Background: Blood pressure level is associated with the risk of clinical Alzheimer disease (AD), yet the underlying mechanisms are unclear. High blood pressure levels may cause cerebral small- vessel pathology, which ...Background: Blood pressure level is associated with the risk of clinical Alzheimer disease (AD), yet the underlying mechanisms are unclear. High blood pressure levels may cause cerebral small- vessel pathology, which contributes to cognitive decline in patients with AD. Alternatively, in persons with high blood pressure, increased numbers of neurofibrillary tangles and amyloid plaques at autopsy have also been observed, suggesting direct links between blood pressure and AD. Abstract:Objective: To investigate the association of blood pressure and markers of small- vessel disease (white matter lesions [WMLs] on MRI)- with hippocampal and amygdalar atrophy on MRI - potential in vivo indicators of Alzheimer pathology. Methods: In 1995 to 1996, 511 nondemented elderly subjects (age 60 to 90) underwent MRI. The extent of WMLs was assessed, and volumes of the hippocampus and amygdala were measured. Blood pressure levels were assessed at the time of MRI and 5 years before the MRI. Results: Higher diastolic blood pressure 5 years before MRI predicted more hippocampal atrophy in persons untreated for hypertension (per SD increase - 0.10 mL [95% CI - 0.19 to - 0.02, p = 0.02]). Conversely, in persons treated for hypertension, a low diastolic blood pressure was associated with more severe atrophy. Persons with more WMLs on MRI more often had severe atrophy of the hippocampus and amygdala. Conclusion: Blood pressure and indicators of small- vessel disease in the brain may be associated with atrophy of展开更多
Objective: To smtudy the association between white matter lesions (WML) in spe cific locations and the risk of dementia. Design: The Rotterdam Scan Study, a pr ospective population based cohort study. We scored perive...Objective: To smtudy the association between white matter lesions (WML) in spe cific locations and the risk of dementia. Design: The Rotterdam Scan Study, a pr ospective population based cohort study. We scored periventricular and subcortic al WML on magnetic resonance imaging and observed participants until January 200 2 for incident dementia. Setting: General population. Participants: We included 1077 people aged 60 to 90 years who did not have dementia at baseline. Main Outc ome Measure: Incident dementia by Diagnostic and Statistical Manual of Mental Di sorders, Third Edition (DSM III R) criteria. Results: During a mean follow up of 5.2 years, 45 participants developed dementia. Higher severity of periventric ular WML increased the risk of dementia, whereas the association between subcort ical WML and dementia was less prominent. The adjusted hazard ratio of dementia for each standard deviation increase in periventricular WML severity was 1.67 (9 5%confidence interval, 1.25-2.24). This increased risk was independent of othe r risk factors for dementia and partly independent of other structural brain cha nges on magnetic resonance imaging. Conclusion: White matter lesions, especially in the periventricular region, increase the risk of dementia in elderly people.展开更多
文摘Background: Blood pressure level is associated with the risk of clinical Alzheimer disease (AD), yet the underlying mechanisms are unclear. High blood pressure levels may cause cerebral small- vessel pathology, which contributes to cognitive decline in patients with AD. Alternatively, in persons with high blood pressure, increased numbers of neurofibrillary tangles and amyloid plaques at autopsy have also been observed, suggesting direct links between blood pressure and AD. Abstract:Objective: To investigate the association of blood pressure and markers of small- vessel disease (white matter lesions [WMLs] on MRI)- with hippocampal and amygdalar atrophy on MRI - potential in vivo indicators of Alzheimer pathology. Methods: In 1995 to 1996, 511 nondemented elderly subjects (age 60 to 90) underwent MRI. The extent of WMLs was assessed, and volumes of the hippocampus and amygdala were measured. Blood pressure levels were assessed at the time of MRI and 5 years before the MRI. Results: Higher diastolic blood pressure 5 years before MRI predicted more hippocampal atrophy in persons untreated for hypertension (per SD increase - 0.10 mL [95% CI - 0.19 to - 0.02, p = 0.02]). Conversely, in persons treated for hypertension, a low diastolic blood pressure was associated with more severe atrophy. Persons with more WMLs on MRI more often had severe atrophy of the hippocampus and amygdala. Conclusion: Blood pressure and indicators of small- vessel disease in the brain may be associated with atrophy of
文摘Objective: To smtudy the association between white matter lesions (WML) in spe cific locations and the risk of dementia. Design: The Rotterdam Scan Study, a pr ospective population based cohort study. We scored periventricular and subcortic al WML on magnetic resonance imaging and observed participants until January 200 2 for incident dementia. Setting: General population. Participants: We included 1077 people aged 60 to 90 years who did not have dementia at baseline. Main Outc ome Measure: Incident dementia by Diagnostic and Statistical Manual of Mental Di sorders, Third Edition (DSM III R) criteria. Results: During a mean follow up of 5.2 years, 45 participants developed dementia. Higher severity of periventric ular WML increased the risk of dementia, whereas the association between subcort ical WML and dementia was less prominent. The adjusted hazard ratio of dementia for each standard deviation increase in periventricular WML severity was 1.67 (9 5%confidence interval, 1.25-2.24). This increased risk was independent of othe r risk factors for dementia and partly independent of other structural brain cha nges on magnetic resonance imaging. Conclusion: White matter lesions, especially in the periventricular region, increase the risk of dementia in elderly people.
