Megumi Tsubota-Utsugi1, Michihiro Satoh2, Naoki Tomita3, Azusa Hara4, Takeo Kondo5, Miki Hosaka6, Sho Saito7, Kei Asayama8, Ryusuke Inoue9, Mikio Hirano10, Aya Hosokawa11, Keiko Murakami8, Takahisa Murakami2, Hirohito Metoki2, Masahiro Kikuya12, Shin-Ichi Izumi5, Yutaka Imai6, Takayoshi Ohkubo8. 1. Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine, Iwate, Japan. Electronic address: mutsugky@iwate-med.ac.jp. 2. Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan. 3. Institute of Development, Aging and Cancer, Department of Geriatrics and Gerontology, Tohoku University, Sendai, Japan. 4. Department of Social Pharmacy and Public Health, Showa Pharmaceutical University, Tokyo, Japan. 5. Physical Medicine and Rehabilitation, Tohoku University Hospital, Sendai, Japan. 6. Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan. 7. Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan. 8. Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. 9. Department of Medical Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan. 10. Department of Community Medical Support, Tohoku University, Sendai, Japan. 11. Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan. 12. Tohoku Medical Megabank organization, Tohoku University, Sendai, Japan.
Abstract
OBJECTIVE: We aimed to determine the associations between silent cerebrovascular lesions, characterized by lacunar infarcts and white matter hyperintensity, and future decline in higher level functional capacity in older community-dwelling adults. MATERIALS AND METHODS: For this observational study, we selected individuals from the general population of Ohasama, a rural Japanese community. Three hundred thirty-one participants who were free of functional decline at baseline and who were at least 60 years old underwent brain magnetic resonance imaging and answered a questionnaire on higher level functional capacity derived from the Tokyo Metropolitan Institute of Gerontology Index of Competence. Weassessed the relationship between silent cerebrovascular lesions with a decline in higher level functional capacity at 7 years using multiple logistic regression analysis adjusted for possible confounding factors. RESULTS: During the follow-up, 22.1% reported declines in higher level functional capacity. After adjustment for putative confounding factors, the presence of silent cerebrovascular lesions (odds ratio [95% confidence interval], 2.10 [1.05-4.21]) and both lacunar infarcts (2.04 [1.05-3.95]) and white matter hyperintensity (2.02 [1.02-3.95]) was significantly associated with the risk of functional decline at 7-year follow-up. In subscale analysis, specifically lacunar infarcts were strongly associated with the future risk of decline in intellectual activity (3.16 [1.27-7.84]). CONCLUSION: Silent cerebrovascular lesions are associated with future risk of decline in higher level functional capacity. Appropriate management of health risk factors to prevent silent cerebrovascular lesions may prevent higher level functional decline in the elderly population.
OBJECTIVE: We aimed to determine the associations between silent cerebrovascular lesions, characterized by lacunar infarcts and white matter hyperintensity, and future decline in higher level functional capacity in older community-dwelling adults. MATERIALS AND METHODS: For this observational study, we selected individuals from the general population of Ohasama, a rural Japanese community. Three hundred thirty-one participants who were free of functional decline at baseline and who were at least 60 years old underwent brain magnetic resonance imaging and answered a questionnaire on higher level functional capacity derived from the Tokyo Metropolitan Institute of Gerontology Index of Competence. Weassessed the relationship between silent cerebrovascular lesions with a decline in higher level functional capacity at 7 years using multiple logistic regression analysis adjusted for possible confounding factors. RESULTS: During the follow-up, 22.1% reported declines in higher level functional capacity. After adjustment for putative confounding factors, the presence of silent cerebrovascular lesions (odds ratio [95% confidence interval], 2.10 [1.05-4.21]) and both lacunar infarcts (2.04 [1.05-3.95]) and white matter hyperintensity (2.02 [1.02-3.95]) was significantly associated with the risk of functional decline at 7-year follow-up. In subscale analysis, specifically lacunar infarcts were strongly associated with the future risk of decline in intellectual activity (3.16 [1.27-7.84]). CONCLUSION: Silent cerebrovascular lesions are associated with future risk of decline in higher level functional capacity. Appropriate management of health risk factors to prevent silent cerebrovascular lesions may prevent higher level functional decline in the elderly population.