Stroke risk profile, brain volume, and cognitive function

Background: Mid-life stroke risk factors have been related to late-life cognitive impairment. This association may result not only from clinical strokes but also from subclinical brain injury, such as a global atrophy demonstrable on quantitative brain MRI. Methods: The authors evaluated the community-based cohort of Framingham Offspring Study participants. A total of 1,841 subjects (mean age, 62 years; 857 men, 984 women) who underwent quantitative MRI and cognitive testing between 1999 and 2001 and were free of clinical stroke and dementia constituted our study sample. The authors used age- and sex-adjusted linear regression models to relate previous (1991 to 1995) and recent (1998 to 2001) Framingham Stroke Risk Profile (FSRP) scores to the total cerebral brain volume ratio (TCBVr) on follow-up MRI, and further to relate the TCBVr with education-adjusted scores on neuropsychological tests administered at the time of imaging. Results: There was an inverse association between FSRP scores and TCBVr. The TCBVr also showed a significant positive association with performance on tests of attention (Trails A), executive function (Trails B), and visuospatial function (visual reproduction, Hooper visual organization), but not with performance on tests of verbal memory or naming. Conclusions: The Framingham Stroke Risk Profile may identify subjects with smaller brains and poorer cognitive function among stroke- and dementia-free subjects, reinforcing the importance of managing stroke risk factors.

[1]  L. Honig,et al.  Dementia with cerebrovascular disease. , 2006, Science of aging knowledge environment : SAGE KE.

[2]  L. Nyberg,et al.  Cerebral atrophy as predictor of cognitive function in old, community‐dwelling individuals , 2003, Acta neurologica Scandinavica.

[3]  Tom den Heijer,et al.  Association between blood pressure levels over time and brain atrophy in the elderly , 2003, Neurobiology of Aging.

[4]  C. Maffeis,et al.  Long-Term Effects of Childhood Obesity on Morbidity and Mortality , 2001, Hormone Research in Paediatrics.

[5]  R. Paul,et al.  Performance on the Hooper Visual Organizational Test in patients diagnosed with subcortical vascular dementia: relation to naming performance. , 2001, Neuropsychiatry, neuropsychology, and behavioral neurology.

[6]  A. Folsom,et al.  Cardiovascular risk factors and cognitive decline in middle-aged adults , 2001, Neurology.

[7]  M. Bayes,et al.  The Probability of , 2001 .

[8]  Y. Zhi.  Apolipoprotein E Alleles, Dyslipidemia,and Coronary Heart Disease , 2001 .

[9]  M W Weiner,et al.  Hippocampal and cortical atrophy predict dementia in subcortical ischemic vascular disease , 2000, Neurology.

[10]  I. McKeith,et al.  Cognitive Performance in Hypertensive and Normotensive Older Subjects , 2000, Hypertension.

[11]  E. Rostrup,et al.  Relation between age-related decline in intelligence and cerebral white-matter hyperintensities in healthy octogenarians: a longitudinal study , 2000, The Lancet.

[12]  Klaus P. Ebmeier,et al.  Memory impairment in out-of-hospital cardiac arrest survivors is associated with global reduction in brain volume, not focal hippocampal injury. , 2000, Stroke.

[13]  C. DeCarli,et al.  Biobehavioral characteristics of nondemented older adults with subclinical brain atrophy , 2000, Neurology.

[14]  Nick Bryan,et al.  Clinical Correlates of Ventricular and Sulcal Size on Cranial Magnetic Resonance Imaging of 3,301 Elderly People , 1999, Neuroepidemiology.

[15]  C. Dufouil,et al.  Cognitive decline in individuals with high blood pressure , 1999, Neurology.

[16]  P. Sachdev,et al.  Differentiation of vascular dementia from AD on neuropsychological tests , 1999, Neurology.

[17]  C. DeCarli,et al.  Impact of Apolipoprotein E ε4 and Vascular Disease on Brain Morphology in Men From the NHLBI Twin Study , 1999 .

[18]  C. DeCarli,et al.  Predictors of brain morphology for the men of the NHLBI twin study. , 1999, Stroke.

[19]  C. DeCarli,et al.  Impact of apolipoprotein E epsilon4 and vascular disease on brain morphology in men from the NHLBI twin study. , 1999, Stroke.

[20]  D. Carmelli,et al.  Systolic blood pressure tracking over 25 to 30 years and cognitive performance in older adults. , 1998, Stroke.

[21]  J. Tuomilehto,et al.  Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial , 1998, The Lancet.

[22]  C. DeCarli,et al.  Association of midlife blood pressure to late-life cognitive decline and brain morphology , 1998, Neurology.

[23]  L. Hansson,et al.  Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. , 1998, Hypertension.

[24]  J. Cerhan,et al.  Correlates of Cognitive Function in Middle-Aged Adults , 1998, Gerontology.

[25]  C. Brayne,et al.  Five‐year incidence and prediction of dementia and cognitive decline in a population sample of women aged 70–79 at baseline , 1997, International journal of geriatric psychiatry.

