less alcohol (3.7 ± 5.8 vs 7.0 ± 10.7 drinks
per week), had greater white matter hyperintensity volumes (0.56% ±
0.82% vs 0.25% ± 0.34% of cranial volume), and had an increased prevalance
of apolipoprotein E4 genotype (31.4% vs 19.2%) than normal subjects. White
matter hyperintensity and the presence of the apolipoprotein E4 genotype were
associated with a significantly increased risk for MCI. When all subjects
were included in the analysis, alcohol consumption was associated with a reduced
risk for MCI (RR = 0.93, P<.05). When subjects
with a history of symptomatic cerebrovascular disease were excluded from the
analysis, elevated midlife diastolic blood pressure was associated with an
increased risk for MCI (RR = 1.70, P<.05).
Conclusions Elevated midlife blood pressures, and the resulting increased white
matter hyperintensities, increase the risk for MCI in a group of community-dwelling
older men to at least the same degree as apolipoprotein E4 genotype. Given
the common occurrence of elevations in midlife blood pressure, early and effective
treatment may be warranted to prevent late-life brain abnormalities and MCI.
Moreover, since many individuals with MCI progress to clinical dementia, longitudinal
evaluations of this cohort will be important.
From the Department of Neurology, University of Kansas, Kansas City
(Dr DeCarli); Department of Neurology, University of California at San Francisco
(Dr Miller); Health Sciences Division, SRI International, Menlo Park, Calif
(Drs Swan and Carmelli); Department of Medical and Molecular Genetics, Indiana
University, Indianapolis (Dr Reed); and Department of Neurology, Boston University,
Boston, Mass (Dr Wolf). Dr DeCarli is now with the Department of Neurology,
University of California at Davis.
Corresponding author and reprints: Charles DeCarli, MD, Department
of Neurology, University of California at Davis, 4860 Y St, Suite 3700, Sacramento,
CA 95817 (e-mail: cdecarli{at}ucdavis.edu).
RELATED ARTICLE
Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 2001;58(4):684-685.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
 |
Spatial Distribution of White-Matter Hyperintensities in Alzheimer Disease, Cerebral Amyloid Angiopathy, and Healthy Aging
Holland et al.
Stroke 2008;39:1127-1133.
ABSTRACT
| FULL TEXT
Magnetic Resonance Imaging White Matter Hyperintensities and Brain Volume in the Prediction of Mild Cognitive Impairment and Dementia
Smith et al.
Arch Neurol 2008;65:94-100.
ABSTRACT
| FULL TEXT
Prevalence of Subcortical Vascular Lesions and Association With Executive Function in Mild Cognitive Impairment Subtypes
Bombois et al.
Stroke 2007;38:2595-2597.
ABSTRACT
| FULL TEXT
Endothelial Function and White Matter Hyperintensities in Older Adults With Cardiovascular Disease
Hoth et al.
Stroke 2007;38:308-312.
ABSTRACT
| FULL TEXT
Heterogeneity in Risk Factors for Cognitive Impairment, No Dementia: Population-Based Longitudinal Study From the Kungsholmen Project
Monastero et al.
AJGP 2007;15:60-69.
ABSTRACT
| FULL TEXT
Extent and distribution of white matter hyperintensities in normal aging, MCI, and AD
Yoshita et al.
Neurology 2006;67:2192-2198.
ABSTRACT
| FULL TEXT
Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease
Portet et al.
J. Neurol. Neurosurg. Psychiatry 2006;77:714-718.
ABSTRACT
| FULL TEXT
Clinical trials in mild cognitive impairment: lessons for the future
Jelic et al.
J. Neurol. Neurosurg. Psychiatry 2006;77:429-438.
ABSTRACT
| FULL TEXT
Association of White Matter Hyperintensity Volume With Decreased Cognitive Functioning: The Framingham Heart Study
Au et al.
Arch Neurol 2006;63:246-250.
ABSTRACT
| FULL TEXT
Decline in intelligence is associated with progression in white matter hyperintensity volume
Garde et al.
J. Neurol. Neurosurg. Psychiatry 2005;76:1289-1291.
ABSTRACT
| FULL TEXT
Anatomical Mapping of White Matter Hyperintensities (WMH): Exploring the Relationships Between Periventricular WMH, Deep WMH, and Total WMH Burden
DeCarli et al.
Stroke 2005;36:50-55.
ABSTRACT
| FULL TEXT
MCI conversion to dementia and the APOE genotype: A prediction study with FDG-PET
Mosconi et al.
Neurology 2004;63:2332-2340.
ABSTRACT
| FULL TEXT
Vascular risk factors, incidence of MCI, and rates of progression to dementia
Solfrizzi et al.
Neurology 2004;63:1882-1891.
ABSTRACT
| FULL TEXT
Memory impairment, but not cerebrovascular disease, predicts progression of MCI to dementia
DeCarli et al.
Neurology 2004;63:220-227.
ABSTRACT
| FULL TEXT
Medial temporal lobe atrophy on MRI predicts dementia in patients with mild cognitive impairment
Korf et al.
Neurology 2004;63:94-100.
ABSTRACT
| FULL TEXT
Cerebrospinal Fluid Tau Protein and Periventricular White Matter Lesions in Patients With Mild Cognitive Impairment: Implications for 2 Major Pathways
Maruyama et al.
Arch Neurol 2004;61:716-720.
ABSTRACT
| FULL TEXT
Framingham Stroke Risk Profile and Lowered Cognitive Performance
Elias et al.
Stroke 2004;35:404-409.
ABSTRACT
| FULL TEXT
Neuroimaging tools to rate regional atrophy, subcortical cerebrovascular disease, and regional cerebral blood flow and metabolism: consensus paper of the EADC
Frisoni et al.
J. Neurol. Neurosurg. Psychiatry 2003;74:1371-1381.
ABSTRACT
| FULL TEXT
Blood Pressure and Cognitive Impairment in India and the United States: A Cross-National Epidemiological Study
Pandav et al.
Arch Neurol 2003;60:1123-1128.
ABSTRACT
| FULL TEXT
Cigarette Smoking and Alcohol Consumption in Relation to Cognitive Performance in Middle Age
Kalmijn et al.
Am J Epidemiol 2002;156:936-944.
ABSTRACT
| FULL TEXT
Imaging Interactions between Alzheimer's Disease and Cerebrovascular Disease
WU et al.
Ann. N. Y. Acad. Sci. 2002;977:403-410.
ABSTRACT
| FULL TEXT
Cognitive decline in AD and mild cognitive impairment is associated with global brain damage
van der Flier et al.
Neurology 2002;59:874-879.
ABSTRACT
| FULL TEXT
Alzheimer Disease as a Vascular Disorder: Nosological Evidence
de la Torre
Stroke 2002;33:1152-1162.
ABSTRACT
| FULL TEXT
|