BACKGROUND AND PURPOSE: White matter hyperintensities and MRI-defined brain infarcts (BIs) have individually been related to stroke, dementia, and mortality in population-based studies, mainly in older people. Their significance in middle-aged community-dwelling persons and the relative importance of these associations remain unclear. We simultaneously assessed the relation of white matter hyperintensities and BI with incident stroke, mild cognitive impairment, dementia, and mortality in a middle-aged community-based cohort. METHODS: A total of 2229 Framingham Offspring Study participants aged 62+/-9 years underwent volumetric brain MRI and neuropsychological testing (1999 to 2005). Incident stroke, dementia, and mortality were prospectively ascertained and for 1694 participants in whom a second neuropsychological assessment was performed (2005 to 2007), incident mild cognitive impairment was evaluated. All outcomes were related to white matter hyperintensities volume (WMHV), age-specific extensive WMHV and BI adjusting for age and gender. RESULTS: Extensive WMHV and BI were associated with an increased risk of stroke (hazard ratio [HR]=2.28, 95% CI: 1.02 to 5.13; HR=2.84, 95% CI: 1.32 to 6.10). WMHV, extensive WMHV, and BI were associated with an increased risk of dementia (HR=2.22, 95% CI: 1.32 to 3.72; HR=3.97, 95% CI: 1.10 to 14.30; HR=6.12, 95% CI: 1.82 to 20.54) independently of vascular risk factors and interim stroke. WMHV and extensive WMHV were associated with incident amnestic mild cognitive impairment in participants aged > or = 60 years only (OR=2.47, 95% CI: 1.31 to 4.66 and OR=1.49, 95% CI: 1.14 to 1.97). WMHV and extensive WMHV were associated with an increased risk of death (HR=1.38, 95% CI: 1.13 to 1.69; HR=2.27, 95% CI: 1.41 to 3.65) independent of vascular risk factors and of interim stroke and dementia. CONCLUSIONS: In a large community-based sample of middle-aged adults, BI predicted an increased risk of stroke and dementia independent of vascular risk factors. White matter hyperintensities portended an increased risk of stroke, amnestic mild cognitive impairment, dementia, and death independent of vascular risk factors and interim vascular events.
BACKGROUND AND PURPOSE:White matter hyperintensities and MRI-defined brain infarcts (BIs) have individually been related to stroke, dementia, and mortality in population-based studies, mainly in older people. Their significance in middle-aged community-dwelling persons and the relative importance of these associations remain unclear. We simultaneously assessed the relation of white matter hyperintensities and BI with incident stroke, mild cognitive impairment, dementia, and mortality in a middle-aged community-based cohort. METHODS: A total of 2229 Framingham Offspring Study participants aged 62+/-9 years underwent volumetric brain MRI and neuropsychological testing (1999 to 2005). Incident stroke, dementia, and mortality were prospectively ascertained and for 1694 participants in whom a second neuropsychological assessment was performed (2005 to 2007), incident mild cognitive impairment was evaluated. All outcomes were related to white matter hyperintensities volume (WMHV), age-specific extensive WMHV and BI adjusting for age and gender. RESULTS: Extensive WMHV and BI were associated with an increased risk of stroke (hazard ratio [HR]=2.28, 95% CI: 1.02 to 5.13; HR=2.84, 95% CI: 1.32 to 6.10). WMHV, extensive WMHV, and BI were associated with an increased risk of dementia (HR=2.22, 95% CI: 1.32 to 3.72; HR=3.97, 95% CI: 1.10 to 14.30; HR=6.12, 95% CI: 1.82 to 20.54) independently of vascular risk factors and interim stroke. WMHV and extensive WMHV were associated with incident amnestic mild cognitive impairment in participants aged > or = 60 years only (OR=2.47, 95% CI: 1.31 to 4.66 and OR=1.49, 95% CI: 1.14 to 1.97). WMHV and extensive WMHV were associated with an increased risk of death (HR=1.38, 95% CI: 1.13 to 1.69; HR=2.27, 95% CI: 1.41 to 3.65) independent of vascular risk factors and of interim stroke and dementia. CONCLUSIONS: In a large community-based sample of middle-aged adults, BI predicted an increased risk of stroke and dementia independent of vascular risk factors. White matter hyperintensities portended an increased risk of stroke, amnestic mild cognitive impairment, dementia, and death independent of vascular risk factors and interim vascular events.
Authors: M Yoshita; E Fletcher; D Harvey; M Ortega; O Martinez; D M Mungas; B R Reed; C S DeCarli Journal: Neurology Date: 2006-12-26 Impact factor: 9.910
Authors: Charles DeCarli; Joseph Massaro; Danielle Harvey; John Hald; Mats Tullberg; Rhoda Au; Alexa Beiser; Ralph D'Agostino; Philip A Wolf Journal: Neurobiol Aging Date: 2005-04 Impact factor: 4.673
Authors: Victor E A Gerdes; Vincent I H Kwa; Hugo ten Cate; Dees P M Brandjes; Harry R Büller; Jan Stam Journal: Atherosclerosis Date: 2005-08-11 Impact factor: 5.162
Authors: M Arfan Ikram; Meike W Vernooij; Henri A Vrooman; Albert Hofman; Monique M B Breteler Journal: Neurobiol Aging Date: 2007-09-04 Impact factor: 4.673
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: Hypertension Date: 2003-12-01 Impact factor: 10.190
Authors: Lewis H Kuller; Oscar L Lopez; Anne Newman; Norman J Beauchamp; Greg Burke; Corinne Dulberg; Annette Fitzpatrick; Linda Fried; Mary N Haan Journal: Neuroepidemiology Date: 2003 Jan-Feb Impact factor: 3.282
Authors: Tom Jeerakathil; Philip A Wolf; Alexa Beiser; Joseph Massaro; Sudha Seshadri; Ralph B D'Agostino; Charles DeCarli Journal: Stroke Date: 2004-06-24 Impact factor: 7.914
Authors: Natalie L Marchant; Bruce R Reed; Charles S DeCarli; Cindee M Madison; Michael W Weiner; Helena C Chui; William J Jagust Journal: Neurobiol Aging Date: 2011-11-01 Impact factor: 4.673
Authors: Frederick K Korley; Jason Goldstick; Mitra Mastali; Jennifer E Van Eyk; William Barsan; William J Meurer; Jeremy Sussman; Hayley Falk; Deborah Levine Journal: Stroke Date: 2019-05-29 Impact factor: 7.914
Authors: Ling Zheng; Wendy J Mack; Helena C Chui; Lara Heflin; Dan Mungas; Bruce Reed; Charles DeCarli; Michael W Weiner; Joel H Kramer Journal: J Am Geriatr Soc Date: 2012-01-27 Impact factor: 5.562
Authors: Lisa C Silbert; Hiroko H Dodge; Louie G Perkins; Lena Sherbakov; David Lahna; Deniz Erten-Lyons; Randall Woltjer; Lynne Shinto; Jeffrey A Kaye Journal: Neurology Date: 2012-07-25 Impact factor: 9.910