Characteristics of MR Infarcts Associated with Dementia and Cognitive Function in the Elderly

Overview

Journal Neuroepidemiology

Specialties Neurology
Public Health

Date 2011 Dec 20

PMID 22179433

Citations 8

Authors

Neelum T Aggarwal

Julie A Schneider

Robert S Wilson

Todd L Beck

Denis A Evans

Charles De Carli

Affiliations

Soon will be listed here.

Abstract

Background: Little information exists on the simultaneous effects of magnetic resonance (MR) infarct characteristics, that may increase the likelihood of dementia or lower cognitive function in community populations.

Methods: Participants were 580 community-dwelling individuals from the Chicago Health and Aging Project (CHAP) who underwent detailed clinical evaluation and MR imaging. The association of MR infarct characteristics (region, number, side, and size) with dementia, global cognition and cognition in five separate cognitive domains was examined using logistic and linear regression analyses controlling for age, sex, race, education and time elapsed between clinical evaluation and MRI.

Results: A total of 156 persons had MR infarcts: 108 with 1 infarct and 48 with multiple. Poorer cognitive function and, in particular, slower perceptual speed, were associated with infarcts characterized as cortical, multiple, bilateral or large (all p < 0.05). Multiple infarcts in multiple regions were associated with poor performance in all cognitive domains except visuospatial ability (p < 0.05). Race did not modify any of these associations.

Conclusions: In this community sample, cortical and multiple infarcts in multiple regions were associated with dementia; cortical, multiple, large and bilateral infarcts were associated with lower cognition, particularly lower memory function and perceptual speed. These effects were not modified by race.

Citing Articles

Neuroimaging Findings in Nondemented Frail Individuals: A Systematic Review.

Harandi H, Mohammadi S, Jahanshahi A, Dolatshahi M, Alikarami S, Zafari R J Cachexia Sarcopenia Muscle. 2025; 16(1):e13719.

PMID: 39934085 PMC: 11813630. DOI: 10.1002/jcsm.13719.

Late Midlife Subclinical Infarct Burden and Risk of Dementia: The Atherosclerosis Risk in Communities Neurocognitive Study.

Sullivan K, Griswold M, Ghelani K, Rajesh A, Shrestha S, Gottesman R J Alzheimers Dis. 2022; 91(2):543-549.

PMID: 36463445 PMC: 10168700. DOI: 10.3233/JAD-220746.

The associations of increased cerebral small vessel disease with cognitive impairment in neurosyphilis presenting with ischemic stroke.

Xiang L, Zhang T, Zhang B, Zhang C, Hou S, Yue W Brain Behav. 2021; 11(6):e02187.

PMID: 33998172 PMC: 8213652. DOI: 10.1002/brb3.2187.

Sex-specific association of metabolic risk factors with brain ischemic lesions by severity and location.

Zeng H, Shi W, Jiang W, Rao S, Huang B, Yan H Biol Sex Differ. 2019; 10(1):40.

PMID: 31439027 PMC: 6704651. DOI: 10.1186/s13293-019-0254-6.

Neuroprotective Properties of Linagliptin: Focus on Biochemical Mechanisms in Cerebral Ischemia, Vascular Dysfunction and Certain Neurodegenerative Diseases.

Wicinski M, Gorski K, Walczak M, Wodkiewicz E, Slupski M, Pawlak-Osinska K Int J Mol Sci. 2019; 20(16).

PMID: 31434198 PMC: 6719127. DOI: 10.3390/ijms20164052.

References

Morris J, HEYMAN A, Mohs R, Hughes J, van Belle G, Fillenbaum G . The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology. 1989; 39(9):1159-65. DOI: 10.1212/wnl.39.9.1159. View

Bienias J, Beckett L, Bennett D, Wilson R, Evans D . Design of the Chicago Health and Aging Project (CHAP). J Alzheimers Dis. 2003; 5(5):349-55. DOI: 10.3233/jad-2003-5501. View

Snowdon D, Greiner L, Mortimer J, Riley K, Greiner P, Markesbery W . Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA. 1997; 277(10):813-7. View

Schneider J, Wilson R, Cochran E, Bienias J, Arnold S, Evans D . Relation of cerebral infarctions to dementia and cognitive function in older persons. Neurology. 2003; 60(7):1082-8. DOI: 10.1212/01.wnl.0000055863.87435.b2. View