[26]  R. D'Agostino,et al.  NIDDM and Blood Pressure as Risk Factors for Poor Cognitive Performance: The Framingham Study , 1997, Diabetes Care.

[27]  G. Alexander,et al.  Interactive effects of age and hypertension on volumes of brain structures. , 1997, Stroke.

[28]  G. Bernardi,et al.  Effect of Smoking on Cerebrovascular Reactivity , 1996, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[29]  B. Lernfelt,et al.  15-year longitudinal study of blood pressure and dementia , 1996, The Lancet.

[30]  O Almkvist,et al.  MRI in successful aging, a 5-year follow-up study from the eighth to ninth decade of life. , 1996, Magnetic resonance imaging.

[31]  R. Havlik,et al.  The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study. , 1995, JAMA.

[32]  J. Haxby,et al.  The effect of white matter hyperintensity volume on brain structure, cognitive performance, and cerebral metabolism of glucose in 51 healthy adults , 1995, Neurology.

[33]  F. Fazekas,et al.  Magnetic resonance imaging cerebral abnormalities and neuropsychologic test performance in elderly hypertensive subjects. A case-control study. , 1995, Archives of neurology.

[34]  Barry Horwitz,et al.  Discriminant analysis of MRI measures as a method to determine the presence of dementia of the Alzheimer type , 1995, Psychiatry Research.

[35]  P A Wolf,et al.  Apolipoprotein E alleles, dyslipidemia, and coronary heart disease. The Framingham Offspring Study. , 1994, JAMA.

[36]  Teri,et al.  A method for using MR to evaluate the effects of cardiovascular disease on the brain: the cardiovascular health study. , 1994, AJNR. American journal of neuroradiology.

[37]  Albert Hofman,et al.  Cognitive Correlates of Ventricular Enlargement and Cerebral White Matter Lesions on Magnetic Resonance Imaging: The Rotterdam Study , 1994, Stroke.

[38]  T. Truelsen,et al.  Comparison of Probability of Stroke Between the Copenhagen City Heart Study and the Framingham Study , 1994, Stroke.

[39]  C. Grady,et al.  Reduction of Functional Neuronal Connectivity in Long‐term Treated Hypertension , 1994, Stroke.

[40]  E P Steinberg,et al.  Magnetic resonance abnormalities and cardiovascular disease in older adults. The Cardiovascular Health Study. , 1994, Stroke.

[41]  R B D'Agostino,et al.  Stroke risk profile: adjustment for antihypertensive medication. The Framingham Study. , 1994, Stroke.

[42]  R. D'Agostino,et al.  Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study. , 1993, American journal of epidemiology.

[43]  L. Wei,et al.  Smaller local brain volumes and cerebral atrophy in spontaneously hypertensive rats. , 1993, Hypertension.

[44]  K Pettigrew,et al.  Cerebral glucose utilization and blood flow in adult spontaneously hypertensive rats. , 1992, Hypertension.

[45]  J. Haxby,et al.  Brain atrophy in hypertension. A volumetric magnetic resonance imaging study. , 1992, Hypertension.

[46]  R. Mayeux,et al.  Dementia after stroke , 1992, Neurology.

[47]  B. Horwitz,et al.  Method for quantification of brain, ventricular, and subarachnoid CSF volumes from MR images. , 1992, Journal of computer assisted tomography.

[48]  R B D'Agostino,et al.  Probability of stroke: a risk profile from the Framingham Study. , 1991, Stroke.

[49]  N. R. Schultz,et al.  Is blood pressure an important variable in research on aging and neuropsychological test performance? , 1990, Journal of gerontology.

[50]  D B Hier,et al.  Dementia in stroke survivors in the Stroke Data Bank cohort. Prevalence, incidence, risk factors, and computed tomographic findings. , 1990, Stroke.

[51]  G Neil-Dwyer,et al.  Acute effects of smoking on blood pressure and cerebral blood flow. , 1989, Journal of human hypertension.

[52]  E. Kaplan,et al.  Neuropsychological test performance in Framingham: a descriptive study. , 1987, Psychological reports.

[53]  G. McCloskey.  Wide Range Achievement Test-Revised , 1987 .

[54]  J A Corsellis,et al.  VARIATION WITH AGE IN THE VOLUMES OF GREY AND WHITE MATTER IN THE CEREBRAL HEMISPHERES OF MAN: MEASUREMENTS WITH AN IMAGE ANALYSER , 1980, Neuropathology and applied neurobiology.

[55]  C. Eisdorfer,et al.  Memory and blood pressure in the aged. , 1976, Experimental aging research.

[56]  W. Kannel,et al.  The Framingham Offspring Study. Design and preliminary data. , 1975, Preventive medicine.

[57]  R. Reitan.  Validity of the Trail Making Test as an Indicator of Organic Brain Damage , 1958 .

[58]  D. Wechsler.  Manual for the Wechsler Adult Intelligence Scale. , 1955 .

[59]  D. Wechsler.  A Standardized Memory Scale for Clinical Use , 1945 .