Abstract
Background and Purpose - Magnetic resonance imaging (MRI) scans in the elderly commonly show white matter findings that may raise concerns. We sought to document incidence, manifestations, and predictors of worsening white matter grade on serial imaging. Methods - The Cardiovascular Health Study is a population-based, longitudinal study of 5888 people aged 65 years and older, of whom 1919 have had extensive initial and follow-up evaluations, including 2 MRI scans separated by 5 years. Scans were read without clinical information in standard side-by-side fashion to determine worsening white matter grade. Results - Worsening was evident in 538 participants (28%), mostly (85%) by 1 grade. Although similar at initial scan, participants with worsening white matter grade, compared with those without, experienced greater decline on modified Mini-Mental State examination and Digit-Symbol Substitution test (both P≤0.001) after controlling for potential confounding factors, including occurrence of transient ischemic attack or stroke between scans. Independent predictors of worsening white matter grade included cigarette smoking before initial scan and infarct on initial scan. Otherwise, predictors differed according to white matter grade on initial scan. For low initial grade, increased age, increased diastolic blood pressure, increased high-density lipoprotein cholesterol, and decreased low-density lipoprotein cholesterol were associated with increased risk of worsening. For high initial grade, any cardiovascular disease and low ankle-arm index were associated with decreased risk of worsening, whereas use of diuretics and statins were associated with increased risk. Conclusion - Worsening white matter grade on serial MRI scans in elderly is common, is associated with cognitive decline, and has complex relations with cardiovascular risk factors.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 56-61 |
| Number of pages | 6 |
| Journal | Stroke |
| Volume | 36 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2005 |
Fingerprint
Keywords
- Incidence
- Leukoaraiosis
- Magnetic resonance imaging
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Neuroscience(all)
Cite this
Incidence, manifestations, and predictors of worsening white matter on serial cranial magnetic resonance imaging in the elderly : The cardiovascular health study. / Longstreth, W. T.; Arnold, Alice M.; Beauchamp, Norman J.; Manolio, Teri A.; Lefkowitz, David; Jungreis, Charles; Hirsch, Calvin H; O'Leary, Daniel H.; Furberg, Curt D.
In: Stroke, Vol. 36, No. 1, 01.2005, p. 56-61.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Incidence, manifestations, and predictors of worsening white matter on serial cranial magnetic resonance imaging in the elderly
T2 - The cardiovascular health study
AU - Longstreth, W. T.
AU - Arnold, Alice M.
AU - Beauchamp, Norman J.
AU - Manolio, Teri A.
AU - Lefkowitz, David
AU - Jungreis, Charles
AU - Hirsch, Calvin H
AU - O'Leary, Daniel H.
AU - Furberg, Curt D.
PY - 2005/1
Y1 - 2005/1
N2 - Background and Purpose - Magnetic resonance imaging (MRI) scans in the elderly commonly show white matter findings that may raise concerns. We sought to document incidence, manifestations, and predictors of worsening white matter grade on serial imaging. Methods - The Cardiovascular Health Study is a population-based, longitudinal study of 5888 people aged 65 years and older, of whom 1919 have had extensive initial and follow-up evaluations, including 2 MRI scans separated by 5 years. Scans were read without clinical information in standard side-by-side fashion to determine worsening white matter grade. Results - Worsening was evident in 538 participants (28%), mostly (85%) by 1 grade. Although similar at initial scan, participants with worsening white matter grade, compared with those without, experienced greater decline on modified Mini-Mental State examination and Digit-Symbol Substitution test (both P≤0.001) after controlling for potential confounding factors, including occurrence of transient ischemic attack or stroke between scans. Independent predictors of worsening white matter grade included cigarette smoking before initial scan and infarct on initial scan. Otherwise, predictors differed according to white matter grade on initial scan. For low initial grade, increased age, increased diastolic blood pressure, increased high-density lipoprotein cholesterol, and decreased low-density lipoprotein cholesterol were associated with increased risk of worsening. For high initial grade, any cardiovascular disease and low ankle-arm index were associated with decreased risk of worsening, whereas use of diuretics and statins were associated with increased risk. Conclusion - Worsening white matter grade on serial MRI scans in elderly is common, is associated with cognitive decline, and has complex relations with cardiovascular risk factors.
AB - Background and Purpose - Magnetic resonance imaging (MRI) scans in the elderly commonly show white matter findings that may raise concerns. We sought to document incidence, manifestations, and predictors of worsening white matter grade on serial imaging. Methods - The Cardiovascular Health Study is a population-based, longitudinal study of 5888 people aged 65 years and older, of whom 1919 have had extensive initial and follow-up evaluations, including 2 MRI scans separated by 5 years. Scans were read without clinical information in standard side-by-side fashion to determine worsening white matter grade. Results - Worsening was evident in 538 participants (28%), mostly (85%) by 1 grade. Although similar at initial scan, participants with worsening white matter grade, compared with those without, experienced greater decline on modified Mini-Mental State examination and Digit-Symbol Substitution test (both P≤0.001) after controlling for potential confounding factors, including occurrence of transient ischemic attack or stroke between scans. Independent predictors of worsening white matter grade included cigarette smoking before initial scan and infarct on initial scan. Otherwise, predictors differed according to white matter grade on initial scan. For low initial grade, increased age, increased diastolic blood pressure, increased high-density lipoprotein cholesterol, and decreased low-density lipoprotein cholesterol were associated with increased risk of worsening. For high initial grade, any cardiovascular disease and low ankle-arm index were associated with decreased risk of worsening, whereas use of diuretics and statins were associated with increased risk. Conclusion - Worsening white matter grade on serial MRI scans in elderly is common, is associated with cognitive decline, and has complex relations with cardiovascular risk factors.
KW - Incidence
KW - Leukoaraiosis
KW - Magnetic resonance imaging
UR - http://www.scopus.com/inward/record.url?scp=11144223888&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=11144223888&partnerID=8YFLogxK
U2 - 10.1161/01.STR.0000149625.99732.69
DO - 10.1161/01.STR.0000149625.99732.69
M3 - Article
VL - 36
SP - 56
EP - 61
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 1
ER -