Lopez O, Jagust W, Dulberg C, Becker J, DeKosky S, Fitzpatrick A . Risk factors for mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 2. Arch Neurol. 2003; 60(10):1394-9. DOI: 10.1001/archneur.60.10.1394. View

Jellinger K, Seppi K, Wenning G, Poewe W . Impact of coexistent Alzheimer pathology on the natural history of Parkinson's disease. J Neural Transm (Vienna). 2002; 109(3):329-39. DOI: 10.1007/s007020200027. View

Pohjasvaara T, Erkinjuntti T, Ylikoski R, Hietanen M, Vataja R, Kaste M . Clinical determinants of poststroke dementia. Stroke. 1998; 29(1):75-81. DOI: 10.1161/01.str.29.1.75. View

Tatemichi T, Desmond D, Prohovnik I . Strategic infarcts in vascular dementia. A clinical and brain imaging experience. Arzneimittelforschung. 1995; 45(3A):371-85. View

DeCarli C, Massaro J, Harvey D, Hald J, Tullberg M, Au R . Measures of brain morphology and infarction in the framingham heart study: establishing what is normal. Neurobiol Aging. 2005; 26(4):491-510. DOI: 10.1016/j.neurobiolaging.2004.05.004. View

10.

Knopman D, Parisi J, Boeve B, Cha R, Apaydin H, Salviati A . Vascular dementia in a population-based autopsy study. Arch Neurol. 2003; 60(4):569-75. DOI: 10.1001/archneur.60.4.569. View

11.

Roman G, Tatemichi T, Erkinjuntti T, Cummings J, Masdeu J, Garcia J . Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993; 43(2):250-60. DOI: 10.1212/wnl.43.2.250. View

12.

Foulkes M, Wolf P, Price T, Mohr J, Hier D . The Stroke Data Bank: design, methods, and baseline characteristics. Stroke. 1988; 19(5):547-54. DOI: 10.1161/01.str.19.5.547. View

13.

Price T, Manolio T, Kronmal R, Kittner S, Yue N, Robbins J . Silent brain infarction on magnetic resonance imaging and neurological abnormalities in community-dwelling older adults. The Cardiovascular Health Study. CHS Collaborative Research Group. Stroke. 1997; 28(6):1158-64. DOI: 10.1161/01.str.28.6.1158. View

14.

Pohjasvaara T, Mantyla R, Salonen O, Aronen H, Ylikoski R, Hietanen M . MRI correlates of dementia after first clinical ischemic stroke. J Neurol Sci. 2000; 181(1-2):111-7. DOI: 10.1016/s0022-510x(00)00437-8. View

15.

Jellinger K, Mitter-Ferstl E . The impact of cerebrovascular lesions in Alzheimer disease--a comparative autopsy study. J Neurol. 2003; 250(9):1050-5. DOI: 10.1007/s00415-003-0142-0. View

16.

Tomlinson B, Blessed G, Roth M . Observations on the brains of demented old people. J Neurol Sci. 1970; 11(3):205-42. DOI: 10.1016/0022-510x(70)90063-8. View

17.

White H, Boden-Albala B, Wang C, Elkind M, Rundek T, Wright C . Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study. Circulation. 2005; 111(10):1327-31. DOI: 10.1161/01.CIR.0000157736.19739.D0. View

18.

Evans D, Bennett D, Wilson R, Bienias J, Morris M, Scherr P . Incidence of Alzheimer disease in a biracial urban community: relation to apolipoprotein E allele status. Arch Neurol. 2003; 60(2):185-9. DOI: 10.1001/archneur.60.2.185. View

19.

Mungas D, Jagust W, Reed B, Kramer J, Weiner M, Schuff N . MRI predictors of cognition in subcortical ischemic vascular disease and Alzheimer's disease. Neurology. 2002; 57(12):2229-35. PMC: 1862483. DOI: 10.1212/wnl.57.12.2229. View

20.

Bryan R, Cai J, Burke G, Hutchinson R, Liao D, Toole J . Prevalence and anatomic characteristics of infarct-like lesions on MR images of middle-aged adults: the atherosclerosis risk in communities study. AJNR Am J Neuroradiol. 1999; 20(7):1273-80. PMC: 7055978. View